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High serum follistatin levels in women with ovarian endometriosis.
Hum Reprod. 2009 Oct; 24(10):2600-6.HR

Abstract

BACKGROUND

Follistatin is an activin-binding protein produced by several tissues, including endometrium and endometriotic implants. We aimed to quantify follistatin in patients with ovarian endometriosis and investigate its value as a diagnostic marker.

METHODS

Women undergoing laparoscopic excision of ovarian endometrioma (n = 52) or other benign ovarian cysts (n = 52) were studied, plus women with non-ovarian endometriosis (n = 11) and healthy controls (n = 27). Serum was collected from all subjects, and peritoneal and cystic fluid from a subset with endometrioma. Follistatin was measured by enzyme-linked immunosorbent assay. The diagnostic accuracy of follistatin to detect endometrioma was evaluated by receiver operating characteristic (ROC) curve and compared with cancer antigen (CA)-125.

RESULTS

Serum follistatin was increased in women with ovarian endometrioma (2080 +/- 94 pg/ml) compared with controls (545 +/- 49 pg/ml, P < 0.001), other benign ovarian cysts (795 +/- 60 pg/ml, P < 0.001) or non-ovarian endometriosis (1271 +/- 115 pg/ml, P < 0.001). Cystic fluid showed a higher concentration of follistatin (9850 +/- 4461 pg/ml) than peritoneal fluid (1885 +/- 261 pg/ml, P < 0.001) and serum (P < 0.001). Follistatin levels detected 48/52 cases of endometrioma (92% sensitivity) at 1433 pg/ml cut-off, corresponding to 92% specificity. CA-125 detected only 44% of endometriomas with 90% specificity. ROC curve comparison showed follistatin was more accurate than CA-125 to discriminate women with endometrioma either from controls or women with other benign ovarian cysts (P < 0.0001).

CONCLUSIONS

Serum follistatin is increased in women with endometriosis and allows clear distinction between endometrioma and other benign ovarian cysts. Follistatin has the sensitivity and specificity to become a useful clinical marker of ovarian endometrioma.

Authors+Show Affiliations

Division of Obstetrics and Gynecology, Department of Pediatrics, Obstetrics and Reproductive Medicine, University of Siena, Policlinico Le Scotte, Siena, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19549703

Citation

Florio, P, et al. "High Serum Follistatin Levels in Women With Ovarian Endometriosis." Human Reproduction (Oxford, England), vol. 24, no. 10, 2009, pp. 2600-6.
Florio P, Reis FM, Torres PB, et al. High serum follistatin levels in women with ovarian endometriosis. Hum Reprod. 2009;24(10):2600-6.
Florio, P., Reis, F. M., Torres, P. B., Calonaci, F., Abrao, M. S., Nascimento, L. L., Franchini, M., Cianferoni, L., & Petraglia, F. (2009). High serum follistatin levels in women with ovarian endometriosis. Human Reproduction (Oxford, England), 24(10), 2600-6. https://doi.org/10.1093/humrep/dep195
Florio P, et al. High Serum Follistatin Levels in Women With Ovarian Endometriosis. Hum Reprod. 2009;24(10):2600-6. PubMed PMID: 19549703.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High serum follistatin levels in women with ovarian endometriosis. AU - Florio,P, AU - Reis,F M, AU - Torres,P B, AU - Calonaci,F, AU - Abrao,M S, AU - Nascimento,L L, AU - Franchini,M, AU - Cianferoni,L, AU - Petraglia,F, Y1 - 2009/06/23/ PY - 2009/6/25/entrez PY - 2009/6/25/pubmed PY - 2009/12/16/medline SP - 2600 EP - 6 JF - Human reproduction (Oxford, England) JO - Hum Reprod VL - 24 IS - 10 N2 - BACKGROUND: Follistatin is an activin-binding protein produced by several tissues, including endometrium and endometriotic implants. We aimed to quantify follistatin in patients with ovarian endometriosis and investigate its value as a diagnostic marker. METHODS: Women undergoing laparoscopic excision of ovarian endometrioma (n = 52) or other benign ovarian cysts (n = 52) were studied, plus women with non-ovarian endometriosis (n = 11) and healthy controls (n = 27). Serum was collected from all subjects, and peritoneal and cystic fluid from a subset with endometrioma. Follistatin was measured by enzyme-linked immunosorbent assay. The diagnostic accuracy of follistatin to detect endometrioma was evaluated by receiver operating characteristic (ROC) curve and compared with cancer antigen (CA)-125. RESULTS: Serum follistatin was increased in women with ovarian endometrioma (2080 +/- 94 pg/ml) compared with controls (545 +/- 49 pg/ml, P < 0.001), other benign ovarian cysts (795 +/- 60 pg/ml, P < 0.001) or non-ovarian endometriosis (1271 +/- 115 pg/ml, P < 0.001). Cystic fluid showed a higher concentration of follistatin (9850 +/- 4461 pg/ml) than peritoneal fluid (1885 +/- 261 pg/ml, P < 0.001) and serum (P < 0.001). Follistatin levels detected 48/52 cases of endometrioma (92% sensitivity) at 1433 pg/ml cut-off, corresponding to 92% specificity. CA-125 detected only 44% of endometriomas with 90% specificity. ROC curve comparison showed follistatin was more accurate than CA-125 to discriminate women with endometrioma either from controls or women with other benign ovarian cysts (P < 0.0001). CONCLUSIONS: Serum follistatin is increased in women with endometriosis and allows clear distinction between endometrioma and other benign ovarian cysts. Follistatin has the sensitivity and specificity to become a useful clinical marker of ovarian endometrioma. SN - 1460-2350 UR - https://www.unboundmedicine.com/medline/citation/19549703/High_serum_follistatin_levels_in_women_with_ovarian_endometriosis_ L2 - https://academic.oup.com/humrep/article-lookup/doi/10.1093/humrep/dep195 DB - PRIME DP - Unbound Medicine ER -