Maia Laura M, Rocha Ana L, Del Puerto Helen L, Petraglia Felice, Reis Fernando M
a Department of Obstetrics and Gynecology , Universidade Federal de Minas Gerais , Belo Horizonte , Brazil.
b Department of Pathology , Universidade Federal de Minas Gerais , Belo Horizonte , Brazil.
Gynecol Endocrinol. 2018 Mar;34(3):202-205. doi: 10.1080/09513590.2017.1380188. Epub 2017 Sep 19.
Accurate noninvasive diagnostic tests for endometriosis are still missing. This study evaluated the predictive value of the neuropeptide urocortin 1 (Ucn1) to detect pelvic endometriosis in symptomatic women. We enrolled prospectively 97 consecutive women submitted to gynecologic laparoscopy for chronic or acute pelvic pain, infertility or adnexal mass. Preoperative blood samples were assayed for Ucn1 using enzyme immunoassay. Patients with endometriosis had higher plasma Ucn1 levels compared to patients with no lesions (median 59 vs. 34 pg/ml, p < .01, Dunn's test). Elevated plasma Ucn1 levels were found among all endometriosis phenotypes (superficial peritoneal lesions, ovarian endometrioma, and deep infiltrating endometriosis, p < .05 vs. no lesions). Receiver operating characteristics curve analysis identified plasma Ucn1 > 46 pg/mL as the best cutoff point to detect endometriosis vs. no lesions, with 76% sensitivity and 88% specificity (area under the curve [AUC] 0.827, 95% confidence interval [CI] 0.695 - 0.959), but no cutoff could accurately distinguish endometriosis from other pathological conditions (AUC 0.593 [95% CI 0.474 - 0.711]). In women with chronic pelvic pain, infertility, or both symptoms, the probability of endometriosis (positive predictive value) increased consistently with the increase of plasma Ucn1 levels. The present findings suggest that high plasma Ucn1 levels increase the likelihood of endometriosis in symptomatic women.
目前仍缺乏用于子宫内膜异位症的准确无创诊断测试。本研究评估了神经肽尿皮质素1（Ucn1）在有症状女性中检测盆腔子宫内膜异位症的预测价值。我们前瞻性地纳入了97名连续的女性，她们因慢性或急性盆腔疼痛、不孕或附件包块而接受妇科腹腔镜检查。术前采用酶免疫分析法检测血样中的Ucn1。与无病变的患者相比，子宫内膜异位症患者的血浆Ucn1水平更高（中位数分别为59和34 pg/ml，p < 0.01，Dunn检验）。在所有子宫内膜异位症表型（浅表腹膜病变、卵巢子宫内膜瘤和深部浸润性子宫内膜异位症）中均发现血浆Ucn1水平升高（与无病变相比，p < 0.05）。受试者工作特征曲线分析确定，血浆Ucn1 > 46 pg/mL是检测子宫内膜异位症与无病变的最佳临界值，敏感性为76%，特异性为88%（曲线下面积[AUC] 0.827，95%置信区间[CI] 0.695 - 0.959），但没有临界值能够准确区分子宫内膜异位症与其他病理状况（AUC 0.593 [95% CI 0.474 - 0.711]）。在患有慢性盆腔疼痛、不孕或两种症状皆有的女性中，子宫内膜异位症的概率（阳性预测值）随血浆Ucn1水平的升高而持续增加。目前的研究结果表明血浆Ucn1水平升高会增加有症状女性患子宫内膜异位症的可能性。
