Development of a nonsurgical diagnostic tool for endometriosis based on the detection of endometrial leukocyte subsets and serum CA-125 levels.
OBJECTIVE
To determine whether the proportion of several leukocyte subsets is modulated in the endometrium of patients with endometriosis and, if yes, whether it can be used for diagnostic purposes.


METHODS
Case-control study.


METHODS
Eight clinical institutions of the Montreal area.


METHODS
Women who underwent laparoscopy or laparotomy between 1997 and 2001, who had regular menstrual cycles and were not under hormone treatment for the previous 3 months were selected. This study included 368 women, 173 with surgically confirmed endometriosis and 195 controls with no surgical evidence of endometriosis.


METHODS



METHODS
Cytometry analysis was used to measure the proportion of several leukocyte subsets among CD45(+) endometrial cells.


RESULTS
The proportion of CD3(+), CD16(+), CD3(-)HLADR(-), CD3(-)CD45RA(-), CD3(+)CD16(-), CD3(+)CD56(-), CD56(-)CD16(+), and CD16b(+) leukocytes was significantly altered in the endometrium of cases compared with controls. A multiple logistic regression model was adjusted with these endometrial leukocytes, serum CA-125 levels, risk factors, and confounders. The diagnostic performance of this predictive model was defined by a specificity of 95% and a sensitivity of 61%. Furthermore, the positive and negative predictive values were 91% and 75%, respectively.


CONCLUSIONS
This predictive model represents a novel diagnostic tool to identify women with a high likelihood of suffering from endometriosis.
Gagné
Danièle
D
MetrioGene, Montréal, Québec, Canada.
Rivard
Michèle
M
Pagé
Martin
M
Lépine
Manon
M
Platon
Christèle
C
Shazand
Kamran
K
Hugo
Patrice
P
Gosselin
Diane
D
D000328:Adult; D015703:Antigens, CD / Q000032:analysis; D015415:Biomarkers / Q000032:analysis; D018394:CA-125 Antigen / Q000097:blood*; D016022:Case-Control Studies; D004715:Endometriosis / Q000097:blood* / Q000209:etiology / Q000276:immunology / Q000473:pathology*; D004717:Endometrium / Q000473:pathology*; D005260:Female; D006801:Humans; D007962:Leukocytes / Q000276:immunology / Q000473:pathology*; D011237:Predictive Value of Tests; D012307:Risk Factors; D012680:Sensitivity and Specificity
D015703:Antigens, CD; D015415:Biomarkers; D018394:CA-125 Antigen