Zusammenfassung
Auch heute noch beträgt die Zeitspanne zwischen ersten Symptomen und der definitiven Diagnosestellung „Endometriose“ mittels Laparoskopie etwa 6–7 Jahre. Ein diagnostischer Test – möglichst aus peripherem Blut – scheint deshalb dringend erforderlich zu sein. Immer mehr Studien berichten erfreulicherweise über nichtinvasive Tests mit hoher Sensitivität und Spezifität. Als Marker werden hierbei u. a. folgende Parameter vorgeschlagen: CA 125, CA 19–9, IL-6, ICAM-1 und CCR-1-mRNA. Regressionsmodelle schließen auch klinische Daten wie Zykluslänge und Anzahl der Schwangerschaften neben den oben genannten Serummarkern mit ein. Der mögliche Nutzen einer nichtinvasiven diagnostischen Methode wäre eine frühere Erkennung, einfachere Operationen bei niedrigerem Endometriosestadium, geringere Rezidivraten und damit letztendlich auch eine Kostensenkung. Bis zur Etablierung eines solchen Tests bleiben uns nur die bewährten Techniken wie Anamnese, gründliche gynäkologische Untersuchung, Sonographie und letztendlich Laparoskopie zur Diagnose der Erkrankung Endometriose.
Abstract
Even today, the time-lag between the appearance of the first symptoms of endometriosis and its definitive diagnosis by laparoscopy is about 6–7 years. We seem to be in urgent need of a diagnostic test – preferably using peripheral blood. Fortunately, more and more studies are leading to reports of noninvasive tests with high sensitivity and specificity. The following parameters are suggested as markers: CA 125, CA 19–9, IL-6, ICAM-1 and CCR-1 mRNA. Regression models also use clinical data, such as length of cycle and number of pregnancies, in association with the aforementioned serum markers. The possible benefits of a noninvasive diagnostic test would be: earlier detection, easier surgery because of a less advanced stage of endometriosis and a lower recurrence rate, all combining to mean, ultimately, reduced costs. Until such a test is available, we can only continue to use the tried and tested techniques, such as medical history-taking, thorough gynaecological examination, ultrasound and finally diagnostic laparoscopy, for the diagnosis of endometriosis.
Literatur
Agic A, Xu H, Rehbein M et al. (2007) Cognate chemokine receptor 1 messenger ribonucleic acid expression in peripheral blood as a diagnostic test for endometriosis. Fertil Steril 87: 982–984
Barnhart K, Dunsmoor-Su R, Coutifaris C (2002) Effect of endometriosis on in vitro fertilization. Fertil Steril 77: 1148–1155
Bedaiwy MA, Falcone T (2004) Laboratory testing for endometriosis. Clin Chim Acta 340: 41–56
Brosens I, Puttemans P, Campo R et al. (2003) Non-invasive methods of diagnosis of endometriosis. Curr Opin Obstet Gynecol 15: 519–522
Colacurci N, Fortunato N, De Franciscis P et al. (1996) Serum and peritoneal CA-125 levels as diagnostic test for endometriosis. Eur J Obstet Gynecol Reprod Biol 66: 41–43
Cramer DW, Missmer SA (2002) The epidemiology of endometriosis. Ann N Y Acad Sci 955: 11–22
Eskenazi B, Warner ML (1997) Epidemiology of endometriosis. Obstet Gynecol Clin North Am 24: 235–258
Gagne D, Rivard M, Page M et al. (2003) Development of a nonsurgical diagnostic tool for endometriosis based on the detection of endometrial leukocyte subsets and serum CA-125 levels. Fertil Steril 80: 876–885
Harada T, Kubota T, Aso T (2002) Usefulness of CA19–9 versus CA125 for the diagnosis of endometriosis. Fertil Steril 78: 733–739
Husby GK, Haugen RS, Moen MH (2003) Diagnostic delay in women with pain and endometriosis. Acta Obstet Gynecol Scand 82: 649–653
Kennedy S, Bergqvist A, Chapron C et al. (2005) ESHRE guideline for the diagnosis and treatment of endometriosis. Hum Reprod 20: 2698–2704
Koninckx PR, Meuleman C, Oosterlynck D, Cornillie FJ (1996) Diagnosis of deep endometriosis by clinical examination during menstruation and plasma CA-125 concentration. Fertil Steril 75: 1042–1044
Laufer MR, Goitein L, Bush M et al. (1997) Prevalence of endometriosis in adolescent girls with chronic pelvic pain not responding to conventional therapy. J Pediatr Adolesc Gynecol 10: 199–202
Mahmood TA, Templeton A (1991) Prevalence and genesis of endometriosis. Hum Reprod 6: 544–549
Mol BW, Bayram N, Lijmer JG et al. (1998) The performance of CA-125 measurement in the detection of endometriosis: a meta-analysis. Fertil Steril 70: 1101–1108
Sangi-Haghpeykar H, Poindexter AN III (1995) Epidemiology of endometriosis among parous women. Obstet Gynecol 85: 983–992
Somigliana E, Vigano P, Tirelli AS et al. (2004) Use of the concomitant serum dosage of CA-125, CA 19–9 and interleukin-6 to detect the presence of endometriosis. Results from a series of reproduction age women undergoing laparoscopic surgery for benign gynaecological conditions. Hum Reprod 19: 1871–1876
Somigliana E, Vigano P, Candiani M et al. (2002) Use of serum-soluble intercellular adhesion molecule-1 as a new marker of endometriosis. Fertil Steril 5: 1028–1031
Velebil P, Wingo PA, Xia Z et al. (1995) Rate of hospitalization for gynecologic disorders among reproductive-age women in the United States. Obstet Gynecol 86: 764–769
Vigano P, Somigliana E, Matrone R et al. (2000) Serum leptin concentrations in endometriosis. J Clin Endocrinol Metab 87: 1085–1087
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Agic, A., Djalali, S., Dogan, S. et al. Diagnostische Tests für Endometriosis. Gynäkologe 40, 527–531 (2007). https://doi.org/10.1007/s00129-007-2010-y
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DOI: https://doi.org/10.1007/s00129-007-2010-y