Aromatase P450 messenger RNA expression in eutopic endometrium is not a specific marker for pelvic endometriosis.
OBJECTIVE
To determine whether expression of aromatase P450 mRNA in eutopic endometrium is predictive of the presence of pelvic endometriosis.


METHODS
A prospective, multicenter, observational study.


METHODS
Four tertiary centers for reproductive medicine.


METHODS
Sixty subjects of reproductive age undergoing laparoscopy for subfertility exploration, pain assessment, or sterilization.


METHODS
Endometrial biopsy at time of laparoscopy.


METHODS
The expression of aromatase P450 mRNA in endometrial specimens was determined by single-tube reverse transcription-polymerase chain reaction (RT-PCR). Glyceraldehyde-3-phosphate dehydrogenase (GAPDH) mRNA was amplified in parallel to exclude amplification failure.


RESULTS
The RT-PCR amplification was successful in 56 of the 60 biopsies (93%). Pelvic endometriosis was diagnosed in 34 patients (61%) and was strongly associated with aromatase P450 mRNA expression in eutopic endometrium. As a diagnostic marker for endometriosis, aromatase P450 mRNA expression yielded a sensitivity of 82%, a specificity of 59%, a positive predictive value of 76%, and a negative predictive value of 67%. If additional uterine pathology was taken in account, the sensitivity increased to 84%, the specificity to 72%, the positive predictive value to 87%, but the negative predictive value remained unchanged (67%).


CONCLUSIONS
Although endometrial aromatase P450 gene expression is highly predictive of the presence of pelvic disease, the relative high incidence of false-negative results and lack of specificity is likely to impair clinical application.
Dheenadayalu
Kavitha
K
Department of Obstetrics and Gynaecology, Ealing Hospital, London, United Kingdom.
Mak
Ian
I
Gordts
Stephan
S
Campo
Rudi
R
Higham
Jenny
J
Puttemans
Patrick
P
White
John
J
Christian
Mark
M
Fusi
Luca
L
Brosens
Jan
J
D000328:Adult; D001141:Aromatase / Q000235:genetics*; D015415:Biomarkers / Q000032:analysis*; D001706:Biopsy; D004715:Endometriosis / Q000201:enzymology*; D004717:Endometrium / Q000201:enzymology*; D005188:False Negative Reactions; D005260:Female; D005987:Glyceraldehyde-3-Phosphate Dehydrogenases / Q000235:genetics; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D011446:Prospective Studies; D012333:RNA, Messenger / Q000032:analysis*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012680:Sensitivity and Specificity
D015415:Biomarkers; D012333:RNA, Messenger; D001141:Aromatase; D005987:Glyceraldehyde-3-Phosphate Dehydrogenases