Performance of peripheral (serum and molecular) blood markers for diagnosis of endometriosis

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This study evaluated serum CA-125, CA19-9, and peripheral blood mRNA levels of MMP-3, MMP-9, VEGF, and Survivin to diagnose endometriosis and found a combination of serum and molecular markers may improve diagnosis.

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This case-control study evaluated the diagnostic performance of serum CA-125, CA19-9, and peripheral blood mRNA levels for Survivin, MMP-3, MMP-9, and VEGF in differentiating women with endometriosis from healthy controls. The research included 60 participants, comprising matched groups of patients with ovarian or deep infiltrating endometriosis and healthy individuals, utilizing ROC curves and logistic regression to assess marker efficacy. Results indicated that while no significant difference existed between ovarian and deep disease forms regarding marker concentrations, serum CA-125 and CA19-9 demonstrated superior sensitivity compared to molecular markers, with a multivariable combination achieving an 87% sensitivity rate at a 10% false positive rate. This paper is centrally about endometriosis — specifically investigating non-invasive biomarkers for its diagnosis.

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Abstract

PURPOSE: To quantify the mRNA levels of MMP-3, MMP-9, VEGF and Survivin in peripheral blood and the serum levels of CA-125 and Ca19-9 in women with and without endometriosis and to investigate the performance of these markers to differentiate between deep and ovarian endometriosis. METHODS: A case control study enrolled a series of 60 patients. Twenty controls have been matched with 20 cases of ovarian and 20 cases of deep endometriosis. Univariable and multivariable performance of serum CA125 and CA19-9, mRNA for Survivin, MMP9, MMP3 and VEGF genes have been evaluated by means of ROC curves and logistic regression, respectively. RESULTS: No difference in markers' concentration was detected between ovarian and deep endometriosis. In comparison with controls, serum CA125 and CA19 yielded the better sensitivity followed by mRNA for Survivin gene (81.5, 51.9 and 7.5% at 10% false positive rate, respectively). Multivariable estimated odds of endometriosis yielded a sensitivity of 87% at the same false positive rate. CONCLUSIONS: A combination of serum and molecular markers could allow a better diagnosis of endometriosis.
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Abstract

Purpose To quantify the mRNA levels of MMP-3, MMP-9, VEGF and Survivin in peripheral blood and the serum levels of CA-125 and Ca19-9 in women with and without endometriosis and to investigate the performance of these markers to differentiate between deep and ovarian endometriosis.

Methods

A case control study enrolled a series of 60 patients. Twenty controls have been matched with 20 cases of ovarian and 20 cases of deep endometriosis. Univariable and multivariable performance of serum CA125 and CA19-9, mRNA for Survivin, MMP9, MMP3 and VEGF genes have been evaluated by means of ROC curves and logistic regression, respectively.

Results

No difference in markers’ concentration was detected between ovarian and deep endometriosis. In comparison with controls, serum CA125 and CA19 yielded the better sensitivity followed by mRNA for Survivin gene (81.5, 51.9 and 7.5% at 10% false positive rate, respectively). Multivariable estimated odds of endometriosis yielded a sensitivity of 87% at the same false positive rate.

Conclusions

A combination of serum and molecular markers could allow a better diagnosis of endometriosis. Similar content being viewed by others

References

Missmer SA, Cramer DW (2003) Epidemiology of endometriosis. Obstet Gynecol Clin North Am 30(1):1–19 American Society for Reproductive Medicine (1997) Revised classification of endometriosis. Fertil Steril 67:817–821 Chapron C, Fauconnier A, Vieira M et al (2003) Anatomical distribution of deeply infiltrating endometriosis: surgical implications and proposition for a classification. Hum Reprod 18(1):157–161 Royal College of Obstetrics and Gynaecology (2006) The investigation and management of endometriosis. Green-top guideline no 24. RCOG, London Vercellini P, Fedele L, Aimi G, Pietropaolo G, Consonni D, Crosignani PG (2007) Association between endometriosis stage, lesion type, patient characteristics and severity of pelvic pain symptoms: a multivariate analysis of over 1000 patients. Hum Reprod 22(1):266–271 Koninckx PR, Martin D (1994) Treatment of deeply infiltrating endometriosis. Curr Opin Obstet Gynecol 6(3):231–241 Abrao MS, Goncalves MO, Dias JA Jr, Podgaec S, Chamie LP, Blasbalg R (2007) Comparison between clinical examination, transvaginal sonography and magnetic resonance imaging for the diagnosis of deep endometriosis. Hum Reprod 22(12):3092–3097 Chapron C, Chopin N, Borghese B, Malartic C, Decuypere F, Foulot H (2004) Surgical management of deeply infiltrating endometriosis: an update. Ann NY Acad Sci 1034:326–337 Attaran M, Falcone T, Goldberg J (2002) Endometriosis: still tough to diagnose and treat. Clevel Clin J Med 69(8):647–653 Harkki-Siren P, Sjoberg J, Kurki T (1999) Major complications of laparoscopy: a follow-up Finnish study. Obstet Gynecol 94:94–98 Chapron C, Querleu D, Bruhat MA et al (1998) Surgical complications of diagnostic and operative gynaecological laparoscopy: a series of 29, 966 cases. Hum Reprod 13:867–872 Osteen KG, Yeaman GR, Bruner-Tran KL (2003) Matrix metalloproteinase and endometriosis. Semin Reprod Med 21:155–164 Ueda M, Yamashita Y, Takehara M et al (2002) Survivin gene expression in endometriosis. J Clin Endocrinol Metab 87(7):3452–3459 Ramon L, Gilabert-Estelles J, Castello R, Gilabert J, Espana F, Romeu A et al (2005) mRNA analysis of several components of the plasminogen activator and matrix metalloproteinase systems in endometriosis using a real-time quantitative RT-PCR assay. Hum Reprod 20:272–278 Bruner-tran KL, Eisenberg E, Yeaman GR, Anderson TA, McBean J, Osteen KG (2002) Steroid and cytokine regulation of matrix metalloproteinase expression in endometriosis and the establishment of experimental endometriosis in nude mice. J Clin Endocrinol Metab 87:4782–4791 Mulayim N, Savlu A, Guzeloglu-Kayisli O, Kayisli UA, Arici A (2004) Regulation of endometrial-stromal cell matrix metalloproteinase activity and invasiveness by interleukin-8. Fertil Steril 81:904–911 Wu MH, Shoji Y, Wu MC et al (2005) Suppression of matrix metalloproteinase-9 by prostaglandin E2 in peritoneal macrophage is associated with severity of endometriosis. Am J Pathol 167:1061–1069 Gilabert-Estelle’s J, Ramo’n LA, Espan˜a F et al (2007) Expression of angiogenic factors in endometriosis: relationship to fibrinolytic and metalloproteinase systems. Hum Reprod 22:2120–2127 Eel-D Othman, Hornung D, Salem HT, Khalifa EA, El-Metwally TH, Al-Hendy A (2008) Serum cytokines as biomarkers for nonsurgical prediction of endometriosis. Eur J Obstet Gynecol Reprod Biol Appl 137:240–246 Bourlev V, Volkov N, Pavlovitch S, Lets N, Larsson A, Olovsson M (2006) The relationship between microvessel density, proliferative activity and expression of vascular endothelial growth factor-A and its receptors in eutopic endometrium and endometriotic lesions. Reproduction 132:501–509 Tan XJ, Lang JH, Liu DY, Shen K, Leng JH, Zhu L (2002) Expression of vascular endothelial growth factor and thrombospondin-1 mRNA in patients with endometriosis. Fertil Steril 78:148–153 Takehara M, Ueda M, Yamashita Y, Terai Y, Hung YC, Ueki M (2004) Vascular endothelial growth factor A and C gene expression in endometriosis. Hum Pathol 35:1369–1375 Di Carlo C, Bonifacio M, Tommaselli GA, Bifulco G, Guerra G, Nappi C (2009) Metalloproteinases, vascular endothelial growth factor and angiopoietin 1 and 2 in eutopic and ectopic endometrium. Fertil Steril 91:2315–2323 Machado DE, Abrao MS, Berardo PT, Takiya CM, Nasciutti LE (2008) Vascular density and distribution of vascular endothelial growth factor (VEGF) and its receptor VEGFR-2 (Flk-1) are significantly higher in patients with deeply infiltrating endometriosis affecting the rectum. Fertil Steril 90:148–155 Harada T, Kubota T, Aso T (2002) Usefulness of CA19–9 versus CA125 for the diagnosis of endometriosis. Fertil Steril 78:733–739 Mol BW, Bayram N, Lijmer JG et al (1998) The performance of CA-125 measurement in the detection of endometriosis: a meta-analysis. Fertil Steril 70:1101–1108 Somigliana E, Vigano` P, Tirelli AS et al (2004) Use of the concomitant serum dosage of CA 125, CA 19–9 and interleukin-6 to detect the presence of endometriosis. Results from a series of reproductive age women undergoing laparoscopic surgery for benign gynaecological conditions. Hum Reprod 19(8):1871–1876 Kurdoglu Z, Gursoy R, Kurdoglu M, Erdem M, Erdem O, Erdem A (2009) Comparison of the clinical value of CA 19–9 versus CA 125 for the diagnosis of endometriosis. Fertil Steril 92(5):1761–1763 Osteen KG, Bruner KL, Sharpe-Timms KL (1996) Steroid and growth factor regulation of matrix metalloproteinase expression and endometriosis. Semin Reprod Endocrinol 14:247–255 Sillem M, Prifti S, Koch A, Neher M, Jauckus J, Runnebaum B (2001) Regulation of matrix metalloproteinases and their inhibitors in uterine endometrial cells of patients with and without endometriosis. Eur J Obstet Gynecol Reprod Biol 95:167–174 Gilabert-Estelle’s J, Estelle’s A, Gilabert J et al (2003) Expression of several components of the plasminogen activator and matrix metalloproteinas systems in endometriosis. Hum Reprod 18:1516–1522 Chung HW, Wen Y, Chun SH, Nezhat C, Woo BH, Lake Polan M (2001) Matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-3 mRNA expression in ectopic and eutopic endometrium in women with endometriosis: a rationale for endometriotic invasiveness. Fertil Steril 75:152–159 Li Y, Lang JH (2006) Expressions of matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 mRNA in endometriosis. Zhonghua Fu Chan Ke Za Zhi 41:30–33 Ambrosini G, Adida C, Altieri DC (1999) A novel anti-apoptosis gene, survivin, expressed in cancer and lymphoma. Nat Med 3:917–921 Konno R, Yamakawa H, Utsunomiya H, Ito K, Sato S, Yajima A (2000) Expression of survivin and Bcl-2 in the normal human endometrium. Mol Hum Reprod 6:529–534 Fujino K, Ueda M, Takehara M et al (2006) Transcriptional expression of survivin and its splice variants in endometriosis. Mol Hum Reprod 12(6):383–388 Gagné D, Pagé M, Robitaille G, Hugo P, Gosselin D (2003) Levels of vascular endothelial growth factor (VEGF) in serum of patients with endometriosis. Hum Reprod 18:1674–1680 Matalliotakis IM, Goumenou AG, Koumantakis GE et al (2003) Serum concentrations of growth factors in women with and without endometriosis: the action of anti-endometriosis medicines. Int Immunopharmacol 3:81–89 Oliveira VA, Abreu LG, Ferriani RA, Reis RM, Moura MD (2005) Vascular endothelial growth factor in the plasma, follicular fluid and granulosa cells of women with endometriosis submitted to in vitro fertilization–a pilot study. Gynecol Endocrinol 20:284–288 Xavier P, Belo L, Beires J, Rebelo I, Martinez-de-Oliveira J, Lunet N, Barros H (2006) Serum levels of VEGF and TNF-alpha and their association with C-reactive protein in patients with endometriosis. Arch Gynecol Obstet 273:227–231 Conflict of interest The authors declare that they have no conflict of interest in this study. Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Mabrouk, M., Elmakky, A., Caramelli, E. et al. Performance of peripheral (serum and molecular) blood markers for diagnosis of endometriosis. Arch Gynecol Obstet 285, 1307–1312 (2012). https://doi.org/10.1007/s00404-011-2122-4 Received: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s00404-011-2122-4

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Condition tags

endometriosis

MeSH descriptors

Biomarkers Endometriosis Adult Biomarkers CA-125 Antigen CA-125 Antigen CA-19-9 Antigen CA-19-9 Antigen Case-Control Studies Endometriosis Endometriosis Female Humans Inhibitor of Apoptosis Proteins Inhibitor of Apoptosis Proteins Matrix Metalloproteinase 3 Matrix Metalloproteinase 3 Matrix Metalloproteinase 9 Matrix Metalloproteinase 9 ROC Curve

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