| Endometriosis (EMT) is a common gynecological disease of women of childbearing period, the main clinical manifestations are dysmenorrheal, chronic pelvic pain, algopareunia, abnormal menstruation and infertility. It affects the health and quality of life of women severely. Its incidence rate gradually increases in recent years. The diagonisis of EMT is still a thorny issue currently. Laparoscopy is the gold standard for the diagnosis of EMT. But it is high-cost invasive inspection, and easily misses small, non-specific and extraperitoneal diseases. So it is not yet universal as a routine diagnostic tool. For the past few years, looking for a simple, minimally invasive, low-cost method of diagnosis has become a research focus.Cancer antigen 125 (CA125) is one of the first tumor associated antigen used to diagnose EMT. It has some diagnostic value for EMT, but the diagnostic specificity and sensitivity are low. Therefore CA125 has never been as a separate indicator for the diagnosis of EMT.Anti-transferrin antibody (TFAb) is a kind of IgG antibody that is found in blood serum of the patients with EMT, and can easily bind a kind of antigen in endometrial leaching solution. TFAb has high diagnostic specificity for EMT, but the follow-up study is few, so TFAb has not been used in the diagnosis of EMT.ObjectiveIn order to find some higher sensitivity and specificity of serum and (or) peritoneal fluid markers for the diagnosis of EMT, we determined the expressions of CA125 and TFAb in blood serum and peritoneal fluid of patients with EMT and analyzed the diagnostic value for EMT.Materials and Methods52 patients with EMT (stage I 7 cases and stage II 18 cases are early EMT, stage III 17 cases and stage IV 10 cases are advanced EMT) were internalized into the EMT group,40 patients with normal pelvic were internalized into the control group, all the patients received the laparoscopic operation. Before surgery,3 mL fasting peripheral venous blood were took in both the two groups,2-5 mL peritoneal fluid were collected during surgery, all the samples were centrifugated and the supernatant was saved. Enzyme linked immunosorbent assay (ELISA) was used to detect CA125 in blood serum and peritoneal fluid, indirect ELISA was used to detect TFAb in blood serum and peritoneal fluid. The differences of CA125 and TFAb were analyzed between the two groups, and the differences of CA125 and TFAb were analyzed between early patients with EMT and advanced patients with EMT too.Results1 The CA125 levels of blood serum and peritoneal fluid in patients with EMTBlood serum CA125 levels in patients with EMT were higher than those of the control group (t=5.283, P<0.001). Blood serum CA125 levels had no statistical differences between patients with early EMT and patients in the control group (P=0.069);blood serum CA125 levels in patients with advanced EMT were higher than those of the control group (P<0.001); blood serum CA125 levels in patients with advanced EMT were higher than those of patients with early EMT (P<0.001). Peritoneal fluid CA125 levels in patients with EMT were higher than those of the control group (t=9.843, P<0.001). Peritoneal fluid CA125 levels in patients with early and advanced EMT were higher than those of the control group (P<0.001);peritoneal fluid CA125 levels in patients with advanced EMT were higher than those of patients with early EMT (P=0.001).2 The positive rate of CA125 of blood serum and peritoneal fluid in patients with EMTThe positive rate of blood serum CA125 in patients with EMT was higher than that of the control group (χ2=15.191, P<0.001). The positive rates of blood serum CA125 had no statistical differences between patients with early EMT and patients in the control group (χ2=5.396, P=0.020); the positive rate of blood serum CA125 in patients with advanced EMT was higher than that of the control group (χ2=18.974, P<0.001);the positive rates of blood serum CA125 had no statistical differences between patients with early EMT and patients with advanced EMT (χ2=3.698, P=0.054). The positive rate of peritoneal fluid CA125 in patients with EMT was higher than that of the control group (χ2=44.161, P<0.001). The positive rate of peritoneal fluid CA125 in patients with early and advanced EMT was higher than that of the control group (χ2early=22.208,χ2advanced=35.590;P<0.001);the positive rates of peritoneal fluid CA125had no statistical differences between patients with early EMT and patients with advanced EMT (χ2=2.619, P=0.106).3 The positive rate of TFAb of blood serum and peritoneal fluid in patients with EMTThe positive rate of blood serum TFAb in patients with EMT was higher than that of the control group (χ2=59.531, P<0.001). The positive rate of blood serum TFAb in patients with early and advanced EMT was higher than that of the control group (χearly=38.658,χ2advanced=47.980; P<0.001);the positive rates of blood serum TFAb had no statistical differences between patients with early EMT and patients with advanced EMT (χ2=0.286, P=0.593). The positive rate of peritoneal fluid TFAb in patients with EMT was higher than that of the control group (χ=55.087, P<0.001). The positive rate of peritoneal fluid TFAb in patients with early and advanced EMT was higher than that of the control group (χ2early=36.113,χ2advanced=41.818;P<0.001); the positive rates of peritoneal fluid TFAb had no statistical differences between patients with early EMT and patients with advanced EMT (χ2=0.008, P=0.928).4 The diagnostic value of CA125 and (or) TFAb of blood serum or peritoneal fluid in patients with EMTWhen detecting CA125 in blood serum or peritoneal fluid was used to diagnose EMT, the sensitivity was 57.7% and 84.6% respectively, the specificity was 82.5% and 85.0% respectively; when detecting TFAb in blood serum and peritoneal fluid was used to diagnose EMT, the sensitivity was 88.5% and 90.4% respectively, the specificity was 92.5% and 87.5% respectively. If the joint test of CA125 and TFAb in blood serum was used, the sensitivity and specificity in parallel were 92.3% and 80.0%;the sensitivity and specificity in series were 53.8% and 100.0%. If the joint test of CA125 and TFAb in peritoneal fluid was used, the sensitivity and specificity in parallel were 94.2% and 80.0%; the sensitivity and specificity in series were 80.8% and 100.0%.Conclusion1) CA125 and TFAb have high expressions in blood serum and peritoneal fluid of patients with EMT;2) Detecting CA125 or TFAb in blood serum or peritoneal fluid can all contribute to the diagnosis of EMT;3) Joint determination of CA125 and TFAb in blood serum or peritoneal fluid can improve the diagnostic accuracy. |
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