Evaluating the diagnostic potential of CA-125 and miRNA levels in endometriosis: A narrative review

Evaluating the diagnostic potential of CA-125 and miRNA levels in endometriosis: A narrative review Taha Shokrnejad-namin School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Search for more papers by this authorNeda Farzizadeh Department of Midwifery, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran Search for more papers by this authorZahra Najmi Graduate School of Biomedical Sciences, Clinical and Translational Science Department, Tufts Medical Center, Boston, Massachusetts, USA Associate Professor of Obstetrics and Gynecology, Fellowship in Minimally Invasive Surgery, Zanjan University of Medical Sciences, Zanjan, Iran Search for more papers by this authorMorteza Amoozgar March Health Company, Concord, California, USA Search for more papers by this authorAmirali Hariri Department of Pharmaceutical Biotechnology, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran Search for more papers by this authorElnaz Amini School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Search for more papers by this authorArezoo Khosravi Department of Genetics and Bioengineering, Faculty of Engineering and Natural Sciences, Istanbul Okan University, Istanbul, Turkey Search for more papers by this authorCorresponding Author Ali Zarrabi Department of Biomedical Engineering, Faculty of Engineering and Natural Sciences, Istinye University, Istanbul, Turkey Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan Correspondence Ali Zarrabi, Department of Biomedical Engineering, Faculty of Engineering and Natural Sciences, Istinye University, Istanbul 34396, Turkey. Email: [email protected] Search for more papers by this authorTaha Shokrnejad-namin School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Search for more papers by this authorNeda Farzizadeh Department of Midwifery, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran Search for more papers by this authorZahra Najmi Graduate School of Biomedical Sciences, Clinical and Translational Science Department, Tufts Medical Center, Boston, Massachusetts, USA Associate Professor of Obstetrics and Gynecology, Fellowship in Minimally Invasive Surgery, Zanjan University of Medical Sciences, Zanjan, Iran Search for more papers by this authorMorteza Amoozgar March Health Company, Concord, California, USA Search for more papers by this authorAmirali Hariri Department of Pharmaceutical Biotechnology, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran Search for more papers by this authorElnaz Amini School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Search for more papers by this authorArezoo Khosravi Department of Genetics and Bioengineering, Faculty of Engineering and Natural Sciences, Istanbul Okan University, Istanbul, Turkey Search for more papers by this authorCorresponding Author Ali Zarrabi Department of Biomedical Engineering, Faculty of Engineering and Natural Sciences, Istinye University, Istanbul, Turkey Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan Correspondence Ali Zarrabi, Department of Biomedical Engineering, Faculty of Engineering and Natural Sciences, Istinye University, Istanbul 34396, Turkey. Email: [email protected] Search for more papers by this authorAbstract Endometriosis, a common and complex gynecologic disorder, continues to pose a challenge to clinicians in diagnosis process due to its complexity. The aim of this review was to examine cancer antigen-125 (CA-125) and microRNAs (miRNAs) as biomarkers in endometriosis pathophysiology and their investigational potential roles in clinical diagnostics and prognostics. In this narrative review, a variety of studies are reviewed, including cross-sectional, case–control, and prospective designs, examining a broad spectrum of patient demographics, clinical features, and biomarker (CA-125 and miRNA) expression levels. While frequently elevated in endometriosis, CA-125 is limited by low specificity and sensitivity, preventing its use as a standalone diagnostic tool; its primary utility remains in monitoring established disease and, adjunctively, with other clinical parameters. miRNAs have gained attention as molecular regulators implicated in the disease process, suggesting potential avenues for noninvasive diagnostics and a better understanding of pathogenesis. The combined analysis of biomarker panels, rather than single markers, may present a shift towards more personalized strategies. The convergence of CA-125 and miRNA research represents a promising advance, potentially leading to more accurate diagnostics and personalized treatment. Future research should focus on standardizing methodologies, expanding study cohorts, and integrating findings into clinical practice to fully harness the potential of these biomarkers. CONFLICT OF INTEREST STATEMENT The authors declare no conflict of interest. DATA AVAILABILITY STATEMENT Data sharing is not applicable to this article as no new data were created or analyzed in this study. Supporting Information | Filename | Description | |---|---| | ijgo70554-sup-0001-FigureS1.zipZip archive, 3.8 MB | Figure S1. Endometriosis diagnosing methods. | Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article. REFERENCES - 1Zondervan KT, Becker CM, Missmer SA. Endometriosis. N Engl J Med. 2020; 382(13): 1244-1256. - 2Taylor HS, Kotlyar AM, Flores VA. Endometriosis is a chronic systemic disease: clinical challenges and novel innovations. Lancet. 2021; 397(10276): 839-852. - 3Smolarz B, Szyłło K, Romanowicz H. Endometriosis: epidemiology, classification, pathogenesis, treatment and genetics (review of literature). Int J Mol Sci. 2021; 22(19):10554. - 4Surrey E, Soliman AM, Trenz H, Blauer-Peterson C, Sluis A. Impact of endometriosis diagnostic delays on healthcare resource utilization and costs. Adv Ther. 2020; 37: 1087-1099. - 5Ghai V, Jan H, Shakir F, Haines P, Kent A. Diagnostic delay for superficial and deep endometriosis in the United Kingdom. J Obstet Gynaecol. 2020; 40(1): 83-89. - 6Moss K, Doust J, Homer H, Rowlands I, Hockey R, Mishra G. Delayed diagnosis of endometriosis disadvantages women in ART: a retrospective population linked data study. Hum Reprod. 2021; 36(12): 3074-3082. - 7Warzecha D, Szymusik I, Wielgos M, Pietrzak B. The impact of endometriosis on the quality of life and the incidence of depression—a cohort study. Int J Environ Res Public Health. 2020; 17(10):3641. - 8Kamath MS, Subramanian V, Antonisamy B, Sunkara SK. Endometriosis and oocyte quality: an analysis of 13 614 donor oocyte recipient and autologous IVF cycles. Hum Reprod Open. 2022; 2022(3):hoac025. - 9Al Shukri M, Al Ghafri W, Gowri V. Are there predictors of early diagnosis of endometriosis based on clinical profile? A retrospective study. Oman Med J. 2023; 38(1):e458. - 10Moustafa S, Burn M, Mamillapalli R, Nematian S, Flores V, Taylor HS. Accurate diagnosis of endometriosis using serum microRNAs. Am J Obstet Gynecol. 2020; 223(4): 557.e1-557.e11. - 11Kimber-Trojnar Ż, Pilszyk A, Niebrzydowska M, Pilszyk Z, Ruszała M, Leszczyńska-Gorzelak B. The potential of non-invasive biomarkers for early diagnosis of asymptomatic patients with endometriosis. J Clin Med. 2021; 10(13):2762. - 12He Y, Li J, Qu Y, et al. Identification and analysis of potential immune-related biomarkers in endometriosis. J Immunol Res. 2023; 2023(1):2975581. - 13Samare-Najaf M, Razavinasab SA, Samareh A, Jamali N. Omics-based novel strategies in the diagnosis of endometriosis. Crit Rev Clin Lab Sci. 2024; 61(3): 205-225. - 14Zou L, Meng L, Xu Y, Wang K, Zhang J. Revealing the diagnostic value and immune infiltration of senescence-related genes in endometriosis: A combined single-cell and machine learning analysis. Front Pharmacol. 2023; 14:1259467. - 15Kovalak EE, Karacan T, Zengi O, Karabay Akgül Ö, Özyürek ŞE, Güraslan H. Evaluation of new biomarkers in stage III and IV endometriosis. Gynecol Endocrinol. 2023; 39(1):2217290. - 16Herranz-Blanco B, Daoud E, Viganò P, García-Velasco JA, Colli E. Development and validation of an endometriosis diagnostic method based on serum biomarkers and clinical variables. Biomolecules. 2023; 13(7):1052. - 17Nisenblat V, Bossuyt PM, Shaikh R, et al. Blood biomarkers for the non-invasive diagnosis of endometriosis. Cochrane Database Syst Rev. 1996; 2016(5): CD0121792. - 18Wang J, Cong S, Wu H, et al. Identification and analysis of potential autophagy-related biomarkers in endometriosis by WGCNA. Front Mol Biosci. 2021; 8:743012. - 19Sancakli Usta C, Turan G, Bulbul CB, Usta A, Adali E. Differential expression of Oct-4, CD44, and E-cadherin in eutopic and ectopic endometrium in ovarian endometriomas and their correlations with clinicopathological variables. Reprod Biol Endocrinol. 2020; 18: 1-10. - 20Bae S-J, Jo Y, Cho MK, et al. Identification and analysis of novel endometriosis biomarkers via integrative bioinformatics. Front Endocrinol. 2022; 13:942368. - 21Liu D, Liu M, Yu P, Li H. Brain-derived neurotrophic factor and nerve growth factor expression in endometriosis: A systematic review and meta-analysis. Taiwan J Obstet Gynecol. 2023; 62(5): 634-639. - 22Kokot I, Piwowar A, Jędryka M, Kratz EM. Is there a balance in oxidative-antioxidant status in blood serum of patients with advanced endometriosis? Antioxidants. 2021; 10(7):1097. - 23Lin H, Wu CH, Ou YC, Huang SW, Fu HC. Integration of pretreatment tumor markers in a nomogram model for prognostic prediction of FIGO stage I endometrial cancer: A multi-institutional cohort study. Int J Gynecol Obstet. 2024; 165(3): 1244-1256. - 24Guder C, Heinrich S, Seifert-Klauss V, et al. Extracellular Hsp70 and circulating endometriotic cells as novel biomarkers for endometriosis. Int J Mol Sci. 2024; 25(21): 11643. - 25Jafarabady K, Shafiee A, Bahri RA, et al. Brain-derived neurotrophic factor (BDNF) as a potential marker of endometriosis: a systematic review and meta-analysis. BMC Womens Health. 2024; 24(1):39. - 26Tian Z, Chang X-H, Zhao Y, Zhu H-L. Current biomarkers for the detection of endometriosis. Chin Med J. 2020; 133(19): 2346-2352. - 27Anastasiu CV, Moga MA, Elena Neculau A, et al. Biomarkers for the noninvasive diagnosis of endometriosis: state of the art and future perspectives. Int J Mol Sci. 2020; 21(5): 1750. - 28Bendifallah S, Dabi Y, Suisse S, et al. MicroRNome analysis generates a blood-based signature for endometriosis. Sci Rep. 2022; 12(1): 4051. - 29Chico-Sordo L, Ruiz-Martínez T, Toribio M, et al. Identification of miR-30c-5p microRNA in serum as a candidate biomarker to diagnose endometriosis. Int J Mol Sci. 2024; 25(3): 1853. - 30Walasik I, Klicka K, Grzywa TM, et al. Circulating miR-3613-5p but not miR-125b-5p, miR-199a-3p, and miR-451a are biomarkers of endometriosis. Reprod Biol. 2023; 23(4):100796. - 31Zhang Y, Sun X, Li Z, et al. Interactions between miRNAs and the Wnt/β-catenin signaling pathway in endometriosis. Biomed Pharmacother. 2024; 171:116182. - 32Chen Y, Pan M, Zuo Y, Yang B, Wang S. Research progress of CA125 in endometriosis: teaching an old dog new tricks. Gynecol Obstet Clin Med. 2022; 2(4): 191-198. 10.1016/j.gocm.2022.10.006Google Scholar - 33Azam INA, Wahab NA, Mokhtar MH, Shafiee MN, Mokhtar NM. Roles of microRNAs in regulating apoptosis in the pathogenesis of endometriosis. Life. 2022; 12(9):1321. - 34Bjorkman S, Taylor HS. MicroRNAs in endometriosis: biological function and emerging biomarker candidates. Biol Reprod. 2019; 101(6): 1167-1178. - 35Papari E, Noruzinia M, Kashani L, Foster WG. Identification of candidate microRNA markers of endometriosis with the use of next-generation sequencing and quantitative real-time polymerase chain reaction. Fertil Steril. 2020; 113(6): 1232-1241. - 36Bendifallah S, Dabi Y, Suisse S, et al. Validation of a salivary miRNA signature of endometriosis—interim data. NEJM Evid. 2023; 2(7): EVIDoa2200282. - 37Vanhie A, Dorien O, Peterse D, et al. Plasma miRNAs as biomarkers for endometriosis. Hum Reprod. 2019; 34(9): 1650-1660. - 38Mahini SM, Younesi M, Mortazavi G, Samare-Najaf M, Azadbakht MK, Jamali N. Non-invasive diagnosis of endometriosis: immunologic and genetic markers. Clin Chim Acta. 2023; 538: 70-86. - 39Pant A, Moar K, Arora TK, Maurya PK. Biomarkers of endometriosis. Clin Chim Acta. 2023; 549:117563. - 40Dolińska W, Draper H, Othman L, et al. Accuracy and utility of blood and urine biomarkers for the noninvasive diagnosis of endometriosis: a systematic literature review and meta-analysis. F&S Rev. 2023; 4(2): 116-130. - 41Mardanian F, Sheikh-Soleimani Z. The diagnostic role of cervico-vaginal fluid interleukins-1α in endometriosis: A case-control study. J Res Med Sci. 2014; 19(12): 1145. - 42Machairiotis N, Vasilakaki S, Thomakos N. Inflammatory mediators and pain in endometriosis: a systematic review. Biomedicine. 2021; 9(1):54. - 43Abramiuk M, Grywalska E, Małkowska P, Sierawska O, Hrynkiewicz R, Niedźwiedzka-Rystwej P. The role of the immune system in the development of endometriosis. Cells. 2022; 11(13):2028. - 44Zhong Q, Yang F, Chen X, Li J, Zhong C, Chen S. Patterns of immune infiltration in endometriosis and their relationship to r-AFS stages. Front Genet. 2021; 12:631715. - 45Li G, Lin Y, Zhang Y, et al. Endometrial stromal cell ferroptosis promotes angiogenesis in endometriosis. Cell Death Dis. 2022; 8(1): 29. 10.1038/s41420-022-00821-zGoogle Scholar - 46Nanda A, Thangapandi K, Banerjee P, et al. Cytokines, angiogenesis, and extracellular matrix degradation are augmented by oxidative stress in endometriosis. Ann Lab Med. 2020; 40(5): 390-397. - 47Udayana IGNBS, Adnyana IBPP, Diningrat MA, Setiawan WA. Association of Endometriosis and Oxidative Stress. Eur J Med Health Sci. 2022; 4(5): 109-113. - 48Akbaba E, Sezgin B, Edgünlü T. The role of adropin, salusin-α, netrin-1, and nesfatin-1 in endometriosis and their association with insulin resistance. Turk J Obstet Gynecol. 2021; 18(3): 175-180. - 49Kalaitzopoulos DR, Lempesis IG, Samartzis N, et al. Leptin concentrations in endometriosis: A systematic review and meta-analysis. J Reprod Immunol. 2021; 146:103338. - 50Braza-Boïls A, Marí-Alexandre J, Gilabert J, et al. MicroRNA expression profile in endometriosis: its relation to angiogenesis and fibrinolytic factors. Hum Reprod. 2014; 29(5): 978-988. - 51Matteo M, Cicinelli E, Neri M, et al. Pro-inflammatory M1/Th1 type immune network and increased expression of TSG-6 in the eutopic endometrium from women with endometriosis. Eur J Obstet Gynecol Reprod Biol. 2017; 218: 99-105. - 52Sikora J, Smycz-Kubańska M, Mielczarek-Palacz A, Bednarek I, Kondera-Anasz Z. The involvement of multifunctional TGF-β and related cytokines in pathogenesis of endometriosis. Immunol Lett. 2018; 201: 31-37. - 53Fan Y-Y, Chen H-Y, Chen W, Liu Y-N, Fu Y, Wang L-N. Expression of inflammatory cytokines in serum and peritoneal fluid from patients with different stages of endometriosis. Gynecol Endocrinol. 2018; 34(6): 507-512. - 54Luckow Invitti A, Schor E, Martins Parreira R, et al. Inflammatory cytokine profile of co-cultivated primary cells from the endometrium of women with and without endometriosis. Mol Med Rep. 2018; 18(2): 1287-1296. - 55Bellelis P, Frediani Barbeiro D, Gueuvoghlanian-Silva BY, Kalil J, Abrão MS, Podgaec S. Interleukin-15 and interleukin-7 are the major cytokines to maintain endometriosis. Gynecol Obstet Investig. 2019; 84(5): 435-444. - 56Gu C-l, Zhang Z, Fan W-s, et al. Identification of MicroRNAs as potential biomarkers in ovarian endometriosis. Reprod Sci. 2020; 27: 1715-1723. - 57Cosar E, Mamillapalli R, Ersoy GS, Cho S, Seifer B, Taylor HS. Serum microRNAs as diagnostic markers of endometriosis: a comprehensive array-based analysis. Fertil Steril. 2016; 106(2): 402-409. - 58Oliveira MAP, Raymundo TS, Soares LC, Pereira TRD, Demôro AVE. How to use CA-125 more effectively in the diagnosis of deep endometriosis. Biomed Res Int. 2017; 2017(1):9857196. - 59Kitawaki J, Ishihara H, Koshiba H, et al. Usefulness and limits of CA-125 in diagnosis of endometriosis without associated ovarian endometriomas. Hum Reprod. 2005; 20(7): 1999-2003. - 60Colacurci N, Fortunato N, De Franciscis P, et al. Serum and peritoneal CA-125 levels as diagnostic test for endometriosis. Eur J Obstet Gynecol Reprod Biol. 1996; 66(1): 41-43. - 61Kafali H, Artuc H, Demir N. Use of CA125 fluctuation during the menstrual cycle as a tool in the clinical diagnosis of endometriosis; a preliminary report. Eur J Obstet Gynecol Reprod Biol. 2004; 116(1): 85-88. - 62Socolov R, Butureanu S, Angioni S, et al. The value of serological markers in the diagnosis and prognosis of endometriosis: a prospective case–control study. Eur J Obstet Gynecol Reprod Biol. 2011; 154(2): 215-217. - 63Agic A, Djalali S, Wolfler MM, Halis G, Diedrich K, Hornung D. Combination of CCR1 mRNA, MCP1, and CA125 measurements in peripheral blood as a diagnostic test for endometriosis. Reprod Sci. 2008; 15(9): 906-911. - 64Mihalyi A, Gevaert O, Kyama C, et al. Non-invasive diagnosis of endometriosis based on a combined analysis of six plasma biomarkers. Hum Reprod. 2010; 25(3): 654-664. - 65Burghaus S, Drazic P, Wölfler M, et al. Multicenter evaluation of blood-based biomarkers for the detection of endometriosis and adenomyosis: A prospective non-interventional study. Int J Gynecol Obstet. 2024; 164(1): 305-314. - 66Zhu H, Lei H, Wang Q, et al. Serum carcinogenic antigen (CA)-125 and CA 19-9 combining pain score in the diagnosis of pelvic endometriosis in infertile women. Clin Exp Obstet Gynecol. 2016; 43(6): 826-829. - 67Tang T, Lai H, Huang X, Gu L, Shi H. Application of serum markers in diagnosis and staging of ovarian endometriosis. J Obstet Gynaecol Res. 2021; 47(4): 1441-1450. - 68Irungu S, Mavrelos D, Worthington J, Blyuss O, Saridogan E, Timms JF. Discovery of non-invasive biomarkers for the diagnosis of endometriosis. Clin Proteomics. 2019; 16: 1-16. - 69Guralp O, Kaya B, Tüten N, Kucur M, Malik E, Tüten A. Non-invasive diagnosis of endometriosis and moderate-severe endometriosis with serum CA125, endocan, YKL-40, and copeptin quadruple panel. J Obstet Gynaecol. 2021; 41(6): 927-932. - 70Chen T, Wei JL, Leng T, Gao F, Hou S. The diagnostic value of the combination of hemoglobin, CA199, CA125, and HE4 in endometriosis. J Clin Lab Anal. 2021; 35(9):e23947. - 71Szubert M, Rycerz A, Wilczyński JR. How to improve non-invasive diagnosis of endometriosis with advanced statistical methods. Medicina (Kaunas). 2023; 59(3):499. - 72Micu R, Gaia-Oltean AMI, Budişan L, Braicu C, Irimie A, Berindan-Neagoe I. The added value of CA125, HE4, and CA72-4 as markers for ovarian endometriosis diagnosis. Romanian J Morphol Embryol. 2023; 64(2): 159-164. - 73Hornstein M, Harlow B, Thomas P, Check J. Endometriosis: use of a new CA 125 assay in the diagnosis of endometriosis. Hum Reprod. 1995; 10(4): 932-934. - 74Karimi-Zarchi M, Dehshiri-Zadeh N, Sekhavat L, Nosouhi F. Correlation of CA-125 serum level and clinico-pathological characteristic of patients with endometriosis. Int J Reprod Biomed. 2016; 14(11): 713-718. - 75Szubert M, Suzin J, Wierzbowski T, Kowalczyk-Amico K. CA-125 concentration in serum and peritoneal fluid in patients with endometriosis–preliminary results. Arch Med Sci. 2012; 8(3): 504-508. - 76Moloney MD, Thornton JG, Cooper EH. Serum CA 125 antigen levels and disease severity in patients with endometriosis. Obstet Gynecol. 1989; 73(5): 767-769. - 77O'shaughnessy A, Check JH, Nowroozi K, Lurie D. CA 125 levels measured in different phases of the menstrual cycle in screening for endometriosis. Obstet Gynecol. 1993; 81(1): 99-103. - 78Amaral VF, Ferriani RA, Sá MFS, et al. Positive correlation between serum and peritoneal fluid CA-125 levels in women with pelvic endometriosis. Sao Paulo Med J. 2006; 124: 223-227. - 79Maiorana A, Cicerone C, Niceta M, Alio L. Evaluation of serum CA 125 levels in patients with pelvic pain related to endometriosis. Int J Biol Markers. 2007; 22(3): 200-202. - 80Ozhan E, Kokcu A, Yanik K, Gunaydin M. Investigation of diagnostic potentials of nine different biomarkers in endometriosis. Eur J Obstet Gynecol Reprod Biol. 2014; 178: 128-133. - 81Knific T, Vouk K, Vogler A, et al. Models including serum CA-125, BMI, cyst pathology, dysmenorrhea or dyspareunia for diagnosis of endometriosis. Biomark Med. 2018; 12(7): 737-747. - 82Sasamoto N, DePari M, Vitonis AF, et al. Evaluation of CA125 in relation to pain symptoms among adolescents and young adult women with and without surgically-confirmed endometriosis. PLoS One. 2020; 15(8):e0238043. - 83Zhao K, Qu P. Noninvasive evaluation of ovarian endometriosis: a single-center experience. Ann Palliat Med. 2021; 10(4):4728735. - 84Daoud E, Archer DF, Parazzini F, Herranz-Blanco B. Validation of an in vitro diagnostic test for endometriosis: impact of confounding medical conditions and lesion location. Int J Mol Sci. 2024; 25(14):7667. - 85Pittaway DE, Fayez JA. The use of CA-125 in the diagnosis and management of endometriosis. Fertil Steril. 1986; 46(5): 790-795. - 86Koninckx PR, Meuleman C, Oosterlynck D, Cornillie FJ. Diagnosis of deep endometriosis by clinical examination during menstruation and plasma CA-125 concentration. Fertil Steril. 1996; 65(2): 280-287. - 87Chen F-P, Soong Y-K, Lee N, Kai Lo S. The use of serum CA-125 as a marker for endometriosis in patients with dysmenorrhea for monitoring therapy and for recurrence of endometriosis. Acta Obstet Gynecol Scand. 1998; 77(6): 665. - 88Vodolazkaia A, El-Aalamat Y, Popovic D, et al. Evaluation of a panel of 28 biomarkers for the non-invasive diagnosis of endometriosis. Hum Reprod. 2012; 27(9): 2698-2711. - 89Rosa e Silva A, Rosa e Silva J, Ferriani R. Serum CA-125 in the diagnosis of endometriosis. Int J Gynaecol Obstet. 2007; 96(3): 206-207. - 90Fassbender A, Verbeeck N, Börnigen D, et al. Combined mRNA microarray and proteomic analysis of eutopic endometrium of women with and without endometriosis. Hum Reprod. 2012; 27(7): 2020-2029. - 91Jia S-z, Yang Y, Lang J, Sun P, Leng J. Plasma miR-17-5p, miR-20a and miR-22 are down-regulated in women with endometriosis. Hum Reprod. 2013; 28(2): 322-330. - 92Wang L, Huang W, Ren C, et al. Analysis of serum microRNA profile by solexa sequencing in women with endometriosis. Reprod Sci. 2016; 23(10): 1359-1370. - 93Brady P, Yousif A, Sasamoto N, et al. Plasma microRNA expression in adolescents and young adults with endometriosis: the importance of hormone use. Front Reprod Health. 2024; 6:1360417. - 94Nematian SE, Mamillapalli R, Kadakia TS, Majidi Zolbin M, Moustafa S, Taylor HS. Systemic inflammation induced by microRNAs: endometriosis-derived alterations in circulating microRNA 125b-5p and let-7b-5p regulate macrophage cytokine production. J Clin Endocrinol Metab. 2018; 103(1): 64-74. - 95Cheng Z, Qiu S, Jiang L, et al. MiR-320a is downregulated in patients with myasthenia gravis and modulates inflammatory cytokines production by targeting mitogen-activated protein kinase 1. J Clin Immunol. 2013; 33: 567-576. - 96He Z, Deng W, Jiang B, et al. Hsa-let-7b inhibits cell proliferation by targeting PLK1 in HCC. Gene. 2018; 673: 46-55. - 97Wang X-P, Yao J, Guan J, Zhou Z-Q, Zhang Z-Y, Yang J. MicroRNA-542-3p functions as a tumor suppressor via directly targeting survivin in hepatocellular carcinoma. Biomed Pharmacother. 2018; 99: 817-824. - 98Wang W-T, Zhao Y-N, Han B-W, Hong S-J, Chen Y-Q. Circulating microRNAs identified in a genome-wide serum microRNA expression analysis as noninvasive biomarkers for endometriosis. J Clin Endocrinol Metab. 2013; 98(1): 281-289. - 99Yang Z, He J, Gao P, et al. miR-769-5p suppressed cell proliferation, migration and invasion by targeting TGFBR1 in non-small cell lung carcinoma. Oncotarget. 2017; 8(69):113558. - 100Shi LB, Zhou F, Zhu HY, et al. Transforming growth factor beta1 from endometriomas promotes fibrosis in surrounding ovarian tissues via Smad2/3 signaling. Biol Reprod. 2017; 97(6): 873-882. - 101Ding J, Xia Y, Yu Z, et al. Identification of upstream miRNAs of SNAI2 and their influence on the metastasis of gastrointestinal stromal tumors. Cancer Cell Int. 2019; 19: 1-15. - 102Chen W, Yao G, Zhou K. miR-103a-2-5p/miR-30c-1-3p inhibits the progression of prostate cancer resistance to androgen ablation therapy via targeting androgen receptor variant 7. J Cell Biochem. 2019; 120(8): 14055-14064. - 103Haikalis ME, Wessels JM, Leyland NA, Agarwal SK, Foster WG. MicroRNA expression pattern differs depending on endometriosis lesion type. Biol Reprod. 2018; 98(5): 623-633. - 104Xu X-X, Jia S-Z, Dai Y, et al. Identification of circular RNAs as a novel biomarker for ovarian endometriosis. Chin Med J. 2018; 131(5): 559-566. - 105Nisenblat V, Sharkey DJ, Wang Z, et al. Plasma miRNAs display limited potential as diagnostic tools for endometriosis. J Clin Endocrinol Metab. 2019; 104(6): 1999-2022. - 106Saare M, Rekker K, Laisk-Podar T, et al. Challenges in endometriosis miRNA studies — from tissue heterogeneity to disease specific miRNAs. Biochim Biophys Acta (BBA) – Mol Basis Dis. 2017; 1863(9): 2282-2292. doi:10.1016/j.bbadis.2017.06.018 - 107Pateisky P, Pils D, Szabo L, et al. Hsa-miRNA-154-5p expression in plasma of endometriosis patients is a potential diagnostic marker for the disease. Reprod Biomed Online. 2018; 37(4): 449-466. - 108Zhang L, Li H, Yuan M, Li D, Sun C, Wang G. Serum exosomal microRNAs as potential circulating biomarkers for endometriosis. Dis Markers. 2020; 2020(1):2456340. - 109Razi MH, Eftekhar M, Ghasemi N, Sheikhha MH, Firoozabadi AD. Expression levels of circulatory mir-185-5p, vascular endothelial growth factor, and platelet-derived growth factor target genes in endometriosis. Int J Reprod BioMed. 2020; 18(5): 347-358. - 110Borisov E, Knyazeva M, Novak V, et al. Analysis of reciprocally dysregulated miRNAs in eutopic endometrium is a promising approach for low invasive diagnostics of adenomyosis. Diagnostics. 2020; 10(10): 782. - 111Misir S, Hepokur C, Oksasoglu B, Yildiz C, Yanik A, Aliyazicioglu Y. Circulating serum miR-200c and miR-34a-5p as diagnostic biomarkers for endometriosis. J Gynecol Obstet Human Reprod. 2021; 50(4):102092. - 112Zafari N, Tarafdari AM, Izadi P, et al. A panel of plasma miRNAs 199b-3p, 224-5p and let-7d-3p as non-invasive diagnostic biomarkers for endometriosis. Reprod Sci. 2021; 28: 991-999. - 113Kumari P, Sharma I, Saha SC, Srinivasan R, Bhardwaj P. Role of serum microRNAs as biomarkers for endometriosis, endometrioid carcinoma of ovary & endometrioid endometrial cancer. Indian J Med Res. 2022; 156(3): 516-523. - 114Abo C, Biquard L, Girardet L, et al. Unbiased in silico analysis of gene expression pinpoints circulating miRNAs targeting KIAA1324, a new gene drastically downregulated in ovarian endometriosis. Biomedicine. 2022; 10(9): 2065. - 115Lin C, Zeng S, Li M. miR-424-5p combined with miR-17-5p has high diagnostic efficacy for endometriosis. Arch Gynecol Obstet. 2023; 307(1): 169-177. - 116Bashti O, Noruzinia M, Garshasbi M, Abtahi M. miR-31 and miR-145 as potential non-invasive regulatory biomarkers in patients with endometriosis. Cell J. 2018; 20(1): 84-89. - 117Chen G, Guo J, Li W, Zheng R, Shang H, Wang Y. Diagnostic value of the combination of circulating serum miRNAs and CA125 in endometriosis. Medicine (Baltimore). 2023; 102(48):e36339. - 118Wu J, Huang H, Huang W, Wang L, Xia X, Fang X. Analysis of exosomal lncRNA, miRNA and mRNA expression profiles and ceRNA network construction in endometriosis. Epigenomics. 2020; 12(14): 1193-1213. - 119Dong L, Zhang L, Liu H, et al. Circ_0007331 knock-down suppresses the progression of endometriosis via miR-200c-3p/HiF-1α axis. J Cell Mol Med. 2020; 24(21): 12656-12666. - 120Bendifallah S, Suisse S, Puchar A, et al. Salivary MicroRNA signature for diagnosis of endometriosis. J Clin Med. 2022; 11(3): 612. - 121Pokrovenko DA, Vozniuk V, Medvediev MV. MicroRNA let-7: A promising non-invasive biomarker for diagnosing and treating external genital endometriosis. Turk J Obstet Gynecol. 2021; 18(4): 291-297. - 122Wu Y, Yuan W, Ding H, Wu X. Serum exosomal miRNA from endometriosis patients correlates with disease severity. Arch Gynecol Obstet. 2022; 305(1): 117-127. - 123Dabi Y, Suisse S, Jornea L, et al. Clues for improving the pathophysiology knowledge for endometriosis using plasma micro-RNA expression. Diagnostics. 2022; 12(1): 175. - 124Neuhausser WM, Faure-Kumar E, Mahurkar-Joshi S, Iliopoulos D, Sakkas D. Identification of miR-34-3p as a candidate follicular phase serum marker for endometriosis: A pilot study. F&S Science. 2022; 3(3): 269-278. - 125Perricos A, Proestling K, Husslein H, et al. Hsa-mir-135a shows potential as a putative diagnostic biomarker in saliva and plasma for endometriosis. Biomolecules. 2022; 12(8): 1144. - 126Hirsch M, Duffy J, Davis C, Nieves Plana M, Khan K, International Collaboration to Harmonise Outcomes and Measures for Endometriosis. Diagnostic accuracy of cancer antigen 125 for endometriosis: a systematic review and meta-analysis. BJOG. 2016; 123(11): 1761-1768. - 127Rokhgireh S, Mehdizadeh Kashi A, Chaichian S, et al. The diagnostic accuracy of combined enolase/Cr, CA125, and CA19-9 in the detection of endometriosis. Biomed Res Int. 2020; 2020(1):5208279. 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