The role of tumor necrosis factor alpha in regulating CYFRA ۲۱-۱ as a potential biomarker for endometriosis: A cross-sectional study

Background: Endometriosis is one of the most common gynecological conditions, and the gold standard for its diagnosis is laparoscopy. Cytokeratin fragment ۲۱-۱ (CYFRA ۲۱-۱) has emerged as a potential biomarker candidate due to its strong association with endometriosis. The mechanisms underlying the cleavage of cytokeratin-۱۹ into CYFRA ۲۱-۱ remain unclear. Tumor necrosis factor alpha (TNF-α) may play a regulatory role in this process. Objective: This study aimed to analyze the correlation between intraperitoneal TNF-α levels and CYFRA ۲۱-۱ expression levels in women with endometriosis. Materials and Methods: This was an analytical study with a cross-sectional study design, involving ۳۸ women diagnosed with endometriosis and ۳۵ non-endometriosis women as controls. Both CYFRA ۲۱-۱ and TNF-α concentrations were measured using the Enzyme-Linked Immunosorbent Assay method. Urine creatinine was measured using the Electrochemiluminescence Immunoassay method, while clinical data were collected through medical records. Results: The mean intraperitoneal TNF-α level was significantly higher in the endometriosis group compared to controls (p < ۰.۰۰۱). A significant positive correlation was found between intraperitoneal TNF-α concentrations and CYFRA ۲۱-۱ levels (p < ۰.۰۰۱; r ۰,۶۶۲ [۹۵% CI: ۰.۴۲۶-۰.۸۱۴]), indicating a strong association. Furthermore, a strong positive correlation was observed between the urinary CYFRA ۲۱-۱ to creatinine ratio and intraperitoneal TNF-α levels, particularly during the proliferative phase of the menstrual cycle. Conclusion: These findings suggest that TNF-α may influence CYFRA ۲۱-۱ expression in a cycle phase-dependent manner, supporting the potential role of CYFRA ۲۱-۱ as a non-invasive biomarker for endometriosis, particularly during the proliferative phase.

کلیدواژه ها:

Endometriosis ، CYFRA ۲۱-۱ ، Cytokeratin-۱۹ ، Tumor necrosis factor alpha. ، اندومتریوز ، CYFRA ۲۱-۱ ، سیتوکراتین-۱۹ ، فاکتور نکروزکننده تومور آلفا.