Objectives To evaluate whether micrRNAs associated with endometriosis are detectable in the circulation and could serve as potential noninvasive biomarkers for endometriosis. Design Case-control study. Setting University hospital. Patient(s) Twenty-four women with endometriosis and 24 women without the disease (controls). Interventions Serum samples were collected from women undergoing laparoscopy for endometriosis and other benign gynecologic disease. Main Outcome Measure(s) Total RNA was extracted from serum and qRT-PCR was used to determine levels of miRNA let-7a–f and miR-135a,b. Result(s) Levels of circulating let-7b and miR-135a were significantly decreased in women with endometriosis compared with controls, while let-7d and 7f showed a trend toward down-regulation. Let-7b expression strongly correlated with serum CA-125 levels and showed the highest AUC curve of 0.691. When the subjects were analyzed according to the phase of the menstrual cycle, expression of let-7b, 7c, 7d, and 7e were significantly lower in women with endometriosis during the proliferative phase. Using a logistic regression model, the diagnostic power of differently expressed miRNAs were evaluated, and the combination of let-7b, let-7d and let-7f during the proliferative phase yielded the highest ACU curve value of 0.929 in discriminating endometriosis from controls. Conclusions Several circulating miRNAs are differentially expressed in sera of patients with endometriosis compared to controls. Combination of serum let-7b, 7d and 7f levels during the proliferative phase may serve as a diagnostic marker for endometriosis.

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