Fibrinogen, a Biomarker for Early Diagnosis of Endometriosis

Abstract

Background: Endometriosis is histologically explained as the appearance of endometrial-like tissues or glands that lies on the outer side of uterine cavity. Endometriosis influence 10–15% of all women of fertile age. Considering the need of timely diagnosis of endometriosis, the present study aimed to discover new biomarkers for early diagnosis of this disease by using proteomics and mass spectrometry. Method: In this study, 250 females with endometriosis from Lady Willingdon Hospital Lahore, Pakistan in reproductive age of 16–45 years were registered. Out of these, 120 patients were of lower age group (16–30 Y) and 130 of higher age group (31–45 Y). Controls, n = 170 were involved in the study. After quantification of protein in blood samples, 2-dimensional gel electrophoresis was performed. After identification by LC-MS/MS (liquid chromatography-tandem mass spectrometry) and Mascot (version 2.3.02, Matrix Science Inc., Boston, MA, USA), Samespots software (4.5.1, TotalLab Ltd., New Castle, UK) was applied to calculate the volume and area covered by each protein. The data was analyzed statistically by using SPSS version 20.0 (IBM SPSS statistics, Chicago, IL, USA) and GraphPad Prism (5.0, GraphPad Software Inc., San Diego, CA, USA). Results: LC-MS/MS results were inspiring, indicating that significant up-regulation was showed by fibrinogen among lower and higher age groups of endometriosis patients when compared with healthy controls. The logistic regression showed odds ratio [OR] 4.70 [95% CI (confidence interval) 0.34–6.25] with p = 0.245 of fibrinogen. ROC (receiver operating characteristic) analysis showed AUC (area under the ROC curve) value of 0.917 (95% CI 0.825–1.00, p < 0.0001) with 82.40% sensitivity, 76.50% specificity. Conclusions: Hyperfibrinogenemia induced by endometriosis depicts risk of future complications. This study not only uncovered protein patterns specifically associated with the disease but also serves as a new test to non-invasively diagnose endometriosis at early stage.