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Comparative Study
. 2014 Jun;210(6):533.e1-533.e10.
doi: 10.1016/j.ajog.2014.01.022. Epub 2014 Jan 17.

Measurement of hs-CRP is irrelevant to diagnose and stage endometriosis: prospective study of 834 patients

Thibault Thubert  1 , Pietro Santulli  2 , Louis Marcellin  3 , Sophie Menard  4 , Magatte M'Baye  4 , Isabelle Streuli  4 , Bruno Borghese  3 , Dominique de Ziegler  4 , Charles Chapron  3
Affiliations
Comparative Study

Measurement of hs-CRP is irrelevant to diagnose and stage endometriosis: prospective study of 834 patients

Thibault Thubert et al. Am J Obstet Gynecol. 2014 Jun.

Abstract

Objective: The pathogenesis of endometriosis is associated with an inflammatory process. Here, we assessed if the levels of high-sensitivity C-reactive protein (hs-CRP) in serum could constitute an effective method for detecting systemic inflammation during endometriosis.

Study design: This was a prospective, laboratory-based study, which was carried out in a tertiary care university hospital. Patients with histologically proven endometriosis (n = 370) and unaffected women (n = 464) were enrolled from January 2005 through December 2009. We performed complete surgical excision of endometriotic lesions with pathological analysis. In addition, hs-CRP levels were determined through a particle-enhanced immunoturbidimetric method. The hs-CRP levels were measured in both controls and women with endometriosis according to the established surgical classifications of endometriosis: superficial peritoneal endometriosis, endometrioma, and deep infiltration endometriosis. Also, hs-CRP levels were evaluated according to hormonal treatment and menstrual cycle.

Results: The hs-CRP serum levels did not statistically differ between women with endometriosis and controls (median in ng/mL [range]: 0.82 [0.04-42.89] vs 0.9 [0.03-43.73], respectively; P = .599). Moreover, subgroup analysis revealed no difference among superficial peritoneal endometriosis, endometrioma, deep infiltration endometriosis, and controls: 0.8 (0.15-13.35), 0.81 (0.04-38.82), 0.83 (0.09-42.89), and 0.9 (0.03-43.73), respectively; P = .872. Furthermore, no effect was observed regarding hormonal treatment or menstrual cycle.

Conclusion: Although endometriosis is an inflammatory disease, we failed to identify any systemic changes in hs-CRP serum levels. Therefore, hs-CRP analysis appears to be irrelevant to the diagnosis and staging of endometriosis.

Keywords: C-reactive protein; endometrioma; endometriosis; high-sensitivity C-reactive protein; inflammation; pathogenesis.

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