High serum follistatin levels in women with ovarian endometriosis

Pasquale Florio, P Florio, Fernando M. Reis, F M Reis, Paulo B. Torres, P B Torres, F Calonaci, Francesco Calonaci, M S Abrao, Maurício Simões Abrão, L L Nascimento, Livia Leni de Oliveira do Nascimento, M Franchini, L Cianferoni, Felice Petraglia, F Petraglia
Human Reproduction · 2009 · vol. 24(10) , pp. 2600–2606 · doi:10.1093/humrep/dep195 · PMID:19549703 · W2117027199
article OA: closed CC0 ⤵ 41 in-corpus citations
View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

Serum follistatin levels were significantly increased in women with ovarian endometrioma compared to controls, other benign ovarian cysts, or non-ovarian endometriosis, demonstrating higher diagnostic accuracy than CA-125 for detecting endometrioma.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

Abstract

BACKGROUND: Follistatin is an activin-binding protein produced by several tissues, including endometrium and endometriotic implants. We aimed to quantify follistatin in patients with ovarian endometriosis and investigate its value as a diagnostic marker. METHODS: Women undergoing laparoscopic excision of ovarian endometrioma (n = 52) or other benign ovarian cysts (n = 52) were studied, plus women with non-ovarian endometriosis (n = 11) and healthy controls (n = 27). Serum was collected from all subjects, and peritoneal and cystic fluid from a subset with endometrioma. Follistatin was measured by enzyme-linked immunosorbent assay. The diagnostic accuracy of follistatin to detect endometrioma was evaluated by receiver operating characteristic (ROC) curve and compared with cancer antigen (CA)-125. RESULTS: Serum follistatin was increased in women with ovarian endometrioma (2080 +/- 94 pg/ml) compared with controls (545 +/- 49 pg/ml, P < 0.001), other benign ovarian cysts (795 +/- 60 pg/ml, P < 0.001) or non-ovarian endometriosis (1271 +/- 115 pg/ml, P < 0.001). Cystic fluid showed a higher concentration of follistatin (9850 +/- 4461 pg/ml) than peritoneal fluid (1885 +/- 261 pg/ml, P < 0.001) and serum (P < 0.001). Follistatin levels detected 48/52 cases of endometrioma (92% sensitivity) at 1433 pg/ml cut-off, corresponding to 92% specificity. CA-125 detected only 44% of endometriomas with 90% specificity. ROC curve comparison showed follistatin was more accurate than CA-125 to discriminate women with endometrioma either from controls or women with other benign ovarian cysts (P < 0.0001). CONCLUSIONS: Serum follistatin is increased in women with endometriosis and allows clear distinction between endometrioma and other benign ovarian cysts. Follistatin has the sensitivity and specificity to become a useful clinical marker of ovarian endometrioma.

My notes (saved in your browser only)

Condition tags

endometriosisendometrioma

MeSH descriptors

Endometriosis Follistatin Ovarian Diseases Adult Biomarkers CA-125 Antigen CA-125 Antigen Diagnosis, Differential Endometriosis Endometriosis Female Follistatin Humans Ovarian Diseases Ovarian Diseases

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (36)

Cited by (41)

Source provenance

europepmc
last seen: 2026-06-21T06:12:49.409960+00:00
openalex
last seen: 2026-06-04T00:00:01.174412+00:00
pubmed
last seen: 2026-05-13T22:14:05.573375+00:00
License: CC0 · commercial use OK