Urocortin 1 as a noninvasive diagnostic marker for endometriosis

Elevated plasma urocortin 1 levels can be used to predict the likelihood of endometriosis in symptomatic women.

Key Points

Highlights:

• In women with chronic pelvic pain, infertility, or both, the probability of endometriosis was found to increase parallel to the increase in plasma urocortin 1 (Ucn1) levels.

Importance:

• The gold standard for endometriosis diagnosis is the direct visualization of lesions by laparoscopy followed by histological confirmation. A sensitive and non-invasive diagnostic method remains a challenge in the field; however, the current study proposes plasma Ucn1 levels as a non-invasive diagnostic marker for endometriosis.

What’s done here?

• The study evaluated the predictive value of plasma Ucn1 levels to detect endometriosis in symptomatic women.
• A total of 97 participants, who were scheduled for laparoscopy, were enrolled in this study; and their preoperative blood samples were tested for plasma Ucn1 levels.

Key results:

• Patients with endometriosis had higher plasma Ucn1 levels compared to patients with no lesions.
• Although to a lesser extent, elevated plasma Ucn1 levels were also found in women with other pathological gynecologic conditions.

Limitations of the study:

• In addition to women with endometriosis, elevated Ucn1 levels were also found in women with other gynecologic conditions, hence, its diagnostic sensitivity is not sufficient; other diagnostic tools are still required to confirm the endometriosis diagnosis and rule out false positive cases.

Lay Summary

Urocortin 1 (Ucn1) is a neuropeptide secreted by epithelial cells of the endometrium. It promotes endometrial differentiation to help with embryo implantation. Endometriotic lesions were shown to be rich in Ucn1, suggesting a potential role for Ucn1 in the pathogenesis of endometriosis.

Currently, endometriosis is diagnosed by visual examination of the lesions by laparoscopy and subsequent histological confirmation. Because this is an invasive procedure, many patients go undiagnosed, resulting in delayed treatment and advanced disease. Development of the reliable and sensitive noninvasive diagnostic tests for endometriosis are among the top priority areas. In the present study, plasma Ucn1 levels of patients scheduled for gynecologic laparoscopy were evaluated to assess the predictive value of plasma Ucn1 to detect endometriosis in women with pelvic pain, infertility or both symptoms. The study enrolled 97 patients,

In the present study, plasma Ucn1 levels of patients scheduled for gynecologic laparoscopy were evaluated to assess the predictive value of plasma Ucn1 to detect endometriosis in women with pelvic pain, infertility or both symptoms. The study enrolled 97 patients, of which 38 were later diagnosed with endometriosis, 8 with no lesions, and 51 with other gynecologic conditions. Patients with endometriosis had higher plasma Ucn1 levels compared to patients with no lesions. Elevated Ucn1 levels were found in all endometriosis subgroups including ovarian and deep infiltrating endometriosis. Increased Ucn1 levels were also detected in women with other gynecologic conditions but to a lesser extent. This indicated that the diagnostic accuracy of plasma Ucn1 levels.

However, increased Ucn1 levels were also detected in women with other gynecologic conditions, but to a lesser extent. This indicated that the diagnostic accuracy of plasma Ucn1 levels might be sufficient to distinguish between endometriosis group and a healthy control group, but not enough to make a distinction between patients with endometriosis versus other pathological conditions. Therefore, other diagnostic tools are still required to confirm the diagnosis of endometriosis. In spite of that, plasma Ucn1 levels may still be used in combination with other biochemical and clinical markers to develop a reliable strategy for detection of endometriosis and reduce the disease burden.

Research Source: https://www.ncbi.nlm.nih.gov/pubmed/28925754