Endometriosis: diagnostic accuracy of hormonal biomarkers

  • Gao Y & al.
  • J Minim Invasive Gynecol
  • 6 Apr 2019

  • International Clinical Digest
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Takeaway

  • In a systematic review and meta-analysis of 7 hormonal biomarkers, aromatase had the best diagnostic performance for endometriosis.

Why this matters

  • Accurate biomarkers might help avoid unnecessary laparoscopy.

Key results

  • Respective sensitivity and specificity values were as follows:
    • 0.79 (95% CI, 0.71-0.86) and 0.89 (95% CI, 0.82-0.94) for aromatase,
    • 0.30 (95% CI, 0.18-0.46) and 0.80 (95% CI, 0.65-0.90) for human chorionic gonadotropin/luteinizing hormone (HCG/LH) receptor,
    • 0.75 (95% CI, 0.66-0.83) and 0.47 (95% CI, 0.34-0.60) for estrogen receptor (ER)-α,
    • 0.65 (95% CI, 0.56-0.74) and 0.68 (95% CI, 0.55-0.80) for ER-β,
    • 0.45 (95% CI, 0.38-0.52) and 0.92 (95% CI, 0.85-0.97) for serum prolactin,
    • 0.69 (95% CI, 0.51-0.83) and 0.30 (95% CI, 0.16-0.49) for estrogen sulfotransferase (EST), and
    • 0.73 (95% CI, 0.60-0.84) and 0.48 (95% CI, 0.33-0.63) for 17β-hydroxysteroid dehydrogenase (17βHSD2) type 2.
  • Aromatase had superior sensitivity, specificity, positive likelihood ratio, and diagnostic OR compared with HCG/LH receptor, ER-α, ER-β, EST, and 17βHSD2 (P<.05 for all>

Study design

  • 17 studies including 1279 subjects were subjected to meta-analysis.
  • Funding: Science and Technology Plan Project of Gansu Province.

Limitations

  • Included studies had moderate quality and limited sample size.
  • Nearly 50% of included studies had high risk for bias.

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