Multicenter evaluation of blood-based biomarkers for the detection of endometriosis and adenomyosis: A prospective non-interventional study.

CA-125 S100-A12 adenomyosis blood-based biomarkers diagnosis endometriosis sFRP-4

Journal

International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
ISSN: 1879-3479
Titre abrégé: Int J Gynaecol Obstet
Pays: United States
ID NLM: 0210174

Informations de publication

Date de publication:
28 Aug 2023
Historique:
revised: 01 08 2023
received: 16 05 2023
accepted: 02 08 2023
medline: 28 8 2023
pubmed: 28 8 2023
entrez: 28 8 2023
Statut: aheadofprint

Résumé

To evaluate blood-based biomarkers to detect endometriosis and/or adenomyosis across nine European centers (June 2014-April 2018). This prospective, non-interventional study assessed the diagnostic accuracy of 54 blood-based biomarker immunoassays in samples from 919 women (aged 18-45 years) with suspicion of endometriosis and/or adenomyosis versus symptomatic controls. Endometriosis was stratified by revised American Society for Reproductive Medicine stage. Symptomatic controls were "pathologic symptomatic controls" or "pathology-free symptomatic controls". The main outcome measure was receiver operating characteristic-area under the curve (ROC-AUC) and Wilcoxon P values corrected for multiple testing (q values). CA-125 performed best in "all endometriosis cases" versus "all symptomatic controls" (AUC 0.645, 95% confidence interval [CI] 0.600-0.690, q < 0.001) and increased (P < 0.001) with disease stage. In "all endometriosis cases" versus "pathology-free symptomatic controls", S100-A12 performed best (AUC 0.692, 95% CI 0.614-0.769, q = 0.001) followed by CA-125 (AUC 0.649, 95% CI 0.569-0.729, q = 0.021). In "adenomyosis only cases" versus "symptomatic controls" or "pathology-free symptomatic controls", respectively, the top-performing biomarkers were sFRP-4 (AUC 0.615, 95% CI 0.551-0.678, q = 0.045) and S100-A12 (AUC 0.701, 95% CI 0.611-0.792, q = 0.004). This study concluded that no biomarkers tested could diagnose or rule out endometriosis/adenomyosis with high certainty.

Identifiants

pubmed: 37635683
doi: 10.1002/ijgo.15062
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : Roche Diagnostics GmbH

Informations de copyright

© 2023 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.

Références

Moradi M, Parker M, Sneddon A, Lopez V, Ellwood D. Impact of endometriosis on women's lives: a qualitative study. BMC Womens Health. 2014;14:123.
Hudelist G, Fritzer N, Thomas A, et al. Diagnostic delay for endometriosis in Austria and Germany: causes and possible consequences. Hum Reprod. 2012;27(12):3412-3416.
Fourquet J, Sinaii N, Stratton P, et al. Characteristics of women with endometriosis from the USA and Puerto Rico. J Endometr Pelvic Pain Disord. 2015;7(4):129-135.
Staal AH, van der Zanden M, Nap AW. Diagnostic delay of endometriosis in The Netherlands. Gynecol Obstet Invest. 2016;81(4):321-324.
Soliman AM, Fuldeore M, Snabes MC. Factors associated with time to endometriosis diagnosis in the United States. J Womens Health (Larchmt). 2017;26(7):788-797.
All Party Parliamentary Group on Endometriosis. Endometriosis in the UK: time for change. APPG on endometriosis inquiry report 2020. Accessed September 2022. https://www.endometriosis-uk.org/sites/endometriosis-k.org/files/files/Endometriosis%20APPG%20Report%20Oct%202020.pdf
Nnoaham KE, Hummelshoj L, Webster P, et al. Impact of endometriosis on quality of life and work productivity: a multicenter study across ten countries. Fertil Steril. 2011;96(2):366-373.e368.
Agarwal SK, Chapron C, Giudice LC, et al. Clinical diagnosis of endometriosis: a call to action. Am J Obstet Gynecol. 2019;220(4):354.e1-354.e12.
rASRM. Revised American Society for Reproductive Medicine classification of endometriosis. Fertil Steril. 1997;67(5):817-821.
Dunselman GAJ, Vermeulen N, Becker C, et al. ESHRE guideline: management of women with endometriosis. Hum Reprod. 2014;29(3):400-412.
National Institue for Health and Care Excellence. NICE guideline: endometriosis: diagnosis and management 2017. Accessed August 9, 2021. https://www.nice.org.uk/guidance/ng73/resources/endometriosis-diagnosis-and-management-pdf-1837632548293
Burghaus S, Schäfer SD, Beckmann MW, et al. Diagnosis and treatment of endometriosis. Guideline of the DGGG, SGGG and OEGGG (S2k level, AWMF Registry Number 015/045, August 2020). Geburtsh Frauenheilk. 2021;81(4):422-446.
Singh SS, Suen MW. Surgery for endometriosis: beyond medical therapies. Fertil Steril. 2017;107(3):549-554.
Albee RB, Sinervo K, Fisher DT. Laparoscopic excision of lesions suggestive of endometriosis or otherwise atypical in appearance: relationship between visual findings and final histologic diagnosis. J Minim Invasive Gynecol. 2008;15(1):32-37.
Chapron C, Vannuccini S, Santulli P, et al. Diagnosing adenomyosis: an integrated clinical and imaging approach. Hum Reprod Update. 2020;26(3):392-411.
Dueholm M. Transvaginal ultrasound for diagnosis of adenomyosis: a review. Best Pract Res Clin Obstet Gynaecol. 2006;20(4):569-582.
Taran FA, Wallwiener M, Kabashi D, et al. Clinical characteristics indicating adenomyosis at the time of hysterectomy: a retrospective study in 291 patients. Arch Gynecol Obstet. 2012;285(6):1571-1576.
Weiss G, Maseelall P, Schott LL, Brockwell SE, Schocken M, Johnston JM. Adenomyosis a variant, not a disease? Evidence from hysterectomized menopausal women in the Study of Women's Health Across the Nation (SWAN). Fertil Steril. 2009;91(1):201-206.
Rahmioglu N, Fassbender A, Vitonis AF, et al. World Endometriosis Research Foundation Endometriosis Phenome and Biobanking Harmonization Project: III. Fluid biospecimen collection, processing, and storage in endometriosis research. Fertil Steril. 2014;102(5):1233-1243.
Fassbender A, Rahmioglu N, Vitonis AF, et al. World Endometriosis Research Foundation Endometriosis Phenome and Biobanking Harmonisation Project: IV. Tissue collection, processing, and storage in endometriosis research. Fertil Steril. 2014;102(5):1244-1253.
Miller LM, Johnson NP. EPHect - the Endometriosis Phenome (and Biobanking) Harmonisation Project - may be very helpful for clinicians and the women they are treating. F1000Res. 2017;6:14.
Laux-Biehlmann A, d'Hooghe T, Zollner TM. Menstruation pulls the trigger for inflammation and pain in endometriosis. Trends Pharmacol Sci. 2015;36(5):270-276.
Rouam S. False discovery rate (FDR). In: Dubitzky W, Wolkenhauer O, Cho K-H, Yokota H, eds. Encyclopedia of Systems Biology. Springer; 2013:731-732.
Benjamini Y, Hochberg Y. Controlling the false discovery rate: a practical and powerful approach to multiple testing. J Royal Statist Soc Series B Methodol. 1995;57(1):289-300.
Bischl B, Lang M, Kotthoff L, et al. mlr: machine learning in R. J Mach Learn Res. 2016;17(170):1-5.
Greenbaum H, Galper B-EL, Decter DH, Eisenberg VH. Endometriosis and autoimmunity: can autoantibodies be used as a non-invasive early diagnostic tool? Autoimmun Rev. 2021;20(5):102795.
Nisenblat V, Bossuyt PM, Shaikh R, et al. Blood biomarkers for the non-invasive diagnosis of endometriosis. Cochrane Database Syst Rev. 2016;2016(5):CD012179.
Luisi S, Pinzauti S, Regini C, Petraglia F. Serum markers for the noninvasive diagnosis of endometriosis. Womens Health (Lond). 2015;11(5):603-610.
Oliveira MAP, Raymundo TS, Soares LC, Pereira TRD, Demôro AVE. How to use CA-125 more effectively in the diagnosis of deep endometriosis. Biomed Res Int. 2017;2017:9857196.
Kitawaki J, Ishihara H, Koshiba H, et al. Usefulness and limits of CA-125 in diagnosis of endometriosis without associated ovarian endometriomas. Hum Reprod. 2005;20(7):1999-2003.
Mol BWJ, Bayram N, Lijmer JG, et al. The performance of CA-125 measurement in the detection of endometriosis: a meta-analysis. Fertil Steril. 1998;70(6):1101-1108.
European Society of Human Reproduction and Embryology. ESHRE guideline endometriosis, Ed [website]. 2013. Accessed September 2022. https://www.eshre.eu/Guidelines-and-Legal/Guidelines/Endometriosis-guideline
Maiorana A, Cicerone C, Niceta M, Alio L. Evaluation of serum CA 125 levels in patients with pelvic pain related to endometriosis. Int J Biol Markers. 2007;22(3):200-202.
Cheng Y-M, Wang S-T, Chou C-Y. Serum CA-125 in preoperative patients at high risk for endometriosis. Obstet Gynecol. 2002;99(3):375-380.
Mandrekar JN. Receiver operating characteristic curve in diagnostic test assessment. J Thorac Oncol. 2010;5(9):1315-1316.
Sharma I, Dhawan V, Saha SC, Rashmi B, Dhaliwal LK. Implication of the RAGE-EN-RAGE axis in endometriosis. Int J Gynaecol Obstet. 2010;110(3):199-202.
Delaney MA, Wan Y-W, Kim G-E, et al. A role for progesterone-regulated sFRP4 expression in uterine leiomyomas. J Clin Endocrinol Metab. 2017;102(9):3316-3326.
Taran FA, Weaver AL, Coddington CC, Stewart EA. Characteristics indicating adenomyosis coexisting with leiomyomas: a case-control study. Hum Reprod. 2010;25(5):1177-1182.
Nisenblat V, Bossuyt PM, Farquhar C, Johnson N, Hull ML. Imaging modalities for the non-invasive diagnosis of endometriosis. Cochrane Database Syst Rev. 2016;2(2):CD009591.
Guerriero S, Saba L, Pascual MA, et al. Transvaginal ultrasound vs magnetic resonance imaging for diagnosing deep infiltrating endometriosis: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2018;51(5):586-595.
Andres MP, Borrelli GM, Ribeiro J, Baracat EC, Abrão MS, Kho RM. Transvaginal ultrasound for the diagnosis of adenomyosis: systematic review and meta-analysis. J Minim Invasive Gynecol. 2018;25(2):257-264.
Bendifallah S, Suisse S, Puchar A, et al. Salivary MicroRNA signature for diagnosis of endometriosis. J Clin Med. 2022;11(3):612.
Chen WC, Cheng CM, Liao WT, Chang TC. Urinary biomarkers for detection of clinical endometriosis or adenomyosis. Biomedicines. 2022;10(4):833.

Auteurs

Stefanie Burghaus (S)

Department of Gynecology and Obstetrics, Erlangen University Hospital, University Endometriosis Center for Franconia, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.

Predrag Drazic (P)

Endometriosis Center, Ammerland Clinic GmbH, Westerstede, Germany.

Monika Wölfler (M)

Department of Gynecology and Obstetrics and Gynecology, Medical University, Graz, Austria.

Sylvia Mechsner (S)

Department of Gynecology, Endometriosis Research Center Charité, Charité University Hospital, Campus Virchow Klinikum, Berlin, Germany.

Magdalena Zeppernick (M)

Department of Gynecology and Obstetrics, RWTH Aachen University Hospital, Aachen, Germany.
Department of Gynecology and Obstetrics, Justus Liebig University, Giessen, Germany.

Ivo Meinhold-Heerlein (I)

Department of Gynecology and Obstetrics, RWTH Aachen University Hospital, Aachen, Germany.
Department of Gynecology and Obstetrics, Justus Liebig University, Giessen, Germany.

Michael D Mueller (MD)

Department of Obstetrics and Gynecology, Inselspital, University of Bern, Bern, Switzerland.

Ralf Rothmund (R)

Department of Obstetrics and Gynecology, University of Tübingen, Tübingen, Germany.

Paola Vigano (P)

Obstetrics and Gynecology Unit, San Raffaele Scientific Institute, Milan, Italy.

Christian M Becker (CM)

Oxford Endometriosis Care and Research (CaRe) Centre, Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK.

Krina T Zondervan (KT)

Oxford Endometriosis Care and Research (CaRe) Centre, Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK.
Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK.

Matthias W Beckmann (MW)

Department of Gynecology and Obstetrics, Erlangen University Hospital, University Endometriosis Center for Franconia, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.

Peter A Fasching (PA)

Department of Gynecology and Obstetrics, Erlangen University Hospital, University Endometriosis Center for Franconia, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.

Sibylle Berner-Gatz (S)

Roche Diagnostics GmbH, Penzberg, Germany.

Felix S Grünewald (FS)

Roche Diagnostics GmbH, Penzberg, Germany.

Martin Hund (M)

Roche Diagnostics International Ltd, Rotkreuz, Switzerland.

Peter Kastner (P)

Roche Diagnostics GmbH, Penzberg, Germany.

Martin Klammer (M)

Roche Diagnostics GmbH, Penzberg, Germany.

Ruediger P Laubender (RP)

Roche Diagnostics GmbH, Penzberg, Germany.

Heike Wegmeyer (H)

Roche Diagnostics GmbH, Penzberg, Germany.

Ursula-Henrike Wienhues-Thelen (UH)

Roche Diagnostics GmbH, Penzberg, Germany.

Stefan P Renner (SP)

Department of Gynecology and Obstetrics, Erlangen University Hospital, University Endometriosis Center for Franconia, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.
Department of Gynecology and Obstetrics, Hospital Böblingen, Klinikverbund-Suedwest, Klinikum Sindelfingen-Böblingen, Böblingen, Germany.

Classifications MeSH