High serum follistatin levels in women with ovarian endometriosis

Author： Florio P. Reis F.M. Torres P.B. Calonaci F. Abrao M.S. Nascimento L.L. Franchini M. Cianferoni L. Petraglia F.

ISSN： 1460-2350

Source： Human Reproduction, Vol.24, Iss.10, 2009-10, pp. : 2600-2606

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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 <> 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.