The role of cytokeratin 19 levels in the determination of endometriosis stages.

OBJECTIVE/AIM: Endometrisosis, one of the most common gynecological disease, is characterized by the presence of endometriotic tissue outside of uterine cavity. The development and the validation of a simple blood biomarker specific and sensitive for endometriosis may facilitate the rapid and the accurate diagnosis of the disease and thus early treatment. Cytokeratin expression changes during epithelial differentiation and this expression is important for the modulation and the control of cell cycle regulation, tumor cell motility and apoptosis. Cytokeratin 19 (CK-19) is expressed in most simple epithelial cells and their malignant counterparts. The aim of this study is to investigate serum CK-19 expression levels in patients with endometriosis and to determine the diagnostic role of CK-19 levels in differentiating various stage of endometriosis. METHODS: Ctytokeratin-19 expression and level were studied in 70 endometriosis patients and 50 volunteers by ELISA and RT-PCR. ROC analysis was performed by comparing all stages with each other and with the control group. RESULTS: The CK-19 levels were significantly higher in the endometriosis groups than that of the control group by ELISA and RT-PCR. A significant (p < .05) difference was observed in endometriosis patients according to the stages. CONCLUSION: Based on our data, it suggests that Cytokeratin-19 may have a potential role in the development of endometriosis.

Circulating serum miR-200c and miR-34a-5p as diagnostic biomarkers for endometriosis.

OBJECTIVE: Endometriosis is defined by the presence of endometrial glands and stroma grow in areas outside the uterus. A simple blood test for endometriosis-specific biomarkers would offer a more timely accurate diagnosis of the disease and could lead to earlier treatment intervention. Alterations in microRNA (miRNA) levels in blood may reflect changes during normal physiologic processes and have been related to several pathologic conditions, including gynecologic diseases. In the present study, we aim to evaluate the level of serum miR-34a-5p and miR-200c from women with and without endometriosis, and to explore the potential of miRNAs as reliable non-invasive biomarkers in the diagnosis of endometriosis. METHODS: Expression levels of miRNAs were performed by quantitative real-time polymerase chain reaction (qRT-PCR). Serum cancer antigen 125 (CA-125) levels were analyzed by autoanalyzer. RESULTS: miR-34a-5p expression levels were decreased and miR-200c expression levels were increased in the endometriosis patients compared to the control group. According to the areas under the ROC curve (AUC) values, miR-200c and miR-34a-5p may serve as biomarkers for the diagnosis of endometriosis. Serum miR-34a-5p and miR-200c had a sensitivity of 78.95 % and 100 % and a specificity of 49.12 % and 100 %, respectively, for the detection of endometriosis. CONCLUSION: Serum miRNAs may provide a promising opportunity for diagnosis of endometriosis. Understanding the role of circulating miRNAs will serve a better comprehension of the systemic effects of endometriosis and offer options for new treatments. It is clear that more work is needed in this area.

Determination of PD-1 expression in peripheral blood cells in patients with endometriosis.

In patients with endometriosis, ectopic endometrial tissues can escape from immune system control and survive in other tissues. The pathophysiology of endometriosis is still not fully understood. In this study, we aimed to clarify the pathophysiology of endometriosis, which is thought to be a benign but infiltrative cancer type, which has many similarities with cancer biology by determining PD-1 expression in patients with endometriosis. In this study, n = 73 cases who underwent surgery or examination at the Obstetrics and Gynecology Clinic of Sivas Cumhuriyet University Faculty of Medicine and diagnosed as endometriosis in the biopsy material taken with the pre-diagnosis of endometriosis constituted the patient group. The control group consisted of n = 64 healthy subjects without concomitant malignancy or chronic inflammatory disease. Venous whole blood samples were obtained from the study groups. PD-1 and PD-L1 levels were determined by the ELISA method from serum and plasma samples. PD-1 gene expression level was determined by RT-PCR. The PD-1 level was found to be approximately 350 ± 150 ng/L and 45 ± 17 ng/L in endometriosis and control group, respectively. While the PD-L1 level was approximately 760 ± 108 ng/L in the patients, this level was 140 ± 14 ng/L in the controls. According to the RT-PCR results, the expression of the PD-1 gene 10 times higher compared to the controls. Conclusion: The identified increase of PD-1 levels and gene expression in endometriosis groups show that immunotherapy may be used in the treatment of endometriosis.