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. 2015 May;22(5):551-5.
doi: 10.1177/1933719114553064. Epub 2014 Oct 8.

Diagnostic accuracy of urinary cytokeratin 19 fragment for endometriosis

B A Lessey  1 , R F Savaris  2 , S Ali  3 , S Brophy  3 , S Tomazic-Allen  4 , K Chwalisz  5
Affiliations

Diagnostic accuracy of urinary cytokeratin 19 fragment for endometriosis

B A Lessey et al. Reprod Sci. 2015 May.

Abstract

Endometriosis affects up to 10% of women of reproductive age and 176 million women worldwide. The prevalence in women with infertility is between 30% and 50% but may be higher in women with pelvic pain, interstitial cystitis, or irritable bowel syndrome. Cytokeratin 19 has been suggested as a potential biomarker in urine for the diagnosis of this condition. The objective of this study was to prospectively determine the accuracy and the performance of a urinary cytokeratin 19 (uCYFRA 21-1) test for diagnosing endometriosis. Ninety-eight consecutive women who underwent laparoscopy had a urinary sample obtained before surgery and were included in the study. Endometriosis was diagnosed by laparoscopy and pathology in 64.3% (63 of 98 women). The estimates and 95% confidence intervals for sensitivity, specificity, positive and negative predictive values, and likelihood ratios were 11.1% (4.5%-21.5%), 94.3% (80.8%-99.3%), 77.7% (39.9-97.1), 37% (27-47.9), 1.94 (0.43-8.86), and 0.94 (0.84-1.06), respectively. Despite the high specificity, the uCYFRA 21-1 test has limited value for clinical practice to discriminate between women with and without endometriosis.

Keywords: cytokeratin 19; endometriosis; sensitivity; specificity.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
A, Analysis of the expression of urinary cytokeratin 19 fragments (uCYFRA) in women with and without endometriosis. No significant difference was found (Mann-Whitney U test). B, Receiver–operating characteristics (ROC) of uCYFRA for the diagnosis of endometriosis. The area under the curve (AUC) revels the low performance of the test. The highest specificity was obtained with a cutoff of 5.3 ng/mL (dotted line in A).
Figure 2.
Figure 2.
Flow chart of the study using a 5.3-ng/mL cutoff.
See this image and copyright information in PMC

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