title: Aromatase P450 messenger RNA expression in eutopic endometrium is not a specific marker for pelvic endometriosis.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynaecology, Ealing Hospital, London, United Kingdom.
authors.forename: Kavitha
authors.initials: K
authors.lastname: Dheenadayalu
authors.forename: Ian
authors.initials: I
authors.lastname: Mak
authors.forename: Stephan
authors.initials: S
authors.lastname: Gordts
authors.forename: Rudi
authors.initials: R
authors.lastname: Campo
authors.forename: Jenny
authors.initials: J
authors.lastname: Higham
authors.forename: Patrick
authors.initials: P
authors.lastname: Puttemans
authors.forename: John
authors.initials: J
authors.lastname: White
authors.forename: Mark
authors.initials: M
authors.lastname: Christian
authors.forename: Luca
authors.initials: L
authors.lastname: Fusi
authors.forename: Jan
authors.initials: J
authors.lastname: Brosens
mesh_terms: 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
chemical_list: D015415:Biomarkers; D012333:RNA, Messenger; D001141:Aromatase; D005987:Glyceraldehyde-3-Phosphate Dehydrogenases