High serum follistatin levels in women with ovarian endometriosis

P Florio, Florio P, Pasquale Florio, Fernando M. Reis, F. M. Reis, Torres PB, Paulo B. Torres, P B Torres, Calonaci F, Francesco Calonaci, F Calonaci, Abrao MS, Maurício Simões Abrão, M S Abrao, Livia Leni de Oliveira do Nascimento, Nascimento LL, L L Nascimento, Franchini M, M. Franchini, L. Cianferoni, Cianferoni L, F Petraglia, Felice Petraglia
Human Reproduction · 2009 · vol. 24(10) , pp. 2600–2606 · doi:10.1093/humrep/dep195 · PMID:19549703 · W2117027199
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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.

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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.

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Condition tags

endometriosisendometrioma

MeSH descriptors

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

Citation neighborhood (2-hop)

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. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (36)

Cited by (43)

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