Diagnosis of endometriosis in the 21st century

Abstract

Endometriosis is a common disease but, due to the wide spectrum of symptoms, diagnosis can be delayed 8–12 years. Laparoscopy is nowadays the gold standard for diagnosis. A less invasive method could shorten the time to diagnosis. The aim of this review is to systematically summarize the literature regarding possible less invasive methods for the diagnosis of endometriosis. Electronic databases, including MEDLINE/PubMed, Cochrane, and Google Scholar, were searched to identify relevant studies; 53 publications contributed to this review. Low invasive tests including imaging, genetic tests, biomarkers, or miRNAs could be the key for establishing a less invasive diagnosis of endometriosis. The findings generally support that different methods can differently contribute to the diagnosis, also depending on the type of endometriosis. For example, transvaginal ultrasound has a sensitivity of 93% and a specificity of 96% in the diagnosis of endometrioma, while superficial/peritoneal endometriosis cannot be detected with imaging processes. Although several non-invasive tests including imaging, genetic tests, biomarkers, or miRNAs show promising diagnostic potential, further research is required before they can be recommended in routine clinical care. The combination of low invasive tests may be the solution to a reliable low invasive diagnosis of endometriosis.

摘要

子宫内膜异位症是一种常见的疾病, 由于其症状较普遍, 使该疾病的确诊可能延迟8-12年。腹腔镜检查是目前诊断的金标准。这是一种微创的并且可以缩短诊断时间的方法。本综述的目的是系统的总结有关子宫内膜异位症诊断中可能的微创方法的文献。搜索包括MEDLINE/PubMed, Cochrane和Google Scholar在内的电子数据库以确定相关研究；53份出版物对本综述作出了贡献。微创检查包括影像学检查、基因检测、生物标志物或miRNAs, 可能是建立子宫内膜异位症微创诊断的关键。研究结果普遍支持不同的方法对诊断有不同的贡献, 也取决于子宫内膜异位症的类型。例如, 经阴道超声对子宫腺肌瘤的诊断敏感性为93%, 特异性为96%, 而浅表/腹膜子宫内膜异位症不能通过影像学检查发现。尽管包括影像、基因检测、生物标志物或miRNAs在内的几种无创检测方法显示出了良好的诊断潜力, 但在将其应用于常规临床检查之前还需要进一步的研究。微创检查方法的结合可能是诊断子宫内膜异位症的一个可靠的微创检查方法。

Keywords:

• Biomarkers in endometriosis
• miRNAs in endometriosis
• non-invasive diagnosis of endometriosis

Potential conflict of interest

No potential conflict of interest was reported by the authors.

Additional information

Funding

Nil.