title: Peripheral biomarkers of endometriosis: a systematic review.
abstract: BACKGROUND
  Endometriosis is estimated to affect 1 in 10 women during the reproductive years. There is often delay in making the diagnosis, mainly due to the non-specific nature of the associated symptoms and the need to verify the disease surgically. A biomarker that is simple to measure could help clinicians to diagnose (or at least exclude) endometriosis; it might also allow the effects of treatment to be monitored. If effective, such a marker or panel of markers could prevent unnecessary diagnostic procedures and/or recognize treatment failure at an early stage.
  
  
  METHODS
  We used QUADAS (Quality Assessment of Diagnostic Accuracy Studies) criteria to perform a systematic review of the literature over the last 25 years to assess critically the clinical value of all proposed biomarkers for endometriosis in serum, plasma and urine.
  
  
  RESULTS
  We identified over 100 putative biomarkers in publications that met the selection criteria. We were unable to identify a single biomarker or panel of biomarkers that have unequivocally been shown to be clinically useful.
  
  
  CONCLUSIONS
  Peripheral biomarkers show promise as diagnostic aids, but further research is necessary before they can be recommended in routine clinical care. Panels of markers may allow increased sensitivity and specificity of any diagnostic test.
authors.affiliation: Nuffield Department of Obstetrics & Gynaecology, University of Oxford, Women's Centre, John Radcliffe Hospital, Oxford OX3 9DU, UK.
authors.forename: K E
authors.initials: KE
authors.lastname: May
authors.forename: S A
authors.initials: SA
authors.lastname: Conduit-Hulbert
authors.forename: J
authors.initials: J
authors.lastname: Villar
authors.forename: S
authors.initials: S
authors.lastname: Kirtley
authors.forename: S H
authors.initials: SH
authors.lastname: Kennedy
authors.forename: C M
authors.initials: CM
authors.lastname: Becker
mesh_terms: D000906:Antibodies / Q000097:blood / Q000378:metabolism / Q000652:urine; D017209:Apoptosis; D015415:Biomarkers / Q000097:blood / Q000378:metabolism* / Q000652:urine; D002448:Cell Adhesion; D016207:Cytokines / Q000097:blood / Q000378:metabolism / Q000652:urine; D004715:Endometriosis / Q000175:diagnosis* / Q000276:immunology / Q000378:metabolism; D005260:Female; D006023:Glycoproteins / Q000097:blood; D006728:Hormones / Q000097:blood; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000378:metabolism; D007962:Leukocytes / Q000473:pathology / Q000502:physiology; D040901:Proteomics; D042461:Vascular Endothelial Growth Factor A / Q000097:blood / Q000652:urine
chemical_list: D000906:Antibodies; D015415:Biomarkers; D016207:Cytokines; D006023:Glycoproteins; D006728:Hormones; D036341:Intercellular Signaling Peptides and Proteins; D042461:Vascular Endothelial Growth Factor A
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