Dynamic assessment of blood inflammation markers in patients during the rehabilitation period after surgical treatment for external genital endometriosis

Background. Providing rehabilitation care to women with external genital endometriosis (EGE) after surgical treatment requires an interdisciplinary approach to selecting patient management strategy and biomarkers for objective monitoring of health status.

Objective: to determine the feasibility of using inflammatory biomarkers in women undergoing rehabilitation after EGE surgical treatment to assess the quality of care.

Material and methods. The study included 40 EGE patients (main group), 40 patients with other gynecological pathologies (comparison group), and 40 nearly healthy women (control group). All participants with gynecological pathologies underwent surgical treatment with subsequent rehabilitation. The severity of the inflammatory process was assessed using the following inflammation biomarkers: serum interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-a), citrullinated histone H3 (CitH3), and the neutrophil to lymphocyte ratio (NLR). The dynamics of changes in biomarker levels were measured before surgery, 1 week and 3 months after it.

Results. The assessment of inflammatory biomarker serum concentrations indicated the presence of inflammatory processes in patients of both the main and comparison groups. However, the levels of IL-6, TNF-a, CitH3 and NLR among EGE patients were statistically significantly higher compared to similar parameters in women with other gynecological pathologies. One week after surgery, the main group showed a significant increase in concentrations of IL-6, CitH3 and NLR and a decrease in TNF-a levels compared to baseline values. Three months after surgery, a significant reduction in the severity of the inflammatory process in the main group was observed compared to the values obtained 1 week after surgery. In several cases, the levels of inflammatory biomarkers were statistically significantly lower than baseline values. Notably, the serum concentration of CitH3 decreased to levels observed in nearly healthy women.

Conclusion. An inflammatory process was recorded in EGE patients, which can be corrected through surgical intervention. Using serum concentrations of CitH3 as a marker for assessing the quality of surgical treatment for EGE and managing patients during the rehabilitation phase was proved to be viable.

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