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Cited by 51Endometriosis Research and TreatmentOvarian cancer diagnosis and treatmentGynecological conditions and treatments

High serum follistatin levels in women with ovarian endometriosis

Florio, P., Reis, F.M., Torres, P.B., Calonaci, F., Abrao, M.S., Nascimento, L.L., Franchini, M., Cianferoni, L. +1 more·2009·Human Reproduction
DOI 10.1093/humrep/dep195
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Abstract

BACKGROUND: Follistatin is an activin-binding protein produced by several tissues, including endometrium and endometriotic implants. We aimed to quantify follistatin in patients with ovarian endometriosis and investigate its value as a diagnostic marker. METHODS: Women undergoing laparoscopic excision of ovarian endometrioma (n = 52) or other benign ovarian cysts (n = 52) were studied, plus women with non-ovarian endometriosis (n = 11) and healthy controls (n = 27). Serum was collected from all subjects, and peritoneal and cystic fluid from a subset with endometrioma. Follistatin was measured by enzyme-linked immunosorbent assay. The diagnostic accuracy of follistatin to detect endometrioma was evaluated by receiver operating characteristic (ROC) curve and compared with cancer antigen (CA)-125. RESULTS: Serum follistatin was increased in women with ovarian endometrioma (2080 +/- 94 pg/ml) compared with controls (545 +/- 49 pg/ml, P < 0.001), other benign ovarian cysts (795 +/- 60 pg/ml, P < 0.001) or non-ovarian endometriosis (1271 +/- 115 pg/ml, P < 0.001). Cystic fluid showed a higher concentration of follistatin (9850 +/- 4461 pg/ml) than peritoneal fluid (1885 +/- 261 pg/ml, P < 0.001) and serum (P < 0.001). Follistatin levels detected 48/52 cases of endometrioma (92% sensitivity) at 1433 pg/ml cut-off, corresponding to 92% specificity. CA-125 detected only 44% of endometriomas with 90% specificity. ROC curve comparison showed follistatin was more accurate than CA-125 to discriminate women with endometrioma either from controls or women with other benign ovarian cysts (P < 0.0001). CONCLUSIONS: Serum follistatin is increased in women with endometriosis and allows clear distinction between endometrioma and other benign ovarian cysts. Follistatin has the sensitivity and specificity to become a useful clinical marker of ovarian endometrioma.

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  • Follistatin has been shown to be increased in endometriosis patients, especially in a subgroup with ovarian endometrioma, and showed good sensitivity and specificity.

    “Follistatin, an inhibitor of activin, has been shown to be increased in endometriosis patients [23], especially in a subgroup of patients with ovarian endometrioma, and showed good sensitivity and specificity [43].”

    From Update on biomarkers for the detection of endometriosis (2015) · cites this paper as [43]

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Authors
Florio, P., Reis, F. M., Torres, P. B., Calonaci, F., Abrao, M. S., Nascimento, L. L., Franchini, M., Cianferoni, L., & Petraglia, F.
Affiliations
  • University of Siena (IT)
  • Universidade Federal de Minas Gerais (BR)
ORCID
Venue
Human Reproduction
Publisher
Oxford University Press (OUP)
Published
2009-06-23
Volume
24
Issue
10
Pages
2600-2606
ISSN
  • 0268-1161 (ISSN-L)
  • 1460-2350
DOI
10.1093/humrep/dep195
OpenAlex
W2117027199
Cited by
51
References
35
Citations by year
2026: 3 · 2025: 2 · 2024: 4 · 2023: 1 · 2022: 3 · 2021: 1 · 2020: 2 · 2017: 4 · 2016: 5 · 2015: 4 · 2014: 5 · 2013: 3 · 2012: 5
FWCI
5.50
Type
journal article
Language
en
Open access
closed
Locations
  • Human Reproduction (publishedVersion)
  • PubMed (publishedVersion)
  • Scientific Electronic Library Online (São Paulo Research Foundation, Latin American and Caribbean Center on Health Sciences Information, Conselho Nacional de Desenvolvimento Científico e Tecnológico) (publishedVersion)
  • Florence Research (University of Florence) (submittedVersion)
  • Use Siena air (University of Siena) (submittedVersion)
Funders
Università degli Studi di Siena
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
  • Health Sciences › Medicine › Reproductive Medicine › Ovarian cancer diagnosis and treatment
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
Keywords
follistatin, endometrioma, serum biomarkers, diagnostic biomarkers, CA125, cyst fluid, peritoneal fluid, benign ovarian cysts, activin-binding protein
MeSH terms
Adult, Diagnosis, Differential, Endometriosis, Female, Humans, Ovarian Diseases, Biomarkers, CA-125 Antigen, Follistatin

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