Development of a nonsurgical diagnostic tool for endometriosis based on the detection of endometrial leukocyte subsets and serum CA-125 levels

• Published in: Fertility and sterility Vol. 80; no. 4; pp. 876 - 885
• Main Authors: Gagné, Danièle, Rivard, Michèle, Pagé, Martin, Lépine, Manon, Platon, Christèle, Shazand, Kamran, Hugo, Patrice, Gosselin, Diane
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.10.2003; Elsevier Science
• Subjects: Adult; Antigens, CD - analysis; Biological and medical sciences; Biomarkers - analysis; CA-125; CA-125 Antigen - blood; case control study; Case-Control Studies; Diagnostic test; endometrial leukocytes; endometriosis; Endometriosis - blood; Endometriosis - etiology; Endometriosis - immunology; Endometriosis - pathology; endometrium; Endometrium - pathology; Female; Female genital diseases; Gynecology. Andrology. Obstetrics; Humans; leukocyte subsets; Leukocytes - immunology; Leukocytes - pathology; logistic regression; Medical sciences; Non tumoral diseases; predictive model; Predictive Value of Tests; Risk Factors; Sensitivity and Specificity; Diagnostic test; predictive model; endometriosis; endometrium; CA-125; endometrial leukocytes; logistic regression; leukocyte subsets; case control study; Validation; Human; Menstrual cycle; Leukocyte; Prediction; Biological marker; Endometriosis; Case control study; Female genital diseases; Logistic regression; Uterus; CA- 125; Female genital system; Risk factor; Uterine diseases; CA 125 antigen; Female; Serum; Diagnosis; Endometrium
• DOI: 10.1016/S0015-0282(03)01153-1
• ISSN: 0015-0282

To determine whether the proportion of several leukocyte subsets is modulated in the endometrium of patients with endometriosis and, if yes, whether it can be used for diagnostic purposes. Case-control study. Eight clinical institutions of the Montreal area. Women who underwent laparoscopy or laparotomy between 1997 and 2001, who had regular menstrual cycles and were not under hormone treatment for the previous 3 months were selected. This study included 368 women, 173 with surgically confirmed endometriosis and 195 controls with no surgical evidence of endometriosis. Main outcome measure(s): Cytometry analysis was used to measure the proportion of several leukocyte subsets among CD45 + endometrial cells. The proportion of CD3 +, CD16 +, CD3 −HLADR −, CD3 -CD45RA −, CD3 +CD16 −, CD3 +CD56 −, CD56 −CD16 +, and CD16b + leukocytes was significantly altered in the endometrium of cases compared with controls. A multiple logistic regression model was adjusted with these endometrial leukocytes, serum CA-125 levels, risk factors, and confounders. The diagnostic performance of this predictive model was defined by a specificity of 95% and a sensitivity of 61%. Furthermore, the positive and negative predictive values were 91% and 75%, respectively. This predictive model represents a novel diagnostic tool to identify women with a high likelihood of suffering from endometriosis.