Seven Hormonal Biomarkers for Diagnosing Endometriosis: Meta-Analysis and Adjusted Indirect Comparison of Diagnostic Test Accuracy

Gao Y, Ya Gao, Minghui Shen, Shen M, Ma X, Xueni Ma, LI Ji-pin, Jipin Li, Li J, Wang B, Bo Wang, Wang J, Jiancheng Wang, Jinhui Tian, Tian J
Journal of minimally invasive gynecology · 2019 · vol. 26(6) , pp. 1026–1035.e4 · doi:10.1016/j.jmig.2019.04.004 · PMID:30965114 · W2935373464
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This meta-analysis evaluated seven hormonal biomarkers for diagnosing endometriosis, comparing their diagnostic accuracy through adjusted indirect comparisons.

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Abstract

ObjectiveTo compare the diagnostic accuracy of different hormonal biomarkers and to find the most effective hormonal biomarker for the diagnosis of endometriosis.Data sourcesWe conducted a systematic search using PubMed, EMBASE, Cochrane Library, and China Biomedical Literature to identify relevant studies from the first day of databases to August 2018.Methods of study selectionTwo independent reviewers screened for study eligibility and extracted data. Random controlled trials, cross-sectional studies, case-control studies, and cohort studies evaluating the diagnostic accuracy of hormonal markers for endometriosis were included.Tabulation, integration, and resultsWe included 17 studies that involved 1279 participants and evaluated 7 hormonal biomarkers. The pooled sensitivity and specificity in endometriosis were .79 (.71, .86) and .89 (.82, .94) for aromatase, .30 (.18, .46) and .80 (.65, .90) for human chorionic gonadotropin/luteinizing hormone receptor, .75 (.66, .83) and .47 (.34, .60) for estrogen receptor (ER)-α, .65 (.56, .74) and .68 (.55, .80) for ER-β, .45 (.38-.52) and .92 (.85-.97) for serum prolactin, .69 (.51, .83) and .30 (.16, .49) for estrogen sulfotransferase, and .73 (.60-.84) and .48 (.33-.63) for 17β-hydroxysteroid dehydrogenase type 2 (17βHSD2). Compared with human chorionic gonadotropin/luteinizing hormone receptor, ER-α, ER-β, estrogen sulfotransferase, and 17βHSD2, aromatase had a higher sensitivity, specificity, positive likelihood ratio, and diagnostic odds ratio. The specificities of aromatase and serum prolactin were comparable, but the sensitivity, positive likelihood ratio, and positive likelihood ratio of serum prolactin were much lower than that of aromatase.ConclusionAromatase may be an excellent diagnostic test for endometriosis. However, because of the moderate quality of the included studies and the limited sample size, this result requires more research to validate. (PROSPERO registration number: PROSPERO 2018 CRD42018105126.).

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Condition tags

endometriosis

MeSH descriptors

Biomarkers Diagnostic Techniques, Endocrine Diagnostic Techniques, Obstetrical and Gynecological Endometriosis Biomarkers Case-Control Studies Cross-Sectional Studies Diagnostic Techniques, Endocrine Diagnostic Techniques, Obstetrical and Gynecological Diagnostic Tests, Routine Diagnostic Tests, Routine Endometriosis Endometriosis Female Hormones Hormones Humans Predictive Value of Tests Reproducibility of Results Sensitivity and Specificity

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