Diagnostische Tests für Endometriosis

Zusammenfassung Auch heute noch beträgt die Zeitspanne zwischen ersten Symptomen und der definitiven Diagnosestellung „Endometriose“ mittels Laparoskopie etwa 6–7 Jahre. Ein diagnostischer Test – möglichst aus peripherem Blut – scheint deshalb dringend erforderlich zu sein. Immer mehr Studien berichten erfreulicherweise über nichtinvasive Tests mit hoher Sensitivität und Spezifität. Als Marker werden hierbei u. a. folgende Parameter vorgeschlagen: CA 125, CA 19–9, IL-6, ICAM-1 und CCR-1-mRNA. Regressionsmodelle schließen auch klinische Daten wie Zykluslänge und Anzahl der Schwangerschaften neben den oben genannten Serummarkern mit ein. Der mögliche Nutzen einer nichtinvasiven diagnostischen Methode wäre eine frühere Erkennung, einfachere Operationen bei niedrigerem Endometriosestadium, geringere Rezidivraten und damit letztendlich auch eine Kostensenkung. Bis zur Etablierung eines solchen Tests bleiben uns nur die bewährten Techniken wie Anamnese, gründliche gynäkologische Untersuchung, Sonographie und letztendlich Laparoskopie zur Diagnose der Erkrankung Endometriose. Abstract Even today, the time-lag between the appearance of the first symptoms of endometriosis and its definitive diagnosis by laparoscopy is about 6–7 years. We seem to be in urgent need of a diagnostic test – preferably using peripheral blood. Fortunately, more and more studies are leading to reports of noninvasive tests with high sensitivity and specificity. The following parameters are suggested as markers: CA 125, CA 19–9, IL-6, ICAM-1 and CCR-1 mRNA. Regression models also use clinical data, such as length of cycle and number of pregnancies, in association with the aforementioned serum markers. The possible benefits of a noninvasive diagnostic test would be: earlier detection, easier surgery because of a less advanced stage of endometriosis and a lower recurrence rate, all combining to mean, ultimately, reduced costs. Until such a test is available, we can only continue to use the tried and tested techniques, such as medical history-taking, thorough gynaecological examination, ultrasound and finally diagnostic laparoscopy, for the diagnosis of endometriosis. Similar content being viewed by others Literatur Agic A, Xu H, Rehbein M et al. (2007) Cognate chemokine receptor 1 messenger ribonucleic acid expression in peripheral blood as a diagnostic test for endometriosis. Fertil Steril 87: 982–984 Barnhart K, Dunsmoor-Su R, Coutifaris C (2002) Effect of endometriosis on in vitro fertilization. Fertil Steril 77: 1148–1155 Bedaiwy MA, Falcone T (2004) Laboratory testing for endometriosis. Clin Chim Acta 340: 41–56 Brosens I, Puttemans P, Campo R et al. 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Diagnostische Tests für Endometriosis. Gynäkologe 40, 527–531 (2007). https://doi.org/10.1007/s00129-007-2010-y Published: Issue date: DOI: https://doi.org/10.1007/s00129-007-2010-y