Prediction of endometriosis with serum and peritoneal fluid markers: a prospective controlled trial

• Published in: Human reproduction (Oxford) 2002-02, Vol.17 (2), p.426-431
• Main Authors: Bedaiwy, M.A., Falcone, T., Sharma, R.K., Goldberg, J.M., Attaran, M., Nelson, D.R., Agarwal, A.
• Format: Article
• Language: English
• Subjects: Adult; Ascitic Fluid - metabolism; Biological and medical sciences; Biomarkers - blood; cytokines; Cytokines - blood; Cytokines - metabolism; Diagnosis, Differential; endometriosis; Endometriosis - blood; Endometriosis - diagnosis; Endometriosis - metabolism; Female; Female genital diseases; Forecasting; Gynecology. Andrology. Obstetrics; Humans; Interleukin-6 - blood; Likelihood Functions; Medical sciences; Non tumoral diseases; non-surgical diagnosis; Prospective Studies; reactive oxygen species; Reactive Oxygen Species - metabolism; Sensitivity and Specificity; Tumor Necrosis Factor-alpha - metabolism
• ISSN: 0268-1161; 1460-2350; 1460-2350
• DOI: 10.1093/humrep/17.2.426

BACKGROUND: The objective of this prospective controlled trial was to investigate the ability of a group of serum and peritoneal fluid (PF) markers to predict, non-surgically, endometriosis. METHODS AND RESULTS: Serum and PF samples were obtained from 130 women while undergoing laparoscopy for pain, infertility, tubal ligation or sterilization reversal. Concentrations of six cytokines [interleukin (IL)-1β, IL-6, IL-8, IL-12, IL-13 and tumour necrosis factor (TNF)-α] were measured in serum and PF, and reactive oxygen species (ROS) in PF, and levels were compared among women who were allocated to groups according to their post-surgical diagnosis. Fifty-six patients were diagnosed with endometriosis, eight with idiopathic infertility, 27 underwent tubal ligation or reanastomosis (control group) and 39 were excluded due to bloody PF. Only serum IL-6 and PF TNF-α could be used to discriminate between patients with and without endometriosis with a high degree of sensitivity and specificity (P < 0.001). A threshold of 15 pg/ml PF TNF-α provided 100% sensitivity and 89% specificity (positive likelihood ratio of 9.1 and negative likelihood ratio of 0). A threshold of 2 pg/ml for serum IL-6 provided a sensitivity of 90% and specificity of 67% (positive likelihood ratio of 2.7 and negative likelihood ratio of 0.14). CONCLUSIONS: By measuring serum IL-6 and PF TNF-α, it was possible to discriminate between patients with endometriosis and those without. Before these markers can be used as a non-surgical diagnostic tool, these data should be verified in a larger study.