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      CYFRA 21-1 in urine: a diagnostic marker for endometriosis?

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          Abstract

          Diagnostic workup of endometriosis usually involves laparoscopic inspection and histological examination of biopsies. Unequivocal laboratory parameters for this ailment have not been available in routine diagnostic evaluations thus far. In this study, we examined urine concentrations of cytokeratin 19 (CYFRA 21-1), a structural protein specific for epithelia. We performed immunoassays for CYFRA 21-1 in urine samples from women afflicted with endometriosis throughout their menstrual cycle. We observed a significant increase in CYFRA 21-1 concentrations, corrected by creatinine levels, in the late follicular phase as compared with the level in healthy controls. We conclude that cyclically increased CYFRA 21-1 concentrations in urine could serve as a valuable noninvasive diagnostic parameter in the workup of clinically manifesting endometriosis.

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          Most cited references32

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          Incidence of laparoscopically confirmed endometriosis by demographic, anthropometric, and lifestyle factors.

          The authors investigated the relations of demographic, anthropometric, and lifestyle factors with endometriosis in the Nurses' Health Study II prospective cohort. During 10 years of follow-up (1989-1999), 1,721 cases of laparoscopically confirmed endometriosis were reported among women with no past infertility. The incidence rate was greatest among women aged 25-29 years and lowest among women over 44 years (p(trend) 30 vs. 19-20.4 kg/m(2): rate ratio = 0.8, 95% confidence interval: 0.6, 1.1; p(trend) = 0.004) and with current alcohol intake (for >10 vs. 0 g/day: rate ratio = 0.7, 95% confidence interval: 0.6, 0.8; p(trend) < 0.0001) but no association with height, waist/hip ratio, or caffeine intake. An inverse relation with current body mass index and current cigarette smoking was observed only when cases were concurrently infertile. The authors conclude that age, race, body mass index, alcohol use, and cigarette smoking are associated with the incidence of endometriosis and that some of these relations may differ by infertility status at the time of laparoscopic diagnosis.
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            What's the delay? A qualitative study of women's experiences of reaching a diagnosis of endometriosis.

            To investigate the reasons women experience delays in the diagnosis of endometriosis and the impact of this. A qualitative interview-based study of 32 women, 28 of whom were subsequently diagnosed with endometriosis. Southeast England. Women attending a pelvic pain clinic. Semistructured interviews. Women's reported experiences of being diagnosed with endometriosis. Delays in the diagnosis of endometriosis occur at an individual patient level and a medical level, as both women and family doctors normalize symptoms, symptoms are suppressed through hormones, and nondiscriminatory investigations are relied upon. Women benefited from a diagnosis, because it provided a language in which to discuss their condition, offered possible management strategies to control symptoms, and provided reassurance that symptoms were not due to cancer. Diagnosis also sanctioned women's access to social support and legitimized absences from social and work obligations. Although recent guidelines for the management of chronic pelvic pain suggest that diagnostic laparoscopy may be considered a secondary investigation after the failure of therapeutic interventions, the present study highlights the importance of an early diagnosis for women who suffer at physical, emotional, and social levels when they remain undiagnosed.
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              Practice bulletin no. 114: management of endometriosis.

              (2010)
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                Author and article information

                Journal
                Int J Womens Health
                International journal of women's health
                Informa UK Limited
                1179-1411
                1179-1411
                2015
                : 7
                Affiliations
                [1 ] Department of Laboratory Medicine, Bodenseelabor, Hörbranz, Austria ; Institute of Anatomy II, University of Jena, Jena University Hospital, Jena, Germany.
                Article
                ijwh-7-205
                10.2147/IJWH.S75288
                4332289
                25709504
                1c85246e-2b16-4303-9862-81256c85f17a
                History

                CYFRA 21-1,biomarkers,immunoassay,menstrual cycle,noninvasive diagnosis

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