Plasma Urocortin Levels in the Diagnosis of Ovarian Endometriosis

Florio P, Pasquale Florio, Fernando M. Reis, Torres PB, Paulo B. Torres, Francesco Calonaci, Calonaci F, Paolo Toti, Caterina Bocchi, Linton EA, Elizabeth A. Linton, Felice Petraglia
Obstetrics and gynecology · 2007 · vol. 110(3) , pp. 594–600 · doi:10.1097/01.aog.0000278572.86019.ae · PMID:17766605 · W2169692511
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Plasma urocortin levels, which were twice as high in women with ovarian endometriomas, showed 88% detection rate and 90% specificity for diagnosis compared to CA 125.

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This study investigated whether plasma urocortin levels could serve as a diagnostic marker for distinguishing ovarian endometriomas from other benign ovarian cysts. Researchers measured urocortin concentrations via radioimmunoassay in forty women with endometriomas and forty controls, while also assessing peptide localization through immunohistochemistry. The findings revealed that plasma urocortin levels were significantly higher in the endometrioma group, demonstrating 88% sensitivity and 90% specificity, which outperformed the standard CA 125 marker. This paper is centrally about endometriosis — specifically the diagnostic utility of urocortin for identifying ovarian endometriomas.

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Abstract

OBJECTIVE: Urocortin is a neuropeptide, member of the corticotropin-releasing hormone family, that is produced by the human endometrium. Ovarian endometrioma is a prevalent gynecologic disorder still lacking specific serum markers. In the present study we measured systemic levels of urocortin to assess the diagnostic performance of its determination in distinguishing endometriomas from other benign ovarian cysts. METHODS: Plasma urocortin was measured by radioimmunoassay in women with ovarian endometrioma (n=40) and in women with benign, nonendometriotic ovarian cysts (n=40). The diagnostic accuracy of urocortin measurement was evaluated by receiver operating characteristic curve and compared with the standard marker, CA 125. To support the local origin of the peptide, we also evaluated its localization in endometriomas by immunohistochemistry and its concentrations in cyst fluid and peritoneal fluid of 12 women with endometrioma. RESULTS: Plasma urocortin levels were twice as high in women with endometrioma (median 49 pg/mL, interquartile range 41-63 pg/mL) than in the control group (19 [15-23] pg/mL, P<.001) and significantly higher in the cystic content of endometriomas than in the peritoneal fluid and plasma (P<.05). The peptide was immunolocalized in endometrioma glands and stromal capillary vessels. Elevated plasma urocortin levels detected 88% of the cases of endometrioma with 90% specificity, whereas CA 125 detected only 65% of the cases with the same specificity. CONCLUSION: Plasma urocortin is increased in women with endometriomas, and its measurement may be useful for the differential diagnosis of endometrioma compared with other benign ovarian cysts. LEVEL OF EVIDENCE: II.
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Objective

Urocortin is a neuropeptide, member of the corticotropin-releasing hormone family, that is produced by the human endometrium. Ovarian endometrioma is a prevalent gynecologic disorder still lacking specific serum markers. In the present study we measured systemic levels of urocortin to assess the diagnostic performance of its determination in distinguishing endometriomas from other benign ovarian cysts.

Methods

Plasma urocortin was measured by radioimmunoassay in women with ovarian endometrioma (n=40) and in women with benign, nonendometriotic ovarian cysts (n=40). The diagnostic accuracy of urocortin measurement was evaluated by receiver operating characteristic curve and compared with the standard marker, CA 125. To support the local origin of the peptide, we also evaluated its localization in endometriomas by immunohistochemistry and its concentrations in cyst fluid and peritoneal fluid of 12 women with endometrioma.

Results

Plasma urocortin levels were twice as high in women with endometrioma (median 49 pg/mL, interquartile range 41–63 pg/mL) than in the control group (19 [15–23] pg/mL, P<.001) and significantly higher in the cystic content of endometriomas than in the peritoneal fluid and plasma (P<.05). The peptide was immunolocalized in endometrioma glands and stromal capillary vessels. Elevated plasma urocortin levels detected 88% of the cases of endometrioma with 90% specificity, whereas CA 125 detected only 65% of the cases with the same specificity.

Conclusion

Plasma urocortin is increased in women with endometriomas, and its measurement may be useful for the differential diagnosis of endometrioma compared with other benign ovarian cysts. LEVEL OF EVIDENCE: II

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Condition tags

endometriosisendometrioma

MeSH descriptors

Corticotropin-Releasing Hormone Endometriosis Ovarian Cysts Ovarian Diseases Adult Ascitic Fluid Ascitic Fluid Ascitic Fluid Biomarkers Biomarkers CA-125 Antigen CA-125 Antigen Corticotropin-Releasing Hormone Cyst Fluid Cyst Fluid Cyst Fluid Diagnosis, Differential Endometriosis Endometriosis Female

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