Measurement of hs-CRP is irrelevant to diagnose and stage endometriosis: prospective study of 834 patients.
OBJECTIVE
The pathogenesis of endometriosis is associated with an inflammatory process. Here, we assessed if the levels of high-sensitivity C-reactive protein (hs-CRP) in serum could constitute an effective method for detecting systemic inflammation during endometriosis.


METHODS
This was a prospective, laboratory-based study, which was carried out in a tertiary care university hospital. Patients with histologically proven endometriosis (n = 370) and unaffected women (n = 464) were enrolled from January 2005 through December 2009. We performed complete surgical excision of endometriotic lesions with pathological analysis. In addition, hs-CRP levels were determined through a particle-enhanced immunoturbidimetric method. The hs-CRP levels were measured in both controls and women with endometriosis according to the established surgical classifications of endometriosis: superficial peritoneal endometriosis, endometrioma, and deep infiltration endometriosis. Also, hs-CRP levels were evaluated according to hormonal treatment and menstrual cycle.


RESULTS
The hs-CRP serum levels did not statistically differ between women with endometriosis and controls (median in ng/mL [range]: 0.82 [0.04-42.89] vs 0.9 [0.03-43.73], respectively; P = .599). Moreover, subgroup analysis revealed no difference among superficial peritoneal endometriosis, endometrioma, deep infiltration endometriosis, and controls: 0.8 (0.15-13.35), 0.81 (0.04-38.82), 0.83 (0.09-42.89), and 0.9 (0.03-43.73), respectively; P = .872. Furthermore, no effect was observed regarding hormonal treatment or menstrual cycle.


CONCLUSIONS
Although endometriosis is an inflammatory disease, we failed to identify any systemic changes in hs-CRP serum levels. Therefore, hs-CRP analysis appears to be irrelevant to the diagnosis and staging of endometriosis.
Faculty of Medicine Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Department of Gynecology, Obstetrics, and Reproductive Medicine, Centre Hospitalier Universitaire Cochin of the Groupe Hospitalier Universitaire Ouest, Assistance Publique-Hôpitaux de Paris, Paris, France. Electronic address: thibault.thubert@gmail.com.
Thibault
T
Thubert
Faculty of Medicine Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Department of Gynecology, Obstetrics, and Reproductive Medicine, Centre Hospitalier Universitaire Cochin of the Groupe Hospitalier Universitaire Ouest, Assistance Publique-Hôpitaux de Paris, Paris, France; Immunology Laboratory EA 1833, Paris, France; Institut Cochin, Université Paris Descartes, Centre National de Recherche Scientifique, Paris, France; Institut National de la Santé et de la Recherche Médicale, Unité de recherche U1016, Paris, France.
Pietro
P
Santulli
Faculty of Medicine Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Department of Gynecology, Obstetrics, and Reproductive Medicine, Centre Hospitalier Universitaire Cochin of the Groupe Hospitalier Universitaire Ouest, Assistance Publique-Hôpitaux de Paris, Paris, France; Institut Cochin, Université Paris Descartes, Centre National de Recherche Scientifique, Paris, France; Institut National de la Santé et de la Recherche Médicale, Unité de recherche U1016, Paris, France.
Louis
L
Marcellin
Faculty of Medicine Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Department of Gynecology, Obstetrics, and Reproductive Medicine, Centre Hospitalier Universitaire Cochin of the Groupe Hospitalier Universitaire Ouest, Assistance Publique-Hôpitaux de Paris, Paris, France.
Sophie
S
Menard
Faculty of Medicine Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Department of Gynecology, Obstetrics, and Reproductive Medicine, Centre Hospitalier Universitaire Cochin of the Groupe Hospitalier Universitaire Ouest, Assistance Publique-Hôpitaux de Paris, Paris, France.
Magatte
M
M'Baye
Faculty of Medicine Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Department of Gynecology, Obstetrics, and Reproductive Medicine, Centre Hospitalier Universitaire Cochin of the Groupe Hospitalier Universitaire Ouest, Assistance Publique-Hôpitaux de Paris, Paris, France.
Isabelle
I
Streuli
Faculty of Medicine Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Department of Gynecology, Obstetrics, and Reproductive Medicine, Centre Hospitalier Universitaire Cochin of the Groupe Hospitalier Universitaire Ouest, Assistance Publique-Hôpitaux de Paris, Paris, France; Institut Cochin, Université Paris Descartes, Centre National de Recherche Scientifique, Paris, France; Institut National de la Santé et de la Recherche Médicale, Unité de recherche U1016, Paris, France.
Bruno
B
Borghese
Faculty of Medicine Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Department of Gynecology, Obstetrics, and Reproductive Medicine, Centre Hospitalier Universitaire Cochin of the Groupe Hospitalier Universitaire Ouest, Assistance Publique-Hôpitaux de Paris, Paris, France.
Dominique
D
de Ziegler
Faculty of Medicine Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Department of Gynecology, Obstetrics, and Reproductive Medicine, Centre Hospitalier Universitaire Cochin of the Groupe Hospitalier Universitaire Ouest, Assistance Publique-Hôpitaux de Paris, Paris, France; Institut Cochin, Université Paris Descartes, Centre National de Recherche Scientifique, Paris, France; Institut National de la Santé et de la Recherche Médicale, Unité de recherche U1016, Paris, France.
Charles
C
Chapron
D000328:Adult; D002097:C-Reactive Protein / Q000032:analysis*; D016022:Case-Control Studies; D004715:Endometriosis / Q000097:blood / Q000145:classification / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000175:diagnosis*; D008597:Menstrual Cycle / Q000378:metabolism; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018709:Statistics, Nonparametric
D002097:C-Reactive Protein
C-reactive protein; endometrioma; endometriosis; high-sensitivity C-reactive protein; inflammation; pathogenesis