Update on Biomarkers for the Detection of Endometriosis

Abstract

Endometriosis is histologically characterized by the displacement of endometrial tissue to extrauterine locations including the pelvic peritoneum, ovaries, and bowel. An important cause of infertility and pelvic pain, the individual and global socioeconomic burden of endometriosis is significant. Laparoscopy remains the gold standard for the diagnosis of the condition. However, the invasive nature of surgery, coupled with the lack of a laboratory biomarker for the disease, results in a mean latency of 7–11 years from onset of symptoms to definitive diagnosis. Unfortunately, the delay in diagnosis may have significant consequences in terms of disease progression. The discovery of a sufficiently sensitive and specific biomarker for the nonsurgical detection of endometriosis promises earlier diagnosis and prevention of deleterious sequelae and represents a clear research priority. In this review, we describe and discuss the current status of biomarkers of endometriosis in plasma, urine, and endometrium.

How to use CA-125 More Effectively in the Diagnosis of Deep Endometriosis?

“…CA-125 is the serum biomarker that has been more extensively studied in the diagnosis of endometriosis, but it had not reached its full potential. Other serum markers such as CA19-9, interleukins 6, 8, and 10, and tumor necrosis factor alpha have also already been studied [12,13]. In comparative studies, those markers were not superior to CA-125 in relation to diagnostic performance in endometriosis.…”

“…In comparative studies, those markers were not superior to CA-125 in relation to diagnostic performance in endometriosis. However, no serum biomarkers have been validated for a noninvasive diagnostic test with adequate sensitivity and specificity [13,14]. The purpose of our study was to improve the diagnostic performance of CA-125 by measuring the difference between the values of this biomarker collected in menstruation and in midcycle.…”

Endometriosis-Search for Biomarkers

“…Several genes have been found to be upregulated or changed in endometriosis (Fassbender et al, 2015). The major genes include hypermethylated HOXA10 (Wu et al, 2005) and PR-B (Wu et al, 2006), aromatase (Izawa et al, 2008) and E-cadherin (Wu et al, 2007).…”

“…Additional potential biomarkers being elevated in endometriosis are TGF-β1, COX-2, VEGF, ER-1α and aromatase (Meng et al, 2011), but their elevated levels are unfortunately not fully endometriosis-specific to be utilized in clinical practice. Despite extensive research, co consensus exists on the use of cytokines in diagnosis (Fassbender et al, 2015).…”

Endometriosis research using capture microdissection techniques: Progress and future applications

“…Thus far, intrinsic differences have been detected among ectopic and eutopic endometrium in endometriosis, and normal endometrium in controls (10). However, endometrial samples used in numerous studies may not be ideal (11), biopsy samples showing the 'typical' macroscopic appearance of endometriotic lesions cannot be confirmed under the microscope, and areas that appear 'normal' may turn out to be endometriotic at the microscopic level (12).…”