title: Survivin and VEGF as Novel Biomarkers in Diagnosis of Endometriosis.
abstract: BACKGROUND
  The aim of this study was to investigate the role of peripheral blood markers as additional diagnostic tools to transvaginal ultrasound (TVU) findings in the diagnosis of endometriosis.
  
  
  METHODS
  This study included 40 patients undergoing laparoscopy for suspected endometriosis from January to December 2012. Preoperative levels of serum CA125, CA19-9, CEA and mRNA expression levels for survivin and VEGF were obtained. Real-time PCR was used to determine relative gene expression. A new diagnostic score was obtained by deploying the peripheral blood markers to the TVU findings. Statistical methods used were Chi-square, Fisher's, Student's t-test or the Mann - Whitney test.
  
  
  RESULTS
  There was a statistically significant difference in serum CA125, survivin and VEGF levels in patients with endometriosis and those without endometriosis (p<0.001, p=0.025 and p=0.009, respectively). False negative TVU findings were noted in 3/13 patients (23.1%) with peritoneal endometriosis without ovaries involvement. High sensitivity (93.3%), specificity (90.0%), PPV (96.6%), NPV (81.8%) and accuracy (92.5%) were obtained for a diagnostic score based on TVU and significant peripheral blood markers (CA125, survivin and VEGF).
  
  
  CONCLUSIONS
  Determination of serum CA125, mRNA expression levels for survivin and VEGF along with TVU can contribute to higher accuracy of the noninvasive diagnostic tools for endometriosis.
authors.affiliation: Department of Gynecology and Obstetrics, Medical Center Uzice, Serbia.
authors.forename: Milena
authors.initials: M
authors.lastname: Acimovic
authors.affiliation: Institute for Gynecology and Obstetrics, Clinical Center, Belgrade, Serbia.
authors.forename: Snezana
authors.initials: S
authors.lastname: Vidakovic
authors.affiliation: Institute for Medical Statistics and Informatics, Medical Faculty, University of Belgrade, Belgrade, Serbia.
authors.forename: Natasa
authors.initials: N
authors.lastname: Milic
authors.affiliation: Institute for Gynecology and Obstetrics, Clinical Center, Belgrade, Serbia.
authors.forename: Katarina
authors.initials: K
authors.lastname: Jeremic
authors.affiliation: Institute for Microbiology and Immunology, School of Medicine, University of Belgrade, Serbia.
authors.forename: Milos
authors.initials: M
authors.lastname: Markovic
authors.affiliation: Department of Gynecology and Obstetrics, Medical Center Uzice, Serbia.
authors.forename: Ana
authors.initials: A
authors.lastname: Milosevic-Djeric
authors.affiliation: Institute for Gynecology and Obstetrics, Clinical Center, Belgrade, Serbia.
authors.forename: Gordana
authors.initials: G
authors.lastname: Lazovic-Radonjic
keywords: CA125; VEGF; endometriosis; laparoscopy; survivin; transvaginal ultrasound