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1.
Bratisl Lek Listy ; 120(12): 912-918, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31855050

RESUMO

OBJECTIVES: The objective of this study was to evaluate the diagnostic value of the neutrophil-to-lymphocyte ratio (NLR), lymphocyte­to­monocyte ratio (LMR), and mean platelet volume (MPV) in patients with endometriosis as compared with healthy controls. BACKGROUND: Currently, no non-invasive diagnostic test of endometriosis has been implemented in clinical practice. METHODS: A total of 121 women with endometriosis and 136 controls participated in this retrospective study. The extent of the disease in the patients with endometriosis was determined using the American Society of Reproductive Medicine revised classification. Sensitivities and specificities of NLR, LMR and MPV were evaluated by receiver-operating characteristic (ROC) analysis. RESULTS: Patients with endometriosis had higher neutrophil counts, white blood cell (WBC) levels, NLR, MPV, and lower lymphocyte count and LMR than the control group. The cut-off values were found to be 1.6 for NLR at 87.6 % sensitivity and 44.8 % specificity and 8 for MPV at 75.2 % sensitivity and 68.4 % specficity. For LMR, the cut-off value was 5.6 with 66.1 % sensitivity, 50 % specificity. Patients with stages III or IV had significantly lower MPV (p = 0.039) and LMR levels (p = 0.016) than patients with stages I or II. CONCLUSION: NLR, LMR, and MPV may be used to distinguish patients with endometriosis from controls (Tab. 4, Fig. 4, Ref. 37).


Assuntos
Biomarcadores Tumorais/sangue , Antígeno Ca-125/sangue , Endometriose/diagnóstico , Contagem de Linfócitos , Volume Plaquetário Médio , Estudos de Casos e Controles , Endometriose/sangue , Endometriose/imunologia , Feminino , Humanos , Linfócitos , Neutrófilos , Estudos Retrospectivos , Sensibilidade e Especificidade
2.
Biomed Res Int ; 2019: 3673060, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31428634

RESUMO

There is a great need for a noninvasive diagnosis for endometriosis. Several biomarkers and biomarker panels have been proposed. Biomarker models consisting of CA-125, VEGF, Annexin V, and glycodelin/sICAM-1 were previously developed by our group. The objective of our current study was to assess the impact of technical and biological variability on the performance of those previously developed prediction models in a technical verification and a validation setting. The technical verification cohort consisted of peripheral blood plasma samples from a subset of the patients included in the original study of Vodolazkaia et al. (99 women with and 37 women without endometriosis). The validation study was done in plasma samples of an independent patient cohort (170 women with and 86 women without endometriosis). Single immunoassays were used for CA-125, VEGF-A, sICAM-1, Annexin V, and glycodelin. Statistical analyses were done using univariate and multivariate (logistic regression) approaches. The previously reported prediction models for endometriosis had a low performance in both the technical verification and validation setting. New prediction models were developed, which included CA-125, Annexin V, and sICAM-1, but CA-125 was the only marker that was retained in the models across the technical verification and validation study. Overall, successful validation of a biomarker model depends on several factors such as patient selection, collection methods, assay selection/handling, stability of the marker, and statistical analysis and interpretation. There is a need for standardized studies in large, well-defined patient cohorts with robust assay methodologies.


Assuntos
Anexina A5/sangue , Antígeno Ca-125/sangue , Endometriose/sangue , Molécula 1 de Adesão Intercelular/sangue , Modelos Biológicos , Adulto , Biomarcadores/sangue , Feminino , Humanos
3.
Int J Gynaecol Obstet ; 147(2): 212-218, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31469423

RESUMO

OBJECTIVE: To assess the utility of hematologic, inflammatory, and immunologic biomarkers for differentiating between ovarian cancer and endometriosis. METHODS: Data were retrospectively reviewed from women diagnosed with ovarian cancer and endometriosis after ovarian cyst surgery in Zhejiang, China, 2014-2016. Serologic and hematologic biomarkers, including white blood cell count, lymphocyte count, neutrophil count, red blood cell count, hemoglobin, platelets, and D-dimer, albumin, globulin, cancer antigen 125 (CA125) and CA199 serum levels recorded pre-operatively were assessed by ROC curve and logistic regression analysis. RESULTS: Overall, 49 women were diagnosed with ovarian cancer and 192 with endometriosis. For predicting ovarian cancer, the area under the curve (AUC) was 0.96 (95% confidence interval [CI], 0.94-0.99); sensitivity, 93.2%; specificity, 87.5%) for log(D-dimer), 0.95 (95% CI, 0.91-0.98; sensitivity, 81.3%; specificity, 96.3%) for log(CA125), and 0.92 (95% CI, 0.86-0.98; sensitivity, 92.6%; specificity, 79.2%) for neutrophil-to-lymphocyte ratio (NLR). The AUC for the combination of D-dimer, NLR, and CA125 was 0.96 (95% CI, 0.94-0.99; sensitivity, 91.6%; specificity, 89.6%). CONCLUSION: Serum D-dimer, NLR, and CA125 were found to be potential diagnostic factors for ovarian cancer. Combined measurement of D-dimer, NLR, and CA125 might offer a convenient screening method.


Assuntos
Antígeno Ca-125/sangue , Carcinoma Epitelial do Ovário/sangue , Produtos de Degradação da Fibrina e do Fibrinogênio/análise , Linfócitos/metabolismo , Neutrófilos/metabolismo , Neoplasias Ovarianas/sangue , Adulto , Biomarcadores Tumorais/sangue , Carcinoma Epitelial do Ovário/diagnóstico , Carcinoma Epitelial do Ovário/epidemiologia , China/epidemiologia , Diagnóstico Diferencial , Endometriose/sangue , Endometriose/diagnóstico , Endometriose/epidemiologia , Feminino , Humanos , Contagem de Linfócitos , Linfócitos/patologia , Pessoa de Meia-Idade , Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/epidemiologia , Curva ROC , Estudos Retrospectivos , Sensibilidade e Especificidade
4.
Eur J Obstet Gynecol Reprod Biol ; 241: 77-81, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31454753

RESUMO

BACKGROUND: The presence of an endometrioma can often be accompanied by a clinical dilemma during the course of fertility treatment. The aim of this study was to evaluate anti-Müllerian hormone (AMH) levels and spontaneous pregnancy rate in infertility patients with endometriomas depending of initial AMH levels and cyst type. METHODS: This prospective cohort study included infertility patients with unilateral endometrioma (3-5 s m in diameter) aged 25-35. A total of them underwent laparoscopic cystectomy. All patients were divided into two groups due to AMH levels and cyst type during surgery. We investigated AMH levels and spontaneous pregnancy rate in 1,3 and 12 months after surgery. RESULTS: The majority of patients with normal AMH level had type II endometriomas (70%) compared with low AMH level group (30%). There were no significant differences between AMH levels in all the patients with type II endometriomas after surgery. AMH level decreased significantly at 1 month in patients with normal AMH level and type I endometriomas (P = 0.018). But at 3 months the AMH level was compared with initial parameters. Women with low AMH levels before surgery and type I cysts had a significant decrease of AMH level at 1 and at 3 months after surgery. All patients with a time interval of 6 months after surgery had the best outcomes with significantly higher pregnancy rate (PR) in patients with normal AMH level and type II cysts (P = 0.036) and with AMH less than 2 ng/ml and type I cysts (P = 0.021). The group with normal AMH level and type II endometriomas had a significantly higher ongoing cumulative PR than others (59.4%). CONCLUSIONS: Our data suggest that laparoscopic surgery could affect ovarian reserve in case of initial low AMH levels and type I of endometriomas. We believe that the good surgical technique helps to increase pregnancy rate in infertility patients with endometriomas. Good prognosis group are the infertility patients with normal AMH level and type II endometriomas.


Assuntos
Hormônio Antimülleriano/sangue , Endometriose/cirurgia , Infertilidade Feminina/sangue , Adulto , Endometriose/sangue , Feminino , Humanos , Reserva Ovariana , Gravidez , Taxa de Gravidez , Estudos Prospectivos , Adulto Jovem
5.
J Coll Physicians Surg Pak ; 29(8): 702-705, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31358086

RESUMO

OBJECTIVE: To compare the efficacy of albumin and C3 complement as serum marker for the early diagnosis of endometriosis in women of reproductive age. STUDY DESIGN: Cross-sectional comparative study. PLACE AND DURATION OF STUDY: Biochemistry Department, Islamic International Medical College, Rawalpindi, in collaboration with the Gynecology and Obstetrics Department, Pakistan Railways Hospital, Rawalpindi, from March 2017 to February 2018. METHODOLOGY: Forty-four patients with endometriosis and 44 controls of reproductive age group were enrolled for the study. Those having other comorbid systemic or endocrine diseases were excluded from the study. Levels of albumin and C3 complement were measured by using Micro Lab 300 and ELISA, respectively; and the results were compared by using SPSS version 21. groups, respectively (p=0.201). The mean serum C3 levels were 1120.9±265 µg/ml and 2241.0±293 µg/ml in the control and endometriosis patient groups, respectively (p <0.001). RESULTS: The mean serum albumin levels were 4.62±0.88 g/dl and 4.42±0.52 g/dl in the control and endometriosis Conclusion: Serum C3 complement were significantly increased in endometriosis patients but not in controls; whereas, serum albumin levels were not significantly different in endometriosis cases as compared to the controls.


Assuntos
Complemento C3/análise , Endometriose/diagnóstico , Albumina Sérica/análise , Adulto , Biomarcadores/análise , Estudos Transversais , Diagnóstico Precoce , Endometriose/sangue , Feminino , Humanos
6.
Eur J Obstet Gynecol Reprod Biol ; 240: 113-120, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31255930

RESUMO

OBJECTIVE: To establish a model for predicting revised American Society of Reproductive Medicine (rASRM) scores before endometrioma surgery based on serum anti-Müllerian hormone (AMH) level and to identify factors that might reliably predict postoperative fertility of women diagnosed with endometrioma. STUDY DESIGN: The study population was composed of 134 women with endometrioma, 58 with benign cyst, and 115 with non-ovarian lesion. Preoperative serum AMH level and clinical parameters were compared among three groups. Univariate correlation analyses and multivariate linear regression modeling with a stepwise method were performed for constructing an rASRM scores prediction model. Cox regression analysis was then used to identify predictive variables of spontaneous pregnancy following surgical treatment of endometrioma. RESULTS: Preoperative AMH level were significantly lower in the endometrioma group than in the other two groups (p < 0.001). Multivariate linear regression analysis revealed that age (ß=-0.324, p < 0.001), rASRM scores (ß=-0.298, p < 0.001) and serum CA125 level (ß=-0.176, p = 0.026) independently and negatively correlated with serum AMH level. Cox regression analysis of women with endometrioma who underwent surgical resection indicated that older age (per five-year increase, HR: 0.517; 95% CI, 0.299-0.896) and higher serum AMH level (cut-off value: >3.68 ng/ml, HR: 2.383; 95% CI, 1.093-5.197) were independent predictors for postoperative fertility. CONCLUSION: Patients with advanced staged endometriosis tended to have a lower serum AMH level while postoperative infertility was more likely to occur in older patients with a lower level of serum AMH. Thus, timely detection of AMH levels to assess the severity of ovarian endometriosis and possibility for postoperative pregnancy success is necessary to ensure that optimal medical treatment can be provided.


Assuntos
Hormônio Antimülleriano/sangue , Endometriose/sangue , Fertilidade/fisiologia , Doenças Ovarianas/sangue , Ovário/cirurgia , Adulto , Endometriose/diagnóstico , Endometriose/cirurgia , Feminino , Humanos , Doenças Ovarianas/diagnóstico , Doenças Ovarianas/cirurgia , Período Pós-Operatório , Gravidez , Prognóstico , Índice de Gravidade de Doença
7.
Eur J Obstet Gynecol Reprod Biol ; 240: 370-374, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31213335

RESUMO

OBJECTIVES: Gastrointestinal symptoms are common in endometriosis, but the mechanisms behind these symptoms are yet poorly understood. Associations between endometriosis and irritable bowel syndrome (IBS), celiac disease, and various autoimmune diseases have been reported. These diseases express characteristic autoantibodies. The aim of the current study was to investigate autoantibodies against gonadotropin-releasing hormone 1 (GnRH1) and luteinizing hormone (LH) and their receptors, tenascin-C, matrix metalloproteinase-9, deamidated gliadin peptide, and tissue transglutaminase in a cohort of women with endometriosis, compared to controls and women with IBS or enteric dysmotility. STUDY DESIGN: One hundred seventy-two women with laparoscopy-verified endometriosis completed questionnaires regarding socio-demographics, lifestyle habits, medical history, and gastrointestinal symptoms, and sera were analyzed with ELISA for the abovementioned antibodies. Healthy female blood donors (N = 100) served as controls, and women with IBS or enteric dysmotility (N = 29) were used for comparison. RESULTS: A non-significantly higher prevalence of IgM antibodies directed at tenascin-C (7.6% vs. 2.0%; p = 0.06) was the only observed difference in autoantibody levels in endometriosis compared to controls. Antibody presence was not associated with any clinical parameters. Patients with IBS or enteric dysmotility expressed higher levels of IgM antibodies against GnRH1 compared to both patients with endometriosis (p = 0.004) and healthy controls (p = 0.002), and higher levels of tenascin-C antibodies compared to healthy controls (17.2% vs. 2.0%; p = 0.006). CONCLUSIONS: Women with endometriosis do not express higher prevalence of autoantibodies found to be characteristic in other patient groups with gastrointestinal symptoms.


Assuntos
Autoanticorpos/sangue , Endometriose/imunologia , Gastroenteropatias/imunologia , Imunoglobulina M/sangue , Adulto , Estudos Transversais , Endometriose/sangue , Feminino , Gastroenteropatias/sangue , Hormônio Liberador de Gonadotropina/imunologia , Humanos , Metaloproteinase 9 da Matriz/imunologia , Pessoa de Meia-Idade , Receptores LHRH/imunologia , Inquéritos e Questionários , Tenascina/imunologia
8.
Clin Lab ; 65(5)2019 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-31115211

RESUMO

BACKGROUND: The aim of the study was to evaluate the role of human epididymal secretory protein (HE4), cancer antigen 125 (CA125), and the Risk of Ovarian Malignancy Algorithm (ROMA) in diagnosing benign pelvic masses in premenopausal women. METHODS: Serum was collected from 391 premenopausal women with benign pelvic mass prior to surgery and from 45 healthy individuals. Serum HE4 and CA125 levels and ROMA scores were evaluated separately. RESULTS: Among the 391 women with benign pelvic mass, 2.3% (9/391) had elevated HE4 levels (> 70 pmol/L), while 37.1% (145/391) had elevated CA125 levels (> 35 U/mL) (p < 0001). Endometriosis provided false-positive results for CA125 levels in more than half of the cases but resulted in no significant change for HE4 level. In 13 gravid women with a mass, 30.8% (4/13) and 38.5% (5/13) had elevated HE4 and CA125 levels, respectively; however, the difference was not significant (p > 0.05). Moreover, serum levels and patient percentages for CA125 elevation significantly increased with increase in mass diameter, whereas those for HE4 did not. CONCLUSIONS: CA125 elevation showed random results for benign pelvic masses, while HE4 elevation showed a higher specificity. Thus, serum HE4 testing is a better approach than CA125 testing for diagnosing benign pelvic masses in premenopausal women.


Assuntos
Biomarcadores Tumorais/sangue , Antígeno Ca-125/sangue , Endometriose/sangue , Proteínas de Membrana/sangue , Neoplasias Ovarianas/sangue , Pré-Menopausa/sangue , Proteínas/análise , Adolescente , Adulto , Diagnóstico Diferencial , Endometriose/diagnóstico , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias Ovarianas/diagnóstico , Curva ROC , Fatores de Risco , Adulto Jovem
9.
BMC Cancer ; 19(1): 401, 2019 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-31035965

RESUMO

BACKGROUND: Endometrial cancer (EC) is the most common malignancy of the female reproductive tract. Despite years of research, the accurate screening strategy is still not available in this disease and it is usually diagnosed only after the clinical signs are present. The recent technological advances in analytical methodologies enabled detection of multiple molecules in one, small sample of biological materials. Such approach was undertaken in the presented study. METHODS: Concentrations of aldehyde dehydrogenase 1 family, member A1 (ALDH1A1), carbonic anhydrase IX (CA9), CD44, epithelial cell adhesion molecule (EpCAM), hepsin, kallikrein-6, mesothelin, midkine, neural cell adhesion molecule L1 (L1CAM), and transglutaminase 2 (TGM2) were measured using MAGPIX®System in plasma samples of 45 EC, 20 healthy controls and 11 patients with endometriosis. RESULTS: Significantly increased concentration in EC as compared to healthy controls were found in case of CD44 (p <  0.001), EpCAM (p = 0.033) and TGM2 (p <  0.001). EpCAM and mesothelin concentrations differed based on FIGO stages. Regression analysis revealed marker panels with high accuracy in detection of EC. The highest AUC 0.937 was attributed to the 3-marker panel of CD44/TGM2/EpCAM (84% sensitivity, 100% specificity), FIGO IA samples were discriminated from more advanced stages of EC with the mesothelin/grade 1 model featuring AUC of 0.911 (95.24% sensitivity, 78.26% specificity). CONCLUSIONS: Novel plasma biomarkers presenting good accuracy in diagnosing EC were found with TGM2 reported for the first time as plasma marker. It was also revealed that endometriosis may share similarities in the pattern of markers alterations characteristic for EC.


Assuntos
Biomarcadores Tumorais/sangue , Neoplasias do Endométrio/sangue , Molécula de Adesão da Célula Epitelial/sangue , Proteínas de Ligação ao GTP/sangue , Receptores de Hialuronatos/sangue , Transglutaminases/sangue , Neoplasias do Endométrio/diagnóstico , Endometriose/sangue , Endometriose/diagnóstico , Feminino , Humanos , Modelos Logísticos , Gradação de Tumores , Estadiamento de Neoplasias , Curva ROC
10.
Neurosci Lett ; 706: 105-109, 2019 07 27.
Artigo em Inglês | MEDLINE | ID: mdl-31100426

RESUMO

Central sensitivity syndrome (CSS) consists of adaptive pathophysiological changes associated with neuroplasticity in some chronic pain disorders. It could be grouped in two main conceptual conditions: one includes those chronic pain patients without overt structural pathology such as fibromyalgia, and the other subgroup includes conditions with recognizable structural abnormalities, both somatic (osteoarthritis) and visceral (endometriosis). In order to understand the role of neuromodulators in CCS we aim to determine whether brain-derived neurotrophic factor (BDNF) and S100B are associated to specific chronic pain disorders. Serum BDNF and S100B were measured in chronic pain women with different diagnosis: 88 with osteoarthritis, 36 with endometriosis, 117 with fibromyalgia, 33 with chronic tension type headache and in 41 healthy controls. ANCOVA analysis followed by heteroscedasticity-consistent covariance matrix was performed to evaluate BDNF and S100B levels, adjusted for depression severity, pain levels and use of analgesics according different pathologies. Serum BDNF concentrations were higher and not different in patients with fibromyalgia and headache, the CSS group without structural pathology. In contrast, the concentrations of S100B were higher in patients with osteoarthritis and endometriosis, in comparison to controls, fibromyalgia and tensional headache patients. This study supports the hypothesis that BDNF and S100B neuromodulators present different serum levels according to the background disease associated to the chronic pain. These have the potential to be studied as markers of active disease or treatment evolution.


Assuntos
Fator Neurotrófico Derivado do Encéfalo/sangue , Dor Crônica/sangue , Subunidade beta da Proteína Ligante de Cálcio S100/sangue , Adulto , Biomarcadores/sangue , Estudos Transversais , Endometriose/sangue , Feminino , Fibromialgia/sangue , Humanos , Osteoartrite/sangue , Cefaleia do Tipo Tensional/sangue
11.
Wiad Lek ; 72(4): 654-656, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31055551

RESUMO

OBJECTIVE: Introduction: The work has been dedicated the study of pituitary hormone concentration in the blood of women with endometriosis-associated infertility on 2-3 days of the menstrual cycle and the day of the puncture of ovarian stimulation superovulation in the cycle. The aim of our study was to examine the concentration of pituitary hormones in the blood of women with endometriosis associated with infertility. PATIENTS AND METHODS: Materials and methods: For the purpose of the research we have conducted a special study of protein (lutropin - LH, folitropin -FSH) hormones level in the blood plasma of women with endometriosis associated with infertility, which formed the main group of 20 people. Similar studies of protein hormones level were performed in the control group, which made somatically healthy women of reproductive function preserved, whose age corresponded to the age of patients of the main group. The value of p (authenticity difference) was determined by Student's table-Fischer. Differences between contrasting averages were considered significant at p <0.05. RESULTS: Results and conclusions: Analized the results of our research stated that women with endometriosis associated with infertility 2-3 days of the menstrual cycle endocrine function of gonadotropocites anterior pituitary did not differ from that of the control group. This fact appeared to have an additional criteria for the formation of a main group. In patients with endometriosis associated with infertility found significant violation of rhythm and secretion of blood gonadotropin hormones that are proportionate to the degree of severity of the disease.


Assuntos
Endometriose/sangue , Hormônios/sangue , Infertilidade Feminina/sangue , Endometriose/complicações , Feminino , Hormônio Foliculoestimulante/sangue , Humanos , Infertilidade Feminina/etiologia , Hormônio Luteinizante/sangue , Ciclo Menstrual
12.
BJOG ; 126(9): 1176-1182, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31077531

RESUMO

OBJECTIVE: To assess the predictive value of C-reactive protein (CRP) level for early septic complications after laparoscopic bowel resection for endometriosis. DESIGN: Retrospective study using data prospectively recorded in the CIRENDO database. SETTING: University tertiary referral centre. POPULATION: Three hundred and three women managed by segmental resection or disc excision for colorectal endometriosis in 40 consecutive months. METHODS: C-reactive protein was routinely measured at postoperative days 4, 5, and 6. Bowel fistula, pelvic abscess, and pelvic infected haematoma were prospectively recorded. MAIN OUTCOME MEASURES: A receiver operating characteristic (ROC) curve was built to assess the best cut off CRP value to predict early septic complications. RESULTS: The incidence of bowel fistula and pelvic abscess/infected hematoma were 2 and 7.9%, respectively. The CRP cut-off value of 100 mg/l at postoperative day 4 predicts early septic pelvic complications (sensitivity, specificity, positive and negative predictive values of, respectively, 76, 83, 30.2, and 90.4%), and the area under the curve was 0.85 (95% CI 0.78-0.92). CONCLUSION: Postoperative CRP monitoring is useful in the prediction of early septic pelvic complications following bowel endometriosis surgery, with possible impact on the management of postoperative outcomes and hospitalisation stay. TWEETABLE ABSTRACT: Levels of CRP ≥100 mg/l at day 4 after bowel resection or excision for endometriosis are associated with early septic pelvic complications.


Assuntos
Proteína C-Reativa/análise , Colectomia/efeitos adversos , Endometriose/sangue , Laparoscopia/efeitos adversos , Complicações Pós-Operatórias/etiologia , Adulto , Colectomia/métodos , Doenças do Colo/sangue , Doenças do Colo/cirurgia , Bases de Dados Factuais , Endometriose/cirurgia , Feminino , Humanos , Laparoscopia/métodos , Valor Preditivo dos Testes , Estudos Prospectivos , Curva ROC , Doenças Retais/sangue , Doenças Retais/cirurgia , Estudos Retrospectivos , Medição de Risco/métodos , Medição de Risco/estatística & dados numéricos , Fatores de Risco , Centros de Atenção Terciária
13.
J Assist Reprod Genet ; 36(6): 1179-1184, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31020439

RESUMO

PURPOSE: To determine whether the presence of endometriosis in infertile women without prior ovarian surgery influences markers of ovarian reserve, AMH and FSH. METHODS: A retrospective cohort study included three groups of women who presented for IVF treatment at our tertiary care center from 04/27/2015 to 05/31/2017: women with endometriosis and prior ovarian surgery (EnSx), women with endometriosis without prior ovarian surgery (En), and women with a primary diagnosis of male factor infertility (MF; reference group). RESULTS: There were 671 patients that met inclusion criteria (78 EnSx, 60 En, and 533 MF). Compared to the MF group (3.6 ± 3.0), a lower mean AMH level (ng/mL) was observed in the EnSx group (2.5 ± 2.5; aß - 1.21; 95% CI [- 1.79, -0.62]) and in the En group (2.5 ± 2.2; aß - 1.11; 95% CI [- 1.68, - 0.54]). Both endometriosis groups had a statistically significantly higher proportion of patients with an AMH < 1 (EnSx, 24.4%; OR, 2.39 [95% CI, 1.31, 4.36]; En, 28.3%; OR, 2.67 [95% CI, 1.41, 5.08]) compared to the MF group (13.9%). The mean baseline FSH level (lU/L) was statistically significantly higher in both endometriosis groups (EnSx, 8.6 ± 4.3; ß, 1.37 [95% CI, 0.39, 2.34]; En, 8.4 ± 3.7; ß, 0.96 [95% CI, 0.04, 1.87]) compared to the MF group (7.3 ± 2.2). CONCLUSIONS: Among infertility patients with endometriosis, with and without a history of ovarian surgery, ovarian reserve markers were worse (lower AMH and higher FSH) and a higher proportion had decreased ovarian reserve as measured by AMH compared to women with MF.


Assuntos
Hormônio Antimülleriano/sangue , Endometriose/sangue , Infertilidade Feminina/sangue , Técnicas de Reprodução Assistida , Adulto , Endometriose/fisiopatologia , Estradiol/sangue , Feminino , Hormônio Foliculoestimulante/sangue , Humanos , Infertilidade Feminina/fisiopatologia , Reserva Ovariana/genética , Ovário/crescimento & desenvolvimento , Ovário/patologia , Gravidez
14.
Rev Assoc Med Bras (1992) ; 65(3): 336-341, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30994830

RESUMO

OBJECTIVE: Ovarian endometriosis seriously affects the quality of life of females, and long non-coding RNA lncRNA urothelial carcinoma-associated 1 (UCA1) plays pivotal roles in the pathogenesis of various ovarian diseases. However, the involvement of lncRNA UCA1 in ovarian endometriosis remains unknown to date. Therefore, the present study aims to study the role of UCA1 in ovarian endometriosis. METHODS: A total of 98 patients with ovarian endometriosis and 28 healthy females were included. The expression of lncRNA UCA1 in ectopic and eutopic endometrium tissues of ovarian endometriosis patients and controls was detected using qRT-PCR. A ROC curve analysis was performed to evaluate the diagnostic values of serum lncRNA UCA1 for ovarian endometriosis. Patients were followed up for 2 years after discharge, and the recurrence of ovarian endometriosis was recorded. RESULTS: The expression level of lncRNA UCA1 was significantly higher in ectopic endometrium tissues than in paired eutopic endometrium tissues for most of the patients. The serum lncRNA UCA1 level showed no significant correlations with either patients' age or living habits. After the treatment, the serum lncRNA UCA1 level increased, and serum levels of lncRNA UCA1 on the day of discharge were significantly lower in patients with recurrence than those in patients without recurrence. Conclusion: The downregulation of lncRNA UCA1 is involved in the pathogenesis of ovarian endometriosis and may serve as a promising diagnostic and prognostic biomarker for the disease.


Assuntos
Regulação para Baixo , Endometriose/sangue , Endometriose/diagnóstico , Doenças Ovarianas/sangue , Doenças Ovarianas/diagnóstico , RNA Longo não Codificante/sangue , Adulto , Análise de Variância , Biomarcadores/sangue , Estudos de Casos e Controles , Endometriose/genética , Endométrio/patologia , Feminino , Humanos , Doenças Ovarianas/genética , Prognóstico , RNA Longo não Codificante/genética , Reação em Cadeia da Polimerase em Tempo Real , Recidiva , Valores de Referência , Sensibilidade e Especificidade , Adulto Jovem
15.
Fertil Steril ; 111(5): 944-952.e1, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30878253

RESUMO

OBJECTIVE: To examine whether serum antimüllerian hormone (AMH) levels correlate with the size of ovarian endometrioma (OMA). DESIGN: An observational cross-sectional study. SETTING: University hospital. PATIENT(S): Two hundred and sixty-seven nonpregnant women, aged 18-42 years, with no prior history of surgery for endometriosis and a histologically documented ovarian cyst. INTERVENTION(S): Surgical management for a benign ovarian cyst. MAIN OUTCOME MEASURE(S): Correlation between serum AMH concentration and cyst size according to OMA and non-OMA benign cyst. RESULT(S): Women with OMA were compared with a control group of women who had non-OMA benign ovarian cysts. The AMH assay samples were collected less than a month before the surgery. Between January 2004 and September 2016, 148 women were allocated to the OMA group and 119 to the non-OMA benign cyst group. The AMH concentrations were not statistically significantly different between the two groups (3.7 ± 2.8 ng/mL vs. 4.1 ± 3.3 ng/mL). A multiple linear regression model accounting for potential confounders revealed that the log10 of the serum AMH concentration positively correlated with the log10 of the OMA cyst volume (R2 = 0.23; coefficient = 0.05; 95% CI, 0.007-0.10). CONCLUSION(S): In women no prior history of surgery for endometriosis, serum AMH levels increased with cyst size in cases of OMA.


Assuntos
Hormônio Antimülleriano/sangue , Endometriose/sangue , Endometriose/diagnóstico por imagem , Cistos Ovarianos/sangue , Cistos Ovarianos/diagnóstico por imagem , Adolescente , Adulto , Biomarcadores/sangue , Estudos de Coortes , Estudos Transversais , Endometriose/cirurgia , Feminino , Humanos , Cistos Ovarianos/cirurgia , Ovário/diagnóstico por imagem , Ovário/cirurgia , Adulto Jovem
16.
J Coll Physicians Surg Pak ; 29(4): 313-316, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30925951

RESUMO

OBJECTIVE: To determine the efficacy of laparoscopic surgery combined with GnRH agonist (GnRH-a) in treating infertile patients with endometriosis (EMs), and analyze its effect on the levels of serum hormones and inflammatory factors of the patients. STUDY DESIGN: An experimental study. PLACE AND DURATION OF STUDY: The Department of Urology, Zhongda Hospital, Southeast University, Jiang Su, China, from January 2015 to March 2016. METHODOLOGY: One hundred and thirty infertile patients with EMs were randomly divided into a control group and an observation group with 65 cases in each group. Patients in the control group were treated by laparoscopic surgery, while patients in the observation group were added by the subcutaneous injection of GnRH-a, based on the treatment of the control group. Therapeutic effects, recurrence rates, and pregnancy rates between two groups were compared. Moreover, the levels of serum hormones estradiol (E2), luteinizing hormone (LH), follicle stimulating hormone (FSH), inflammatory factors interleukin 17 (IL-17), interleukin 6 (IL-6), and tumor necrosis factor- (TNF-α) between two groups after treatment were compared. RESULTS: The total effective rate and pregnancy rate in the observation group were higher than those of the control group (p=0.009 and 0.002, respectively), and the recurrence rate was lower than that of the control group (p=0.008). After treatment, levels of serum E2, LH, FSH in the observation group were lower than those of the control group (all p<0.001). Levels of serum IL-17, IL-6 and TNF-α were lower than those of the control group (all p<0.001). There was no statistically significant difference in adverse reactions between the two groups (p=0.730). CONCLUSION: Laparoscopic surgery combined with GnRH-a is a more effective treatment modality in endometriosis. It can reduce the serum levels of inflammatory factors in patients, improve their hormone level and pregnancy rate, and reduce the recurrence rate.


Assuntos
Endometriose/cirurgia , Hormônio Liberador de Gonadotropina/agonistas , Infertilidade Feminina/terapia , Inflamação/tratamento farmacológico , Adulto , Endometriose/sangue , Endometriose/tratamento farmacológico , Endométrio/efeitos dos fármacos , Endométrio/patologia , Estradiol/sangue , Feminino , Hormônio Foliculoestimulante/sangue , Humanos , Infertilidade Feminina/sangue , Infertilidade Feminina/etiologia , Inflamação/sangue , Interleucina-17/sangue , Interleucina-6/sangue , Laparoscopia , Hormônio Luteinizante/sangue , Período Pós-Operatório , Gravidez , Taxa de Gravidez , Fator de Necrose Tumoral alfa
17.
Gynecol Endocrinol ; 35(6): 478-480, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30727790

RESUMO

In this case report, we present a case of false positive CA 19-9 and CA 125 levels in a patient with suspected endometriotic cysts. The patient is a 34-year-old nulliparous woman with heavy black tea consumption and elevated CA 19-9 and CA 125 levels. After discontinuation of black tea intake and careful exploration of other possible factors, CA 19-9 and CA 125 levels dropped markedly. As a conclusion, heavy black tea consumption can lead to false positive results of elevated CA 19-9 and CA 125 levels.


Assuntos
Antígeno Ca-125/sangue , Antígeno CA-19-9/sangue , Endometriose/diagnóstico , Proteínas de Membrana/sangue , Doenças Ovarianas/diagnóstico , Neoplasias Ovarianas/diagnóstico , Chá , Adulto , Biomarcadores Tumorais/sangue , Diagnóstico Diferencial , Endometriose/sangue , Endometriose/diagnóstico por imagem , Feminino , Humanos , Doenças Ovarianas/sangue , Doenças Ovarianas/diagnóstico por imagem , Neoplasias Ovarianas/sangue , Neoplasias Ovarianas/diagnóstico por imagem , Ultrassonografia
18.
Gynecol Endocrinol ; 35(6): 494-497, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30732484

RESUMO

OBJECTIVE: To investigate temporary or long-term changes of AMH after laparoscopic endometrioma cystectomy and its dependency on characteristics of endometriomas. METHODS: One hundred and seventy-one women, open-labeled prospective study; five groups divided according age ≤/> 35, uni-/bilateral, cyst ≤/> 7 cm, coagulation/suture surgery, stage III/IV; between- and within-group analyses after 1, 3, 6, and 12 months. RESULTS: After 12 months, compared to pretreament, AMH decreased significantly for patients with bilateral cysts, cyst size >7 cm and endometriosis stage IV. In the between-group analysis all comparisons were significant, with exception of the surgery type. However, this was different performing the multiple linear regression analysis suggesting lower postoperative decrease using suturing technique. This analysis also showed higher age at pretreatment and bilateral cysts as risk factor for AMH decline. CONCLUSIONS: Effects of endometrioma cystectomy on AMH are dependent on characteristics of the endometrioma, showing long-term a decrease in patients with larger, bilateral cysts and in stage IV endometriosis, but only short-time decrease in smaller, unilateral cysts and stage III which sometimes also can fully recover in AMH production within one year. In our study suture compared to coagulation surgery was protective, i.e. may lead to lower postoperative AMH decline.


Assuntos
Hormônio Antimülleriano/sangue , Endometriose/cirurgia , Procedimentos Cirúrgicos em Ginecologia/métodos , Laparoscopia/métodos , Cistos Ovarianos/cirurgia , Doenças Ovarianas/cirurgia , Adulto , Endometriose/sangue , Feminino , Humanos , Cistos Ovarianos/sangue , Doenças Ovarianas/sangue , Reserva Ovariana/fisiologia
19.
Gynecol Obstet Invest ; 84(5): 435-444, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30712043

RESUMO

OBJECTIVE: The objective of this study was to evaluate cytokines related to natural killer and T-regulatory cells in endometriotic lesions, peritoneal fluid (PF) and the peripheral blood (PB) of patients with deep infiltrative endometriosis. STUDY DESIGN: A case-control study was conducted in a tertiary referral hospital. Sixty-four consecutive patients after laparoscopy were divided into 2 groups: with endometriosis (Group A - n = 32) and without endometriosis (Group B - n = 32). MAIN OUTCOME MEASURES: Interleukin (IL)-2, IL-4, IL-7, IL-10, IL-12, IL-15, transforming growth factor ß1, and IFNγ concentration was measured using a LuminexTM multiplex suspension bead array. Tissues from endometriotic lesions of patients with endometriosis and from eutopic endometrium were evaluated, as well as PF and PB of all patients. RESULTS: Compared to the other analyzed groups, IL-15 concentration was significantly higher in the ectopic endometrium and IL-7 in the eutopic endometrium of the endometriosis group (p < 0.05). Compared to endometriosis group, IFNγ, IL-7, and IL-15 were observed to be significantly higher in the PF of the control group, and IL-10 was lower in the control group (p < 0.05). In PB, compared to endometriosis group, IL-4, IL-10, IL-12, IL-15, and IFNγ concentrations were significantly higher in the control group (p < 0.05). CONCLUSIONS: Our hypothesis is that deep endometriosis is a disease out of control. This disease's nature is of progression and invasion of adjacent structures, and proof of this disease state is the disorganized secretion of cytokine regulation and inflammation, which seem to be among the factors responsible for the maintenance of the disease.


Assuntos
Citocinas/sangue , Endometriose/sangue , Interleucina-15/sangue , Interleucina-7/sangue , Linfócitos T Reguladores/metabolismo , Adulto , Líquido Ascítico/metabolismo , Estudos de Casos e Controles , Progressão da Doença , Endometriose/cirurgia , Endométrio/metabolismo , Endométrio/cirurgia , Feminino , Humanos , Laparoscopia
20.
Int J Mol Sci ; 20(1)2019 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-30621017

RESUMO

Although endometriosis is considered an inflammatory disease, no reliable diagnostic biomarkers exist for use in clinical practice. The aim was to investigate the inflammatory profile in endometriosis using an exploratory approach of inflammation-related proteins. Patients with laparoscopy-verified endometriosis (N = 172), women with microscopic colitis (N = 50), healthy controls (N = 31), and age-matched controls from the general population (N = 100) were enrolled and questionnaires regarding socioeconomic factors, lifestyle habits, and medical history were completed. Sera from patients and healthy controls were analyzed for 92 inflammatory biomarkers using Proximity Extension Assay technology (PEA). Plasma AXIN1 levels were analyzed in patients with endometriosis and controls from the general population by ELISA. General linear model adjusted for age, Mann⁻Whitney U-test, and principal component analysis (PCA) were used for statistical calculations. Serum levels of AXIN1 and ST1A1 were increased in endometriosis compared with MC (p < 0.001) and healthy controls (p = 0.001), whereas CXCL9 levels were decreased. Plasma levels of AXIN1 were elevated in endometriosis compared with age-matched controls from the general population (30.0 (17.0⁻38.0) pg/mL vs. 19.5 (15.0⁻28.0) pg/mL, p < 0.001). PCA analysis identified four clusters of proteins, where one cluster differed between endometriosis and controls, with strong correlations for AXIN1 and ST1A1. Plasma/serum AXIN1 is an interesting biomarker to be further evaluated in endometriosis.


Assuntos
Proteína Axina/sangue , Biomarcadores/sangue , Endometriose/sangue , Adulto , Estudos de Casos e Controles , Análise Fatorial , Feminino , Trato Gastrointestinal/patologia , Humanos , Inflamação/sangue , Inflamação/patologia , Análise de Componente Principal , Curva ROC
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