Intérêt du dosage de l’HE4 et du score ROMA dans le diagnostic de l’endométriose

INTRODUCTION: Endometriosis is a common gynecologic disease but still largely unknown. The diagnosis is based on the detection of surgical evocative lesions, but this cannot be done in all cases. Currently, there is no blood marker to help the diagnosis. He4 and ROMA, respectively a known biomarker and a biological score used for epithelium ovarian cancer, have not been tested for Endometriosis diagnosis. The primary objective of this study was to evaluate HE4 and the ROMA score as a diagnostic marker for endometriosis. The secondary objective was to compare AMH levels in a population with endometriosis versus a healthy population.MATERIAL AND METHOD: This was a case-control study that included adult women, followed in our department and for whom an AMH dosage was available in a previously serum bank. The "case" group was composed of women for whom the diagnosis of endometriosis had been done by surgery or highly suspected on a bundle of clinical arguments associated with compatible imaging (MRI or pelvic ultrasound). The "control" group consisted of patients followed in the department of Reproductive Medicine. We compare all three biomarkers levels as well as the ROMA score between our patients and healthy women.RESULTS: The ROMA scores were, on average, higher in the patient group, but this difference was not significant (7.52 % vs 6.76 % (p = 0.470)). HE4 rates are not different between the "case" and the "control" group (45.71 pmol/l vs 47.57 pmol/l (p = 0.527)).However, the rate of CA 125 was significantly higher in patients with endometriosis than in healthy patients (45.95 UI/ml vs 22.29 UI/ml (p = 0.005)) while the level of AMH was lower (2.35 ng/ml vs 4.39 ng/ml (p = 0.004)).CONCLUSION: Determination of He4 and ROMA score do not help when endometriosis is suspected. AMH appears lower in patients with endometriosis.