Sujata Deo1*,
SP Jaiswar1, PL Shankhwar1, Bushra Iqbal2,
Manisha Jhirwar1
1Department of Obs & Gyn,
King George Medical University, Lucknow, India
2Department of Physiology,
King George Medical University, Lucknow, India
*Address for Correspondence: Dr. Sujata
Deo, Professor, Department of Obs
& Gyn, King George Medical University, Lucknow, India
ABSTRACT-
Background: Endometriosis is associated with chronic, benign,
oestrogen-dependent inflammatory disease that affects approximately 10% of
reproductive age women and 35-50% of women with pelvic pain and infertility. It
can be a weakening disease with dysmenorrhoea, dyspareunia, and chronic pelvic
pain symptoms.
Objective: To evaluate the role of serum marker (IL-6, IL-8, TNF-α) as
non-invasive tool to diagnose endometriosis in reproductive age group.
Methods: A case control study was conducted in Department of Obstetrics
and Gynecology, KGMU, Lucknow for a period of one year. Total numbers of women enrolled in study were 100. Out of 100 women, 75
women of reproductive age group with clinical suspicion and USG findings were
taken as cases. Out of 75 cases, 12 cases lost the follow up and 26 cases kept
on conservative management and they responded well. Finally 37 cases of endometriosis
with strong clinical suspicions (Dysmenorrhea, Heavy or irregular bleeding,
Pelvic pain, Lower abdominal or back pain, Dyspareunia, Dyschezia) and USG
finding of endometriosis were recruited as cases and they underwent
laparoscopy/ laparotomy. Control group
comprises of 25 women undergoing for laparoscopic tubal ligation. After
taking informed consent, all the women were subjected to the detailed
menstrual, gynaecological, medical history and general, systemic and
gynaecological examination. Patient was investigated for haemoglobin,
ultrasound abdomen and pelvis and serum markers (IL-6, IL-8, TNF-α). Blood
sample (5ml of blood) was collected in vecutainer tube for serum analysis. The
blood was centrifuged to separate the serum and stored at -70ºC till examined. Finally 37 cases of endometriosis underwent
laparotomy/laparoscopy (gold standard to diagnose endometriosis) for proper
diagnosis and treatment.
Results: Serum IL-8 cut-off at 0.78% pg/ml afforded a sensitivity of 70.3%
and specificity of 80% in the diagnosis of endometriosis and has good
discriminant ability. TNF-α has average discriminant ability, 62.2% sensitivity
and 56% specificity for endometriosis diagnosis. So that serum IL-8 and TNF-α
can differentiate cases with or without endometriosis. By detecting these serum
markers, we can diagnose endometriosis without undergoing laparoscopy or
laparotomy.
Conclusion: The serum markers (IL-8, TNF-α)
can be used as a non-invasive tool for diagnosis of endometriosis.
Key-words-Endometriosis, Interleukins, Tumour necrosis factor, Laparoscopy
