Abstract
Endometriosis is a gynecological disease, the pathogenesis of which seems to be directly associated with inflammatory processes. Serum concentrations of IL-1β, IL-6, hs-CRP, IgG, YKL 40 and PRL, in comparison to the well-known CA 125 levels, were studied with the aim of identifying an additional noninvasive inflammatory marker or set of markers characteristic for endometriosis. The study group included 43 women with endometriosis (E), 35 women with benign gynecological disorders but without endometriosis (NE, non-endometriosis) as a comparative group, and a control group consisting of 18 healthy subjects (C). The serum concentrations of IL-1β, IL-6, hs-CRP, YKL-40, PRL and CA 125 were significantly higher in the E group (median values: 0.41 pg/mL, 2.42 pg/mL, 2.33 mg/L, 79.30 ng/mL, 21.88 ng/mL and 68.00 U/mL, respectively) than in the control group (median values: 0.21 pg/mL, 0.98 pg/mL, 0.52 mg/L, 49.77 ng/mL, 12.08 ng/mL and 12.20 U/mL respectively), with the significance of p = 0.011, p < 0.001, p = 0.028, p = 0.005, p < 0.001 and p < 0.001, respectively. The IgG concentrations were significantly lower in the endometriosis group (median value: 1061.21 mg/dL) as compared to healthy women (median value: 1210.50 mg/dL; p = 0.025). Significant differences in concentrations of IL-6 (p = 0.040), hs-CRP (p = 0.007) and CA 125 (p < 0.001) were observed in stage III vs. stage IV of endometriosis. Significantly higher concentrations of IL-6 (p = 0.010), hs-CRP (p = 0.037) and PRL (p < 0.001) were observed in the NE group vs. the control group. Only CA 125 concentrations were significantly higher in endometriosis patients as compared to the non-endometriosis group (p < 0.001). The proposed panel of inflammatory markers, especially IL-6, PRL and CA 125, may become a useful tool to identify women with advanced endometriosis who could qualify for treatment.
Highlights
Endometriosis is quite a common gynecological disease, which is difficult to diagnose and treat
The concentrations of IL-1β, IL-6, hsCRP, YKL-40, PRL and CA 125 were significantly higher in the E group than in the control group, with significance of p = 0.011, p < 0.001, p = 0.028, p = 0.005, p < 0.001 and p < 0.001, respectively
Significant differences were observed in the concentrations of IL-6, hs-C-reactive protein (CRP) and PRL when the non-endometriosis group was compared with the group of healthy women (p = 0.010, p = 0.037 and p < 0.001, respectively)
Summary
Endometriosis is quite a common gynecological disease, which is difficult to diagnose and treat. The common symptoms of endometriosis are dysmenorrhea, dyspareunia and back pain, as well as bladder and/or bowel problems, which may vary in degree and intensity [1]. These symptoms are usually nonspecific, which makes the clinical diagnosis of the disease very difficult [3]. Superficial peritoneal endometriosis is hard to detect with the use of non-invasive procedures [4]. Even such renowned standards for endometriosis diagnostics as laparoscopy may fail in the very early stages of the disease [5]
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