title: Diagnostic accuracy of urinary cytokeratin 19 fragment for endometriosis.
abstract: Endometriosis affects up to 10% of women of reproductive age and 176 million women worldwide. The prevalence in women with infertility is between 30% and 50% but may be higher in women with pelvic pain, interstitial cystitis, or irritable bowel syndrome. Cytokeratin 19 has been suggested as a potential biomarker in urine for the diagnosis of this condition. The objective of this study was to prospectively determine the accuracy and the performance of a urinary cytokeratin 19 (uCYFRA 21-1) test for diagnosing endometriosis. Ninety-eight consecutive women who underwent laparoscopy had a urinary sample obtained before surgery and were included in the study. Endometriosis was diagnosed by laparoscopy and pathology in 64.3% (63 of 98 women). The estimates and 95% confidence intervals for sensitivity, specificity, positive and negative predictive values, and likelihood ratios were 11.1% (4.5%-21.5%), 94.3% (80.8%-99.3%), 77.7% (39.9-97.1), 37% (27-47.9), 1.94 (0.43-8.86), and 0.94 (0.84-1.06), respectively. Despite the high specificity, the uCYFRA 21-1 test has limited value for clinical practice to discriminate between women with and without endometriosis.
authors.affiliation: Department of Obstetrics and Gynecology, Greenville Health System, Greenville, SC, USA blessey@ghs.org.
authors.forename: B A
authors.initials: BA
authors.lastname: Lessey
authors.affiliation: Departmento de Ginecologia e Obstetrícia, Universidade Federal do Rio Grande do Sul, Rio Grande do Sul, Brazil.
authors.forename: R F
authors.initials: RF
authors.lastname: Savaris
authors.affiliation: Diagnostics Discovery Research, Abbott Laboratories, Abbott Park, IL, USA.
authors.forename: S
authors.initials: S
authors.lastname: Ali
authors.affiliation: Diagnostics Discovery Research, Abbott Laboratories, Abbott Park, IL, USA.
authors.forename: S
authors.initials: S
authors.lastname: Brophy
authors.affiliation: Research, Abbott Laboratories, North Chicago, IL, USA.
authors.forename: S
authors.initials: S
authors.lastname: Tomazic-Allen
authors.affiliation: Research and Development, AbbVie Inc, North Chicago, IL, USA.
authors.forename: K
authors.initials: K
authors.lastname: Chwalisz
mesh_terms: D000328:Adult; D000951:Antigens, Neoplasm / Q000652:urine*; D019540:Area Under Curve; D015415:Biomarkers / Q000652:urine; D004715:Endometriosis / Q000175:diagnosis* / Q000601:surgery / Q000652:urine*; D005260:Female; D006801:Humans; D053539:Keratin-19 / Q000652:urine*; D010535:Laparoscopy; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D016482:Urinalysis; D055815:Young Adult
chemical_list: D000951:Antigens, Neoplasm; D015415:Biomarkers; D053539:Keratin-19; C102012:antigen CYFRA21.1
keywords: cytokeratin 19; endometriosis; sensitivity; specificity