title: Markers of deep infiltrating endometriosis in patients with ovarian endometrioma: a predictive model.
abstract: OBJECTIVE
  The purpose of the study was to develop an easily applicable predictive model to predict deep infiltrating endometriosis in patients with ovarian endometrioma.
  
  
  METHODS
  We performed a retrospective analysis of 178 consecutive women with ovarian endometrioma who underwent surgery, with histological confirmation and complete removal of endometriosis in the Hospital Clinic of Barcelona. Several markers were prospectively obtained and compared between the group of patients presenting deep infiltrating endometriosis associated with ovarian endometrioma and women with only ovarian endometrioma. Multiple logistic regression analysis was performed to create a model to predict the presence of deep infiltrating endometriosis and internal validation was later performed.
  
  
  RESULTS
  Of the 178 patients studied, 80 (45%) were classified in the ovarian endometrioma group and 98 (55%) in the group of patients presenting deep infiltrating endometriosis associated with ovarian endometrioma. The independent variables to predict deep infiltrating endometriosis were: at least one previous pregnancy, a past history of surgery for endometriosis and the mean endometriosis-associated pelvic pain score. The area under the ROC curve was 0.91 (95% confidence interval: 0.86-0.94), with an optimal cut-off of the predicted probability of 0.54. The sensitivity of the model was 80% and the specificity 84%.
  
  
  CONCLUSIONS
  This model predicts the development of deep infiltrating endometriosis in patients with ovarian endometriomas allowing prioritization of women for referral to specialized centers.
authors.affiliation: Clinic Institute of Gynecology, Obstetrics and Neonatology, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.
authors.forename: Maria
authors.initials: M
authors.lastname: Perelló
authors.affiliation: Clinic Institute of Gynecology, Obstetrics and Neonatology, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Martínez-Zamora
authors.affiliation: Clinic Institute of Gynecology, Obstetrics and Neonatology, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.
authors.forename: Ximena
authors.initials: X
authors.lastname: Torres
authors.affiliation: Clinic Institute of Gynecology, Obstetrics and Neonatology, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.
authors.forename: Jordina
authors.initials: J
authors.lastname: Munrós
authors.affiliation: Clinic Institute of Gynecology, Obstetrics and Neonatology, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.
authors.forename: Silvia
authors.initials: S
authors.lastname: Llecha
authors.affiliation: CRESIB (Barcelona Center for International Health Research), Hospital Clínic, Barcelona, Spain.
authors.forename: Elisa
authors.initials: E
authors.lastname: De Lazzari
authors.affiliation: Clinic Institute of Gynecology, Obstetrics and Neonatology, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Balasch
authors.affiliation: Clinic Institute of Gynecology, Obstetrics and Neonatology, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain. Electronic address: fcarmona@clinic.ub.es.
authors.forename: Francisco
authors.initials: F
authors.lastname: Carmona
mesh_terms: D004715:Endometriosis / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D006801:Humans; D008962:Models, Theoretical; D010049:Ovarian Diseases / Q000175:diagnosis* / Q000601:surgery; D010532:Peritoneal Diseases / Q000175:diagnosis* / Q000601:surgery; D012680:Sensitivity and Specificity
keywords: Diagnosis; EAPP score; Endometriosis; Ovarian endometrioma; Prediction model