Non-invasive diagnosis of endometriosis based on a combined analysis of six plasma biomarkers

triosis. methods: This case –control study was conducted in 294 infertile women, consisting of 93 women with a normal pelvis and 201 women with endometriosis. We measured plasma concentrations of interleukin (IL)-6, IL-8, tumour necrosis factor-alpha, high-sensitivity C-reactive protein (hsCRP), and cancer antigens CA-125 and CA-19-9. Analyses were done using the Kruskal –Wallis test, Mann– Whitney test, receiver operator characteristic, stepwise logistic regression and least squares support vector machines (LSSVM). results: Plasma levels of IL-6, IL-8 and CA-125 were increased in all women with endometriosis and in those with minimal –mild endometriosis, compared with controls. In women with moderate –severe endometriosis, plasma levels of IL-6, IL-8 and CA-125, but also of hsCRP, were significantly higher than in controls. Using stepwise logistic regression, moderate–severe endometriosis was diagnosed with a sensitivity of 100% (specificity 84%) and minimal –mild endometriosis was detected with a sensitivity of 87% (specificity 71%) during the secretory phase. Using LSSVM analysis, minimal –mild endometriosis was diagnosed with a sensitivity of 94% (specificity 61%) during the secretory phase and with a sensitivity of 92% (specificity 63%) during the menstrual phase.