Search for diagnostic markers of endometriosis: Tumor necrosis factor and interleukin-8 in peritoneal fluid and plasma.

REPOSSI F.L.; BELLO A.; YOUNG E.; BILOTAS M.; BARAÑAO R.I.; AUGE L.M.

San Francisco, California, USA

Congreso; 64th Annual meeting of the American Society for Reproductive Medicine; 2008

American Society for Reproductive Medicine

OBJECTIVE: Main: Investigate the potential link between patients with EDTand cytokines, such as tumor necrosis factor alpha (TNF-a) and interleukin- 8 (IL-8) in plasma and peritoneal fluid, due to formulate a presumptive disease diagnosis before confirmatory diagnosis by laparoscopy. Secondary: Evaluate variations in analyzed parameters after medical treatment with gestagen- induced ovarian suppression (Desogestrel 75 mcg) for patients with EDT. DESIGN: Prospective controlled randomized trial. MATERIALS AND METHODS: Inclusion criteria: age 20-40, indication for laparoscopic surgery. Exclusion criteria: malignant tumors, pelvic inflammatory disease, surgical procedures or use of hormone therapy for EDT within 6 months pre-study. During surgery, peritoneal fluid and plasma samples were obtained from all patients, as well as peritoneal biopsy of all endometriótica lesions, if detected. Groups were randomized as:Control: 19 healthy women who underwent laparoscopy with no evidence of EDT. Study Group: 18 women with EDT classified according to ASRM 1996 criteria. Group treated with gestagens: 16 patients diagnosed with EDTand presented red lesions (active) seen both at laparoscopy and histology. Immediately after surgery, they began to receive desogestrel during a 3 months period. Measure plasmatic TNF and IL-8 samples were obtained. Statistical evaluation: Test Kruskal-Wallis nonparametric ANOVA and Test Dunn’s. RESULTS: Levels of serum TNF-a and IL-8 showed an increase tendency in women with EDTas compared to those at control group. Therewas a strong decrease in serum TNF-a levels after surgery, decrease in serum IL-8 levels was slighter. Levels of serum TNF-a and IL-8 in patients with EDT before and after surgery, therewas a strong decrease in serum TNF-a levels after the intervention, the decrease in serum IL-8 levels was slighter. Determination of serum TNFa and IL-8 in patients with active post-surgery EDT before and after treatment with gestagens showed that after treatment the levels of both types of cytokines had increased.TNF-a and IL-8 levels in peritoneal fluid did not show any variation as compared to the control group, and regardless of the lesion type. There was an increase of TNF-a and IL-8 levels in peritoneal fluid at disease advanced stages.However, none of those results were statistically significant. CONCLUSIONS: The quantification of TNF-a or IL-8 levels, can´t be used as a reliable marker in the presumptive diagnosis of EDT before laparoscopy, neither in the control of medical treatment.