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Panel of Autoimmune Markers for Noninvasive Diagnosis of Minimal-Mild Endometriosis: A Multicenter Study

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Abstract

Endometriosis, characterized by the presence of endometrial-like tissue at extrauterine sites, is a common, chronic, estrogen-dependent, inflammatory condition associated with pelvic pain, subfertility, dysmenorrhea, and dyspareunia, affecting about 10% of reproductive-age women in any population. The diagnosis of endometriosis is usually delayed on an average by 8 to 11 years leading to significant consequences in terms of disease progression. The current study was aimed to validate enzyme-linked immunosorbent assay based on the epitopes of stomatin-like protein 2, tropomodulin 3 (TMOD3), and tropomyosin 3 (TPM3) for diagnosis of minimal-mild endometriosis (revised American Fertility Society Classification (rAFS) stage I-II) and to compare the performance with the reported markers: cancer antigen (CA) 125, CA19-9, α-enolase, Serine/threonine-protein kinase (PDIK1L), and syntaxin 5. This was a cross-sectional, multicenter study conducted during the year 2012 to 2015. Women with minimal-mild endometriosis (rAFS stage I-II [n = 133]) and healthy controls (n = 104) were screened for 11 novel autoimmune markers and reported markers α-enolase, PDIK1L, syntaxin 5, CA-125, and CA19-9. The sensitivity and diagnostic accuracy of serum antibodies against all the 11 epitopes were higher than that of CA-125, CA19-9, α-enolase, PDIK1L, and syntaxin 5 for diagnosis of rAFS stage I to II endometriosis. The sensitivity of 6 biomarkers (anti-TMOD3b-autoAb, anti-TMOD3c-autoAb, anti-TMOD3d-autoAb, anti-TPM3a-autoAb, anti-TPM3c-autoAb, and anti-TPM3d-autoAb) was higher at the specificity of ≥80% for diagnosis of rAFS stage I to II endometriosis as well as ultrasound-negative endometriosis. Further, logistic regression models of this panel of biomarkers showed increase in sensitivity, specificity, and diagnostic accuracy than individual biomarkers. The panel of 6 autoimmune biomarkers could be useful in setting up of noninvasive diagnostic test for detection of minimal-mild endometriosis.

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Authors and Affiliations

  1. Department of Clinical Research, National Institute for Research in Reproductive Health, Indian Council of Medical Research, J. M. Street, Parel, 400 012, Mumbai, India

    Rahul Gajbhiye MBBS, PhD, Trupti Bendigeri MSc, Arun Ghuge MSc, MPhil, Kashmira Bhusane MSc & Shagufta Khan PhD

  2. Department of Biostatistics, National Institute for Research in Reproductive Health, Indian Council of Medical Research, Mumbai, India

    Shahina Begum PhD

  3. Sanjivani Diagnostic Centre and General Maternity Home, Mumbai, India

    Neeta Warty MD & Raj Sawant MD

  4. Dr Kedar’s Maternity, Infertility, and Surgical Hospital, Endoscopy and IVF Center, Goa, India

    Kedar Padte MD

  5. Department of Obstetrics and Gynecology, Government Medical College, Nagpur, Maharashtra, India

    Anil Humane DGO, DNB

  6. Spectrum Clinic and Endoscopy Research Institute, Kolkata, West Bengal, India

    Pramathes Dasmahapatra MD

  7. Department of Obstetrics and Gynecology, Seth G. S. Medical College and King Edward Memorial Hospital, Mumbai, India

    Anahita Chauhan MD

Authors
  1. Rahul Gajbhiye MBBS, PhD
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  2. Trupti Bendigeri MSc
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  3. Arun Ghuge MSc, MPhil
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  4. Kashmira Bhusane MSc
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  5. Shahina Begum PhD
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  6. Neeta Warty MD
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  7. Raj Sawant MD
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  9. Anil Humane DGO, DNB
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  11. Anahita Chauhan MD
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  12. Shagufta Khan PhD
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Corresponding author

Correspondence to Rahul Gajbhiye MBBS, PhD.

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Gajbhiye, R., Bendigeri, T., Ghuge, A. et al. Panel of Autoimmune Markers for Noninvasive Diagnosis of Minimal-Mild Endometriosis: A Multicenter Study. Reprod. Sci. 24, 413–420 (2017). https://doi.org/10.1177/1933719116657190

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