Prediction of endometriosis with serum and peritoneal fluid markers: a prospective controlled trial.
BACKGROUND
The objective of this prospective controlled trial was to investigate the ability of a group of serum and peritoneal fluid (PF) markers to predict, non-surgically, endometriosis.


RESULTS
Serum and PF samples were obtained from 130 women while undergoing laparoscopy for pain, infertility, tubal ligation or sterilization reversal. Concentrations of six cytokines [interleukin (IL)-1beta, IL-6, IL-8, IL-12, IL-13 and tumour necrosis factor (TNF)-alpha] were measured in serum and PF, and reactive oxygen species (ROS) in PF, and levels were compared among women who were allocated to groups according to their post-surgical diagnosis. Fifty-six patients were diagnosed with endometriosis, eight with idiopathic infertility, 27 underwent tubal ligation or reanastomosis (control group) and 39 were excluded due to bloody PF. Only serum IL-6 and PF TNF-alpha could be used to discriminate between patients with and without endometriosis with a high degree of sensitivity and specificity (P < 0.001). A threshold of 15 pg/ml PF TNF-alpha provided 100% sensitivity and 89% specificity (positive likelihood ratio of 9.1 and negative likelihood ratio of 0). A threshold of 2 pg/ml for serum IL-6 provided a sensitivity of 90% and specificity of 67% (positive likelihood ratio of 2.7 and negative likelihood ratio of 0.14).


CONCLUSIONS
By measuring serum IL-6 and PF TNF-alpha, it was possible to discriminate between patients with endometriosis and those without. Before these markers can be used as a non-surgical diagnostic tool, these data should be verified in a larger study.
Bedaiwy
M A
MA
Center for Advanced Research in Human Reproduction, Infertility, and Sexual Function, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Falcone
T
T
Sharma
R K
RK
Goldberg
J M
JM
Attaran
M
M
Nelson
D R
DR
Agarwal
A
A
D000328:Adult; D001202:Ascitic Fluid / Q000378:metabolism*; D015415:Biomarkers / Q000097:blood*; D016207:Cytokines / Q000097:blood / Q000378:metabolism; D003937:Diagnosis, Differential; D004715:Endometriosis / Q000097:blood / Q000175:diagnosis / Q000378:metabolism*; D005260:Female; D005544:Forecasting; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D016013:Likelihood Functions; D011446:Prospective Studies; D017382:Reactive Oxygen Species / Q000378:metabolism; D012680:Sensitivity and Specificity; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D015415:Biomarkers; D016207:Cytokines; D015850:Interleukin-6; D017382:Reactive Oxygen Species; D014409:Tumor Necrosis Factor-alpha