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

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

Citation

Stefanie Burghaus, Predrag Drazic, Monika Wölfler, Sylvia Mechsner, Magdalena Zeppernick, Ivo Meinhold-Heerlein, Michael D Mueller, Ralf Rothmund, Paola Vigano, Christian M Becker, Krina T Zondervan, Matthias W Beckmann, Peter A Fasching, Sibylle Berner-Gatz, Felix S Grünewald, Martin Hund, Peter Kastner, Martin Klammer, Ruediger P Laubender, Heike Wegmeyer, Ursula-Henrike Wienhues-Thelen, Stefan P Renner. Multicenter evaluation of blood-based biomarkers for the detection of endometriosis and adenomyosis: A prospective non-interventional study. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics. 2024 Jan;164(1):305-314

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PMID: 37635683

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