Diagnostische Tests für Endometriose

Zusammenfassung Der Goldstandard bei der Diagnosestellung der Endometriose ist auch heute noch die Laparoskopie mit histologischer Sicherung. Ein nichtinvasiver diagnostischer Test mit hoher Sensitivität und Spezifität für diese Erkrankung wäre wünschenswert. Die Bestimmung des Tumormarkers CA 125 für die Diagnose einer Endometriose wird diskutiert. Diese Methode ist jedoch nicht dazu geeignet, eine minimale bis milde Endometriose zu identifizieren und weist zudem eine geringe Sensitivität auf. Andere Kandidaten wie Tumornekrosefaktor-α, Interleukin-6, luteinisierendes Hormon, Leukozytensubtypen, Haptoglobin-β-Kettenisoform E, Thomsen-Friedenreich-Antigene und eosinophile Peroxidase wurden von den verschiedensten Forschergruppen als diagnostische Tests vorgeschlagen. Unsere Arbeitsgruppe empfiehlt die Bestimmung von CCR1-mRNA („cognate chemokin receptor 1“) aus peripheren Blutleukozyten als neuen diagnostischen Test. Abstract Laparoscopy with histological confirmation is considered to be the “gold standard” for the diagnosis of endometriosis. New diagnostic tests are necessary to identify endometriosis especially in its early stages. Therefore, a non-invasive test with high sensitivity and specificity would be desirable. Measurement of the tumour marker CA 125 is under discussion for diagnosing endometriosis, however, this marker is not suitable for the detection of patients with minimal or mild forms and only provides very low levels of sensitivity. Other suggested candidates, such as tumour necrosis factor-α, interleukin 6, luteinizing hormone, leukocyte subtypes, haptoglobin beta chain isoform E, Thomsen Friedenreich antigen and eosinophil peroxidase have been proposed by different research groups as diagnostic tools. Our group suggests the determination of cognate chemokine receptor 1 mRNA from peripheral blood leukocytes as a new diagnostic test. Similar content being viewed by others Literatur Agic A, Xu H, Rehbein M et al. (2006) CCR1 mRNA expression in peripheral blood as a diagnostic test for endometriosis. Fertil Steril (in revision) Barbieri RL, Niloff JM, Bast RC Jr et al. (1986) Elevated serum concentrations of CA-125 in patients with advanced endometriosis. Fertil Steril 45(5): 630–634 Bazot M, Darai E, Hourani R et al. (2004) Deep pelvic endometriosis: MR imaging for diagnosis and prediction of extension of disease. Radiology 232(2): 379–389 Bedaiwy MA, Falcone T, Sharma RK et al. (2002) Prediction of endometriosis with serum and peritoneal fluid markers: a prospective controlled trial. Hum Reprod 17(2): 426–431 Blumenthal RD, Taylor A, Samoszuk M, Goldenberg DM (2001) Unique molecular markers in human endometriosis: implications for diagnosis and therapy. Expert Rev Mol Med 20: 1–12 Chen FP, Soong YK, Lee N, Lo SK (1998) The use of serum CA-125 as a marker for endometriosis in patients with dysmenorrhea for monitoring therapy and for recurrence of endometriosis. Acta Obstet Gynecol Scand 77(6): 665–670 Falcone T, Mascha E (2003) The elusive diagnostic test for endometriosis. Fertil Steril 80(4): 886–888 Ferrero S, Gillott DJ, Remorgida V et al. (2005) Haptoglobin beta chain isoforms in the plasma and peritoneal fluid of women with endometriosis. Fertil Steril 83(5): 1536–1543 Furuichi K, Wada T, Sakai N et al. (2000) Distinct expression of CCR1 and CCR5 in glomerular and interstitial lesions of human glomerular diseases. Am J Nephrol 20: 291–299 Gagne D, Rivard M, Page M et al. (2003) Development of a nonsurgical diagnostic tool for endometriosis based on the detection of endometrial leukocyte subsets and serum CA-125 levels. Fertil Steril 80(4): 876–885 Gladue RP, Tylaska LA, Brissette WH et al. (2003) CP-481,715, a potent and selective CCR1 antagonist with potential therapeutic implications for inflammatory diseases. J Biol Chem 278: 40473–40480 Hornung D, Bentzien F, Wallwiener D et al. (2001) Chemokine bioactivity of RANTES in endometriotic and normal endometrial stromal cells and peritoneal fluid. Mol Hum Reprod 7(2): 163–168 Horuk R (1994) Molecular properties of the chemokine receptor family. Trends Pharmacol Sci 15: 159–165 Hummelshoj L, Prentice A, Groothuis P (2006) Update on endometriosis: 9th World Congress on Endometriosis. Women’s Health 2(1): 53–56 Husby GK, Haugen RS, Moen MH (2003) Diagnostic delay in women with pain and endometriosis. Acta Obstet Gynecol Scand 82: 649–653 Illera JC, Silvan G, Illera MJ et al. (2001) Measurement of serum and peritoneal fluid LH concentrations as a diagnostic tool for human endometriosis. Reproduction 121(5): 761–769 Katschke KJ Jr, Rottman JB, Ruth JH et al. (2001) Differential expression of chemokine receptors on peripheral blood, synovial fluid, and synovial tissue monocytes/macrophages in rheumatoid arthritis. Arthritis Rheum 44: 1022–1032 Kennedy S, Bergqvist A, Chapron C et al. (2005) ESHRE guideline for the diagnosis and treatment of endometriosis. Hum Reprod 20(10): 2698–2704 Kitawaki J, Ishihara H, Koshiba H et al. (2005) Usefulness and limits of CA-125 in diagnosis of endometriosis without associated ovarian endometriomas. Hum Reprod 20(7): 1999–2003 Lang GA, Yeaman GR (2001) Autoantibodies in endometriosis sera recognize a Thomsen-Friedenreich-like carbohydrate antigen. J Autoimmun 16(2): 151–161 Marcoux S, Maheux R, Berube S (1997) Laparoscopic surgery in infertile women with minimal or mild endometriosis. Canadian Collaborative Group on Endometriosis. N Engl J Med 337(4): 217–222 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(6): 1101–1108 Okaro E, Condous G, Khalid A et al. (2006) The use of ultrasound-based „soft markers“ for the prediction of pelvic pathology in women with chronic pelvic pain – can we reduce the need for laparoscopy? BJOG 113(3): 251–256 Parazzini F, Bartulessi C, Passini A et al. (2005) Determinants of short term recurrence rate of endometriosis. Eur J Obstet Gynecol Reprod Biol 121: 216–219 Rossi D, Zlotnik A (2000) The biology of chemokines and their receptors. Annu Rev Immunol 18: 217–242 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 reproduction age women undergoing laparoscopic surgery for benign gynaecological conditions. Hum Reprod 19: 1871–1876 Walter AJ, Hentz JG, Magtibay PM et al. (2001) Endometriosis: correlation between histologic and visual findings at laparoscopy. Am J Obstet Gynecol 184(7): 1407–1411 Wieser F, Dogan S, Klingel K et al. (2005) Expression and regulation of CCR1 in peritoneal macrophages from women with and without endometriosis. Fertil Steril 83: 1878–1881 Interessenkonflikt Es besteht kein Interessenkonflikt. Der korrespondierende Autor versichert, dass keine Verbindungen mit einer Firma, deren Produkt in dem Artikel genannt ist, oder einer Firma, die ein Konkurrenzprodukt vertreibt, bestehen. Die Präsentation des Themas ist unabhängig und die Darstellung der Inhalte produktneutral. Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Dogan, S., Agic, A., Frenzel, W. et al. Diagnostische Tests für Endometriose. Gynäkologische Endokrinologie 4, 128–132 (2006). https://doi.org/10.1007/s10304-006-0151-z Issue date: DOI: https://doi.org/10.1007/s10304-006-0151-z