Review Of The Biomarkers’ Role in theDiagnosis of Endometriosis

Introduction: Endometriosis is a common gynecological disorderthat is often misdiagnosed or leads to delayed treatment andincreased complications. Biomarkers have been proposed as apotential diagnostic tool for endometriosis. Various biomarkers,including inflammatory markers, hormones, and imaging markers,have been investigated for their potential diagnostic utilityin endometriosis. While some biomarkers have shown promisein identifying endometriosis, none have yet been identified as adefinitive diagnostic tool. Research is necessary to find dependablebiomarkers for diagnosing endometriosis, which could enhancepatient outcomes and alleviate the impact of the disease.Materials and Methods: A systematic review was conductedfollowing the Preferred Reporting Items for Reviews and usingthe ScienceDirect, PubMed, and Cochrane Library databases.Currently, there is no single diagnostic biomarker for endometriosis,and diagnosis usually involves a combination of clinicalevaluation, imaging studies, and invasive procedures such aslaparoscopy. However, several potential biomarkers have beenidentified that may help in the diagnosis and management ofendometriosis, including CA-۱۲۵, Anti-Mullerian hormone(AMH), inflammatory markers, and microRNAs. Further researchis needed to confirm these biomarkers and determinetheir utility clinically in the diagnosis and management of endometriosis.Result: The study analyzed the concentration of CA-۱۲۵ in ۵۶patients admitted to the Obstetrics and Gynecology departmentfor diagnostic or therapeutic laparoscopy. The patients were dividedinto two groups: The Endometriosis group and the Controlgroup. The results showed that the concentration of CA-۱۲۵in the Endometriosis group was ۳۳.۹۸ U/ml, compared to ۹.۳ U/ml in the Control group. The average amount of CA-۱۲۵ in theperitoneal fluid was ۱۲۴۱.۸۸ U/ml in the Endometriosis group,while this number was ۲۶۴۰.۲۳ U/ml in the non-Endometriosisgroup.Another study found that AMH, AMH RII, and cytochromeP۴۵۰ isoforms were expressed in the epithelial and stromal cellsof endometriosis. Treatment of stromal and epithelial cells withAMH was able to induce a decrease in the percentage of cells inthe S phase and an increase in the percentage of cells in the G۱and G۲ phases. Consistently, a decrease in cell viability and anincrease in the percentage of cell death fraction were observed.Inflammatory markers are also elevated in women with endometriosis.A proposed panel of inflammatory markers, particularlyIL-۶, PRL, and CA ۱۲۵, maybe a useful tool to identifywomen with advanced endometriosis who are eligible for treatment.Finally, six microRNAs were evaluated for predicting endometriosisin patients undergoing laparoscopy. The serum levelof miRNAs was quantitatively measured using real-time polymerasechain reaction. A random forest algorithm incorporatingmiRNA levels showed an area under had the curve of independentset of ۰.۹۳۹.Conclusion: Biomarkers are important in the diagnosis andmanagement of endometriosis, but no single biomarker can definitivelydiagnose it. CA-۱۲۵, HE۴, cytokines, and chemokinescan support the diagnosis and monitor the progression of thedisease. Biomarkers may predict the treatment to response andidentify patients at risk of recurrence. Further research is neededto develop reliable tests, and biomarkers should be used inconjunction with clinical evaluation and imaging studies.

کلیدواژه ها:

Endometriosis ، cancer ، infertility ، biomarkers ofblood ، protein ، plasma ، serum