Non-invasive Diagnosis Of Endometriosis Research Articles

The role of mir-214-5p and mir-548-5p expressions in endometriosis.

Endometriosis is a benign gynecological disease that affects about 1% of all women and up to 15% of women of childbearing age. To date, none of the proposed theories exhaustively explain the pathophysiology of the disease or the associated clinical manifestations. As part of efforts to introduce new methods for the early and non-invasive diagnosis of endometriosis, this project investigated changes in the expression of miR-214-5p and miR-548-5p in ectopic and eutopic tissue compared to normal endometrial tissue. Forty-five samples (15 eutopic, 15 ectopic and 15 healthy controls) from women referred to Shahid Sadoughi Hospital (Yazd, Iran). RNA extraction was performed using an RNA extraction kit, and cDNA was synthesized. Two-step qRT-PCR was performed according to the manufacturer's instructions. GraphPad Prism 8 software and Two-Way ANOVA test were used to compare fold-change expression. The results indicate a significant down-regulation of miR-214-5p expression levels (P-value < 0.05) and an increase in miR-548-5p expression levels (P-value < 0.05) in endometriosis samples compared to those in control tissues. miR-214-5p and miR-548-5p may regulate the pathogenesis of endometriosis. The down-regulation of miR-214-5p in people with endometriosis compared to healthy individuals may indicate its suppressive role. The upregulation of miR-548-5p could confirm the oncogenic role of this microRNA in endometriosis. The development of new therapeutic strategies targeting these miRNAs could be promising in the treatment of this disease.

Endometriosis biomarkers of the disease: an update.

Endometriosis is a complex benign gynaecologic condition with heterogenous presentations and a large impact on the global healthcare system and on the quality of life for millions of women. Currently, the gold standard for diagnosis involves direct visualization of lesions during surgery confirmed by histopathological diagnosis, resulting in an average delay in its initial diagnosis of 8-10 years. Therefore, the search for noninvasive diagnostic testing options has been subject to a large body of research. Multiple potential biomarkers have been explored for noninvasive testing for endometriosis, including glycoproteins, inflammatory cytokines, immunological molecules, angiogenesis markers, hormones, micro RNAs (miRNAs), proteomics, metabolomics, genomics and the microbiome. Although there are challenges to consider, areas for real promise and advancement in the noninvasive diagnosis of endometriosis are currently being explored with real promise in the area of miRNAs, proteomics, metabolomics, genomics and the microbiome.

Non-invasive diagnosis and non-surgical treatment of endometriosis: A review

Endometriosis is a hormone-dependent condition occurring in women of predominantly reproductive age. It has an extremely diverse localization, clinical course and outcomes. The need for organ-sparing treatment to preserve and/or restore fertility, the negative effects of radical surgery for endometriosis on ovarian reserve and the effectiveness of assisted reproductive technologies, and the benign nature of the disease, which tends to self-limitation after menopause, lead to the search for effective methods of non-surgical treatment and the need for noninvasive diagnosis of endometriosis. The article presents the current principles of non-surgical management of patients with endometriosis.

P–340 Novel non-invasive diagnostic options for endometriosis - based on glycome analysis

Abstract Study question Could glycosylation changes on serum and/or urine glycoproteins be suitable biomarkers for the non-invasive diagnosis of endometriosis? Summary answer The glycosylation pattern on serum and urine glycoproteins differed significantly in endometriosis patients compared to controls, suggesting a novel role as biomarkers of the disease. What is known already There is little published on endometriosis and glycosylation, and most of the studies are conducted with tissue or peritoneal fluid samples, collected by invasive means. An Iraqi study draws attention to the importance of serum sialylation, which is dramatically changed in endometriosis patients after zoladex therapy, indicating that changes in serum sialylation may be a new biomarker of the disease. While glycosylation of urine in endometriosis has not been studied so far, in a study of endometrial cancer, the urinary level of two glycoproteins was significantly increased in the patients compared to the control group. Study design, size, duration This was a prospective study. In this basic research project, serum and urine samples were collected for glycome analysis in women with and without endometriosis, as diagnosed at laparoscopy. Glycated haemoglobin (HbA1c), fasting glucose levels as well as hormone levels were also collected from the patients to link our glycomic findings with metabolic and hormone profiles. The study was approved by the Research and Ethics Committee of the National Maternity Hospital, Dublin (EC19.2018). Participants/materials, setting, methods Samples from 24 cases of endometriosis (patients without previous anti-inflammatory or hormonal therapy, endometriosis was confirmed by laparoscopy) and 27 control patients (patients without endometriosis) were processed to analyse N-glycans (total serum), urine glycoproteins, and IgG. The pre-processed, PNGase F-digested serum and urine samples were labelled with fluorescent tag and then analysed by mass spectrometry, ultra-performance liquid chromatography (UPLC) in combination with exoglycosidase digestions and Glycostore (https://glycostore.org/). Main results and the role of chance Glycosylation on total serum and urine glycoproteins and IgG was investigated and differed in endometriosis compared to controls. The N-glycome from the total glycoproteins in serum and urine was also different. The proportion of the galactosylation and sialylation differed between urine and serum IgG and these alterations have an impact on the IgG function. Our preliminary data indicate, that there is an increase in alpha 2–3 sialylation, galactosylation, and fucosylation on urine glycans from endometriosis patients compared to the control pool. Urine is a good source of biomarkers as it can be collected non-invasively. Our group is the first to have developed a protocol for the recovery of N-glycans in urine and to have identified the total N-glycome in urine. The urine N-glycome contains mostly complex N-glycans and also some oligomannosylated and hybrid glycans. Our results may lead to non-invasive biomarkers for the diagnosis of endometriosis and the monitoring of the disease. Limitations, reasons for caution The number of participants involved in this basic research is low but this is a pilot study. A larger, validation study, is warranted in the future. Furthermore, the follow-up of treated patients also would be an interesting field of research. Wider implications of the findings: Glycomics may be a potent source of biomarkers of endometriosis, with a number of glyco-biomarkers already approved by the FDA. Endometriosis-associated glycomic profiles from serum and/or urine glycoproteins may represent viable targets for development of innovative non-invasive or minimally invasive diagnostics in this debilitating disease. Trial registration number Not applicable

P–343 Identification of circulating leukocyte microRNA–125b and microRNA–142–3p expression profiles in women with endometriosis before surgery and at 1 month after surgery

Abstract Study question To investigate the expression profiles of microRNA–125b and micrpRNA–142–3p in women with endometriosis, compared with controls before surgery and at 1 month after surgery. Summary answer The over-expression of miRNA–125b and miRNA–142–3p may be involved in the aetiopathogenesis of endometriosis which is related to systemic chronic inflammation. What is known already Currently, there is no reliable non-invasive diagnostic biomarker for endometriosis. MicroRNAs (miRs) are small, non-coding RNAs that are involved in the post-transcriptional regulation of gene expression and promising biomarker candidates for noninvasive diagnosis of various diseases. Despite the small number of studies found that miRNA–125b and miRNA–142–3p have been associated with endometriosis, further evidence is therefore required from studies that examine these two miRNAs in diagnosis and even follow-up of women with endometriosis. Owing to endometriosis is a systemic chronic inflammatory disease, investigating these miRs in blood leukocytes of patients with endometriosis may illustrates the molecular mechanism of endometriosis. Study design, size, duration This is a prospective longitudinal study performed between 2018 November and 2021 February. The sample size of 42 individuals of two groups were calculated considering the power analysis (α = 0.05) with Mann-Whitney U test (effect size,d=0.8) and were calculated as 80%. Women with endometriosis (n = 21) and surgically confirmed endometriosis-free women (n = 21) were included in the study. Laparoscopy and/or laparotomy was performed to determine the presence or absence of endometriosis. Participants/materials, setting, methods Women aged 18–50 years were recruited from two tertiary hospital settings. Severity of endometriosis was assessed by the rASRM classification. Using real-time quantitative PCR, miRNA–125b and miRNA–142–3p in leukocyte were analyzed in women with endometriosis before surgery and at 1 month after surgery, compared to controls without endometriosis. The results were calculated as relative quantification values. The presumed targets of these two miRNAs were identified via 3 different target prediction algorithms:TargetScan, miRDB and DIANA-TarBase. Main results and the role of chance There were no demographic discrepancies between groups. The relative expression of miRNA–125b and miRNA–142–3p were significantly higher in women with endometriosis than in control subjects before surgery (p = 0.0001;p=0001) and at 1 month after surgery, respectively (p = 0.0001;p=0001). Despite the relative expression of miRNA–125b and miRNA–142–3p were decreased 1.75- and 2.4-fold, respectively at 1 month after surgery, we observed no significant differences in the relative expression of miRNA–125b and miRNA–142–3p between before surgery and at 1 month after surgery, respectively (p = 0.110; p = 0.910). Bioinformatic analyses of three databases showed that miRNA–142–3p expression levels were found to be closely associated with fifty-seven genes. Among these target genes, CFL2, RGL2, WASL, CRK, BNC2, CLOCK, TGFBR1, CIITA and ZNF217 were found to be associated with endometriosis. Whereas, no target gene were observed to be associated with miRNA–125b expression in common with these three databases. The ROC curves showed that the expression of miRNA–125b and microRNA–142–3p had an area under the ROC curve (AUC) of 0.77 (sensitivity 61.9%, specificity 88.1% (0.0001;95%CI 0.65–0.90)) and AUC of 0.71 (sensitivity 52.4%, specificity 73.8% (p &amp;lt; 0.007;95%CI 0.58–0.84)) before surgery, respectively. Correlational analysis showed a significant positive correlation between miRNA–142–3p and Hemoglobin A1c (Spearman’s correlation, r = 0.507;p=0.019) in the endometriosis group. Limitations, reasons for caution Further studies are needed to examine the expression of these miRs with a long-term follow up in order to increase their usefulness as a predictor in the clinical practice. It is required to identify the expressions levels of predicted target genes which are associated with endometriosis and regulated by miRNA–142–3p. Wider implications of the findings: Findings suggest that the over-expression of miRNA–125b and miRNA–142–3p may be potential mechanisms involved in the etiopathogenesis of endometriosis which is a systemic chronic inflammatory disease. We observed that miRNA–125b may be a more reliable biomarker than miRNA–142–3 for noninvasive diagnosis of endometriosis and even follow-up of women with endometriosis. Trial registration number 118S298

Non-invasive diagnostics of endometriosis: review of modern biomarkers of peripheral blood and endometrium

Endometriosis is a chronic progressing estrogen-dependent disease with a high incidence among females characterized by pelvic pain (40-80%) and infertility (25-80%).&#x0D; Aim. To analyze and estimate the modern literature data on the possibility of using potential biomarkers of endometriosis in its non-invasive diagnostics.&#x0D; In recent years, researchers have made significant advances in understanding the disease-specific molecular pathways that regulate the development of ectopic foci of endometriosis, by examining the blood, peritoneal fluid, and eutopic endometrium in women with the disease. Along with understanding the pathophysiology of endometriosis, the question of finding an adequate biomarker that will provide an effective early non-invasive diagnosis of endometriosis and, accordingly, preserve the reproductive health of millions of women, remains relevant.&#x0D; Conclusion. Most reasonable in diagnostics of endometriosis is a combination of different biomarkers that also minimizes false positive and negative results in differential diagnosis.

Non-invasive diagnosis of endometriosis and moderate-severe endometriosis with serum CA125, endocan, YKL-40, and copeptin quadruple panel

Considering the complex pathogenesis of endometriosis, which is associated with many cellular or molecular processes, such as proliferation, angiogenesis, inflammation, we evaluated the diagnostic value of a quadruple panel of serum markers CA125, endocan, YKL-40 and copeptin, for the prediction of endometriosis and moderate – severe endometriosis. Seventy women with endometriosis and 70 women without endometriosis were evaluated. Serum CA125, endocan, copeptin and YKL-40 levels were significantly increased in women with endometriosis compared to the women without endometriosis and in the minimal – mild endometriosis group compared to the no-endometriosis group. YKL-40, endocan and copeptin levels were significantly increased in the moderate – severe endometriosis group compared to the mild –moderate endometriosis group but the difference in CA125 levels remained non-significant. The quadruple panel score had an AUC of 0.954, a sensitivity of 96.5% and specificity of 84.6% for prediction of moderate – severe endometriosis. Zero or one positive marker had a sensitivity of 91.4% and specificity of 88.57% to rule out endometriosis. In conclusion, a quadruple panel of serum markers-CA125, endocan, YKL-40, and copeptin may be beneficial for the diagnosis of endometriosis and especially moderate – severe endometriosis. Further studies are needed to prove the efficacy of this panel. Impact statement What is already known on this subject? Many serum markers including CA125 have been investigated so far and suggested to be associated with endometriosis. However, none of these markers is sensitive and specific enough to diagnose endometriosis. What do the results of this study add? A quadruple panel score (CA125, endocan, YKL-4 and copeptin) had an AUC of 0.954, a sensitivity of 96.5% and specificity of 84.6% for prediction of moderate – severe endometriosis. What are the implications of these findings for clinical practice and/or further research? A high score may be beneficial to warn the surgeon about the risk of moderate to severe endometriosis if the patient will be operated anyway. A negative test of the quadruple panel may show high odds that there is no endometriosis which may prevent unnecessary surgery.

Autoimmune Markers for Non-Invasive Diagnosis of Endometriosis in Women

Autoimmune Markers for Non-Invasive Diagnosis of Endometriosis in Women

Positron emission tomography imaging of vascular endothelial growth factor with 64Cu-labeled bevacizumab for non-invasive diagnosis of endometriosis

Introduction: Non-invasive diagnosis of endometriosis remains challenging. A promising approach for diagnosing endometriosis is the molecular imaging of vascular endothelial growth factor because angiogenesis plays a role in the establishment of endometriosis. This study aimed to evaluate the potential of copper-64-labeled bevacizumab, an anti–vascular endothelial growth factor antibody, for endometriosis imaging. Methods: Mouse endometriosis model was prepared by autologous transplantation. The vascular endothelial growth factor expression was evaluated by immunohistochemical staining. Biodistribution study and positron emission tomography imaging were performed at 1, 24, and 48 h after the injection of radiolabeled bevacizumab. Results: The immunohistochemical staining revealed that vascular endothelial growth factor is expressed around the stroma and glandular epithelial cells in the endometriosis lesion. The biodistribution study showed a high uptake of indium-111 bevacizumab in the endometriosis lesion. Positron emission tomography imaging with copper-64-labeled bevacizumab clearly visualized the endometriosis lesions at 24 and 48 h after injection. Conclusion: These results indicate the potential usefulness of copper-64-labeled bevacizumab for endometriosis imaging.

Non-invasive diagnosis of endometriosis: using machine learning instead of the operating room

Non-invasive diagnosis of endometriosis: using machine learning instead of the operating room

Proteomics in the Diagnosis of Endometriosis: Opportunities and Challenges.

The non-surgical diagnosis of endometriosis is still challenging for the clinician. Ultrasonography and magnetic resonance imaging can be used to diagnose ovarian endometriotic cysts and deep infiltrating endometriosis; but their performance is poor in the diagnosis of initial stages of endometriosis. CA-125 and other serum markers (such as CA 19-9, serum protein PP14, interleukins, and angiogenetic factors) have been measured in women with endometriosis but they are not reliable for the diagnosis of the disease. Although several studies used proteomics technologies to identify plasmatic markers of endometriosis, the non-invasive diagnosis of endometriosis is far from being achieved. In this issue, Manousopoulou etal. compare the integrated quantitative proteomic profile of eutopic endometrium and serum of women with endometriosis and controls. 1214 proteins are differentially expressed in the eutopic endometrium and 404 proteins in the serum of the two study groups. 21 proteins are aberrantly expressed in both eutopic endometrium and serum of women with endometriosis. More work is needed to assess if the differentially expressed proteins identified in this study can be used as clinical markers of endometriosis.

Estimation of TLR-4 and Cytokines Levels (Interleukin-1 Beta, Interleukin-8, and Tumor Necrosis Factor) in Serum and Peritoneal Fluid of Endometriosis Women

Many women have a delay in diagnosis of endometriosis; an important factor that contributes to the diagnostic delay is the lack of noninvasive methods for detecting the disease. The aim of this study was to evaluate the levels of IL-1β, IL-8, TNF-α, and TLR-4 in serum and peritoneal fluid (PF) of women with endometriosis. The case group comprised of 30 women with endometriosis who newly diagnosed (admitted to the Gynecology Department of Al-Emamain Al-Kademian Medical City, Al-Zahraa teaching hospital and Al-kut hospital of pediatric and obstetric) and 30 control group during the period from November 2016 to November 2017. The four biomarkers were measured by using ELISA. Endometriosis patients had significantly higher serum and PF concentrations of the four biomarkers compared to controls. These results may indicate the potential role of these biomarkers in non-invasive diagnosis of endometriosis.

MOLECULAR MECHANISMS OF FORMATION OF CHRONIC PELVIC PAIN SYNDROME IN PATIENTS WITH EXTERNAL GENITAL ENDOMETRIOSIS: MARKERS AND TARGETS FOR DIAGNOSIS AND THERAPY (REVIEW)

This article systematizes the results of studies on the pathogenetic mechanisms of CPPS formation in patients with EGE. Pain is one of the severe clinical manifestations and complications of endometriosis. To ease the pain in patients with EGE is complex but urgent task. Long diagnostic search (mean period 5−8 years) leads to the formation of a persistent Autonomous pain syndrome associated with relapses of pain even after a com-prehensive treatment of patients (surgical and/or long-term hormonal). Patients with endometriosis suffer from mixed pain including neuropathic and nociceptive components which is proved by the example of expression in ectopic foci of specific biomarkers. Therefore, the question of early non-invasive diagnosis of endometriosis is very vital and can be solved by the development of a diagnostic panel consisting of biomarkers expressed by ectopic foci at the initial stage of the disease.

83 - Comparative Analysis of Lipid Composition of Peritoneal Fluid and Blood Plasma in Patients with Endometriosis and Uterine Myoma

Study Objective: To improve the non invasive diagnosis of endometriosis using direct mass spectrometry.

Cervical mucus proteome in endometriosis

BackgroundEndometriosis is a chronic gynecological inflammatory disease characterized by the presence of functional endometrial glands and stroma outside of the uterine cavity. It affects 7–10% of women of reproductive age and up to 50% of women with infertility. The current gold standard for the diagnosis combines laparoscopic evaluation and biopsy of the visualized lesions. However, laparoscopy requires general anesthesia and developed surgical skills and it has a high procedural cost. In addition, it is associated with the risk, although rare, of potential intraoperative or postoperative complications. To date, several noninvasive biomarkers have been proposed; however, no definite diagnostic biomarker is yet available. The aim of this study was to characterize the CM proteome in patients with endometriosis using high resolution mass spectrometry—based proteomics, implemented by bioinformatic tools for quantitative analysis, in order to investigate the pathophysiological mechanisms of endometriosis.MethodsCervical mucus samples were collected from patients affected by endometriosis and fertile controls. An aliquot of the soluble acidic fraction of each cervical mucus sample, corresponding to 0.5 mg of total protein, was left to digest with sequencing grade modified porcine trypsin. The peptides were analyzed by LC–MS/MS on a high resolution Orbitrap Elite mass spectrometer and data were evaluated using bioinformatic tools.ResultsWe aimed at the first total profiling of the cervical mucus proteome in endometriosis. From the list of identified proteins, we detected a number of differentially expressed proteins, including some functionally significant proteins. Six proteins were quantitatively increased in endometriosis, almost all being involved in the inflammatory pattern. Nine proteins were quantitatively reduced in endometriosis, including some proteins related with local innate immunity (CRISP-3 and Pglyrp1) and protection against oxidative stress (HSPB1). Fifteen proteins were not detected in endometriosis samples including certain proteins involved in antimicrobial activity (SLURP1 and KLK13) and related to seminal plasma liquefaction and male fertility (KLK13).ConclusionsThis is the first application of high resolution mass spectrometry—based proteomics aimed in detecting an array of proteins in CM to be proposed for the noninvasive diagnosis of endometriosis. This chronic disease presents in CM an inflammatory protein pattern.

Non-invasive diagnosis of endometriosis, a revolutionary step in reproductive endocrinology

Non-invasive diagnosis of endometriosis, a revolutionary step in reproductive endocrinology

Analysis of Serum microRNA Profile by Solexa Sequencing in Women With Endometriosis

The potential roles of serum microRNAs (miRNAs), as biomarkers, in noninvasive diagnosis of endometriosis have been reported by microarray analysis. However, microarray analysis cannot perform well in outcome accuracy and repeatability and is not suitable to be used for exploring new targets. Here, Solexa sequencing, a wide and precise method, was adopted to further analyze the serum miRNAs profile in endometriosis, which may offer more evidence to apply serum miRNAs as biomarkers in diagnosis of endometriosis. Serum samples were collected from 30 patients with minimal-mild endometriosis and 20 women without endometriosis as control. Expression of serum miRNAs was measured by Solexa sequencing and validated by quantitative real-time polymerase chain reaction (qPCR). Solexa sequencing showed 93.63% clean readouts for all small RNAs in the serum of patients with endometriosis and controls. A total of 108 miRNAs were found to be differentially expressed in the serum of patients with endometriosis by deep sequencing, compared to controls. Among them, 98 miRNAs were significantly downregulated, while 10 miRNAs were significantly upregulated. Only 21 of 98 significantly downregulated miRNAs, and none of significantly upregulated miRNAs were reported in published literatures, which may be due to the differences in samples and analytical methods. The Solexa sequencing results were consequently validated by qPCR in additional samples. Some miRNAs were identified to be promising diagnostic markers of endometriosis. The functional annotation of target genes revealed by Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses indicated that a majority of differential miRNAs might be involved in endometriosis. Circulating miRNAs may be useful as detection biomarkers for the early diagnosis of minimal-mild endometriosis.

New Horizons in the Etiopathogenesis and Non-Invasive Diagnosis of Endometriosis.

Endometriosis is one of the most common gynecological inflammatory diseases, occurring in adolescents and women in the reproductive age group and leading to infertility. The precise etiopathogenesis of endometriosis is unknown, but several theories concerning the phenomena involved in its development have been proposed. Beside classic retrograde menstruation, these include lymphatic and vascular metastases, iatrogenic direct implantation, coelomic metaplasia, embryonic remnants and mesenchymal cell differentiation or induction; the persistence of a form of embryonic endometriosis may also be involved, as well as the theory of the possible role of endometrial stem/progenitor cells. This paper deals with other risk factors which may be potentially involved in the etiopathogenesis of endometriosis, including the immune, inflammatory, endocrine, genetic, anatomical and environmental factors. At present, endometriosis can only be diagnosed with surgery, where laparoscopy is considered a gold standard. Therefore, there is an urgent need for a test allowing to detect non-invasive molecular biomarkers to identify the symptoms of endometriosis early on in disease development. A thorough understanding of the etiopathogenesis of endometriosis is essential toward the development of novel diagnostic assays and effective treatments of the disease.

Interobserver agreement of non-invasive diagnosis of endometriosis by transvaginal sonography (TVS)

Interobserver agreement of non-invasive diagnosis of endometriosis by transvaginal sonography (TVS)

Identification and validation of novel serum markers for early diagnosis of endometriosis

Non-invasive diagnosis of endometriosis is urgently required to prevent the long delay between the onset of symptoms and diagnosis. A biomarker that possesses both high sensitivity and specificity is greatly required. Here, we describe the use of a proteomic approach to identify potential novel endometrial antigens using sera from endometriosis patients and healthy controls, with evaluation of biomarkers for non-invasive diagnosis of endometriosis. A cross-sectional study was conducted to identify specific endometrial antigens using 1D and 2D western blots in women with early endometriosis (n = 17), advanced endometriosis (n = 23) and without endometriosis (n = 30). Five immunoreactive spots were analyzed using matrix-assisted laser desorption/ionization-time-of-flight/mass spectrometry with MASCOT analysis. ELISAs were established for specific epitopes and autoantibody titres were estimated in an independent cohort comprising women with early endometriosis (n = 18), advanced endometriosis (n = 32) and without endometriosis (n = 27) for validation. The 2D western blot analysis resulted in the identification of three endometrial antigens, tropomyosin 3 (TPM3), stomatin-like protein 2 (SLP2) and tropomodulin 3 (TMOD3). Serum levels of antibodies against the epitopes from the immunodominant region of proteins TPM3, SLP2 and TMOD3 were significantly elevated in endometriosis patients when compared with controls. Sensitivity and specificity of serum anti-TPM3a-autoAb (61%, 93%), anti-TPM3c-autoAb (44%, 93%), anti-TPM3d-autoAb (78%, 89%), anti-SLP2a-autoAb (50%, 96%), anti-SLP2c-autoAb (61%, 93%), anti-TMOD3b-autoAb (61%, 96%), serum anti-TMOD3c-autoAb (78%, 93%) and anti-TMOD3d-autoAb (78%, 96%) were better than those of serum CA125 levels (21%, 89%) in the detection of early stages of endometriosis. Serum anti-TPM3a-autoAb, anti-TPM3c-autoAb, anti-TPM3d-autoAb, anti-SLP2a-autoAb, anti-SLP2c-autoAb, anti-TMOD3b-autoAb, anti-TMOD3c-autoAb and anti-TMOD3d-autoAb could be new markers for the early diagnosis of endometriosis.