Plasma miRNAs Display Limited Potential as Diagnostic Tools for Endometriosis

Nisenblat V, Victoria Nisenblat, David J. Sharkey, Zhao Wang, Wang Z, Susan Evans, Susan F Evans, Healey M, Martin Healey, E Maria C Ohlsson Teague, Edward Teague, Ohlsson Teague EMC, Cristin G. Print, Sarah A Robertson, M. Louise Hull
The Journal of clinical endocrinology and metabolism · 2019 · vol. 104(6) , pp. 1999–2022 · doi:10.1210/jc.2018-01464 · PMID:30608536 · W2908419766
article OA: bronze CC0 ⤵ 39 in-corpus citations
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This study identified three plasma miRNAs (miR-155, miR574-3p, and miR139-3p) with modest diagnostic potential for endometriosis, demonstrating 83% sensitivity and 51% specificity.

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Abstract

CONTEXT: Despite extensive searches for novel noninvasive diagnostics, laparoscopy remains the reference test for endometriosis. Circulating miRNAs are purported endometriosis biomarkers; however, the miRNA species and their diagnostic accuracy differ between studies and have not been validated in independent cohorts. OBJECTIVE: Identify endometriosis-specific plasma miRNAs and determine their diagnostic test accuracy. SETTING: Two university-based, public hospitals and a private gynecology practice in Australia. DESIGN AND PARTICIPANTS: Four phases: (i) Explorative phase. Plasma miRNA menstrual cycle fluctuations were evaluated in women with endometriosis and asymptomatic controls (n = 16). (ii) Biomarker discovery. Endometriosis-specific plasma miRNAs were identified in (a) women with endometriosis and asymptomatic controls (n = 16) and (b) women with and without surgically defined endometriosis (n = 20). (iii) Biomarker selection. Plasma miRNAs with the best diagnostic potential for endometriosis were selected in a surgically defined selection cohort (n = 78). (iv) Biomarker validation. The diagnostic test accuracy of these miRNAs was calculated in an independent, surgically defined validation cohort (n = 119). RESULTS: Forty-nine miRNAs were differentially expressed in women with endometriosis. Nine maintained dysregulation in the selection cohort, but only three (miR-155, miR574-3p and miR139-3p) did so in the validation cohort. Combined, these three miRNAs demonstrated a sensitivity and specificity of 83% and 51%, respectively. CONCLUSION: Plasma miRNAs demonstrated modest sensitivity and specificity as diagnostic tests or triage tools for endometriosis. Other groups' findings were not replicated and accorded poorly with our results. Circulating miRNAs demonstrate diagnostic potential, but stringent, standardized methodological approaches are required for the development of a clinically applicable tool.

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Condition tags

endometriosis

MeSH descriptors

Circulating MicroRNA Endometriosis Endometrium Adolescent Adult Australia Biomarkers Biomarkers Case-Control Studies Circulating MicroRNA Circulating MicroRNA Endometriosis Endometriosis Endometriosis Endometriosis Endometrium Endometrium Female Humans Laparoscopy

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