title: Soluble tumor necrosis factor-alpha receptors in the serum of endometriosis patients.
abstract: BACKGROUND
  We examine serum levels sTNFR-I and sTNFR-II in endometriosis patients, and their role as biomarkers of endometriosis.
  
  
  METHODS
  Women were diagnosed with endometriosis during laparoscopy to investigate pelvic pain and/or infertility (N=62). Control group included women with pelvic pain and/or infertility, whose laparoscopy showed no abnormalities (N=55). Serum concentrations of sTNFR-I and sTNFR-II were measured using Bioplex Protein Array system. Non-parametric statistics were used.
  
  
  RESULTS
  Endometriosis patients had significantly higher levels of sTNFR-I than controls (257.46pg/ml, IQR=2.37-1048.92 versus 130.39pg/ml, IQR=0.99-361.1 respectively, P value=0.01). For TNFR-II, difference between women with (232pg/ml, IQR=0.0-624.4), and women without (132.93pg/ml, IQR=0.0-312.81) endometriosis was not significant (P value=0.05). Early stage endometriosis patients had significantly higher level of sTNFR-I (559.13, IQR=1.82-1289.86) and sTNFR-II (248.8, IQR=0-644.65) than control women (P value is 0.01 for TNFR-I and 0.04 for TNFR-II). Levels of sTNFR-I and sTNFR-II were comparable for advanced endometriosis and controls, and between early and advanced endometriosis. As a biomarker for all- stage endometriosis, sTNFR-I produces AUC of 0.62, sensitivity of 61%, and specificity of 47.3%, at a cutoff of 81.87pg/ml. For early stage disease, sTNFR-I yields AUC of 0.68, sensitivity of 60.7%, specificity of 75%, at a cutoff of 351.22pg/ml.
  
  
  CONCLUSIONS
  sTNFR-I is significantly higher in serum of endometriosis patients than controls. As an endometriosis biomarker, sTNFR-I achieves better performance for early stage disease.
authors.affiliation: OB-GYN Department, Assiut University, Egypt; Center of Excellence of Stem Cells and Regenerative Medicine (CESCRM), Assiut University, Egypt. Electronic address: essamrash@yahoo.com.
authors.forename: Essam R
authors.initials: ER
authors.lastname: Othman
authors.affiliation: OB-GYN Department, University of Lübeck, Lübeck, Germany; OB-GYN Department, Diakonissenkrankenhaus Karlsruhe Rüppurr, Karlsruhe, Germany.
authors.forename: Daniela
authors.initials: D
authors.lastname: Hornung
authors.affiliation: OB-GYN Department, Assiut University, Egypt.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Hussein
authors.affiliation: OB-GYN Department, Assiut University, Egypt.
authors.forename: Ibraheem I
authors.initials: II
authors.lastname: Abdelaal
authors.affiliation: Center of Excellence of Stem Cells and Regenerative Medicine (CESCRM), Assiut University, Egypt; Biochemistry Department, Assiut University, Egypt.
authors.forename: Ayat A
authors.initials: AA
authors.lastname: Sayed
authors.affiliation: OB-GYN Department, Assiut University, Egypt.
authors.forename: Ahmed N
authors.initials: AN
authors.lastname: Fetih
authors.affiliation: OB-GYN Department, Medical College of Georgia, Georgia Regents University (GRU), GA, USA.
authors.forename: Ayman
authors.initials: A
authors.lastname: Al-Hendy
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood*; D004715:Endometriosis / Q000097:blood* / Q000473:pathology; D005260:Female; D006801:Humans; D008597:Menstrual Cycle / Q000097:blood; D047888:Receptors, Tumor Necrosis Factor, Type I / Q000097:blood*; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D047888:Receptors, Tumor Necrosis Factor, Type I
keywords: Endometriosis; Non invasive diagnosis; Serum; Soluble TNF receptors