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Measurement of hs-CRP is irrelevant to diagnose and stage endometriosis: prospective study of 834 patients

  • Thibault Thubert
    Correspondence
    Reprints: Thibault Thubert, MD, MS, Service de Gynécologie-Obstétrique II et Médecine de la Reproduction, Port Royal–Hôpitaux Universitaires Paris Centre, 53, avenue de l'Observatoire, 75679 Paris 14 France.
    Affiliations
    Faculty of Medicine Université Paris Descartes, Sorbonne Paris Cité, Paris, France

    Department of Gynecology, Obstetrics, and Reproductive Medicine, Centre Hospitalier Universitaire Cochin of the Groupe Hospitalier Universitaire Ouest, Assistance Publique-Hôpitaux de Paris, Paris, France
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  • Pietro Santulli
    Affiliations
    Faculty of Medicine Université Paris Descartes, Sorbonne Paris Cité, Paris, France

    Department of Gynecology, Obstetrics, and Reproductive Medicine, Centre Hospitalier Universitaire Cochin of the Groupe Hospitalier Universitaire Ouest, Assistance Publique-Hôpitaux de Paris, Paris, France

    Immunology Laboratory EA 1833, Paris, France

    Institut Cochin, Université Paris Descartes, Centre National de Recherche Scientifique, Paris, France

    Institut National de la Santé et de la Recherche Médicale, Unité de recherche U1016, Paris, France
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  • Louis Marcellin
    Affiliations
    Faculty of Medicine Université Paris Descartes, Sorbonne Paris Cité, Paris, France

    Department of Gynecology, Obstetrics, and Reproductive Medicine, Centre Hospitalier Universitaire Cochin of the Groupe Hospitalier Universitaire Ouest, Assistance Publique-Hôpitaux de Paris, Paris, France

    Institut Cochin, Université Paris Descartes, Centre National de Recherche Scientifique, Paris, France

    Institut National de la Santé et de la Recherche Médicale, Unité de recherche U1016, Paris, France
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  • Sophie Menard
    Affiliations
    Faculty of Medicine Université Paris Descartes, Sorbonne Paris Cité, Paris, France

    Department of Gynecology, Obstetrics, and Reproductive Medicine, Centre Hospitalier Universitaire Cochin of the Groupe Hospitalier Universitaire Ouest, Assistance Publique-Hôpitaux de Paris, Paris, France
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  • Magatte M'Baye
    Affiliations
    Faculty of Medicine Université Paris Descartes, Sorbonne Paris Cité, Paris, France

    Department of Gynecology, Obstetrics, and Reproductive Medicine, Centre Hospitalier Universitaire Cochin of the Groupe Hospitalier Universitaire Ouest, Assistance Publique-Hôpitaux de Paris, Paris, France
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  • Isabelle Streuli
    Affiliations
    Faculty of Medicine Université Paris Descartes, Sorbonne Paris Cité, Paris, France

    Department of Gynecology, Obstetrics, and Reproductive Medicine, Centre Hospitalier Universitaire Cochin of the Groupe Hospitalier Universitaire Ouest, Assistance Publique-Hôpitaux de Paris, Paris, France
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  • Bruno Borghese
    Affiliations
    Faculty of Medicine Université Paris Descartes, Sorbonne Paris Cité, Paris, France

    Department of Gynecology, Obstetrics, and Reproductive Medicine, Centre Hospitalier Universitaire Cochin of the Groupe Hospitalier Universitaire Ouest, Assistance Publique-Hôpitaux de Paris, Paris, France

    Institut Cochin, Université Paris Descartes, Centre National de Recherche Scientifique, Paris, France

    Institut National de la Santé et de la Recherche Médicale, Unité de recherche U1016, Paris, France
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  • Dominique de Ziegler
    Affiliations
    Faculty of Medicine Université Paris Descartes, Sorbonne Paris Cité, Paris, France

    Department of Gynecology, Obstetrics, and Reproductive Medicine, Centre Hospitalier Universitaire Cochin of the Groupe Hospitalier Universitaire Ouest, Assistance Publique-Hôpitaux de Paris, Paris, France
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  • Charles Chapron
    Affiliations
    Faculty of Medicine Université Paris Descartes, Sorbonne Paris Cité, Paris, France

    Department of Gynecology, Obstetrics, and Reproductive Medicine, Centre Hospitalier Universitaire Cochin of the Groupe Hospitalier Universitaire Ouest, Assistance Publique-Hôpitaux de Paris, Paris, France

    Institut Cochin, Université Paris Descartes, Centre National de Recherche Scientifique, Paris, France

    Institut National de la Santé et de la Recherche Médicale, Unité de recherche U1016, Paris, France
    Search for articles by this author
Published:January 21, 2014DOI:https://doi.org/10.1016/j.ajog.2014.01.022

      Objective

      The pathogenesis of endometriosis is associated with an inflammatory process. Here, we assessed if the levels of high-sensitivity C-reactive protein (hs-CRP) in serum could constitute an effective method for detecting systemic inflammation during endometriosis.

      Study Design

      This was a prospective, laboratory-based study, which was carried out in a tertiary care university hospital. Patients with histologically proven endometriosis (n = 370) and unaffected women (n = 464) were enrolled from January 2005 through December 2009. We performed complete surgical excision of endometriotic lesions with pathological analysis. In addition, hs-CRP levels were determined through a particle-enhanced immunoturbidimetric method. The hs-CRP levels were measured in both controls and women with endometriosis according to the established surgical classifications of endometriosis: superficial peritoneal endometriosis, endometrioma, and deep infiltration endometriosis. Also, hs-CRP levels were evaluated according to hormonal treatment and menstrual cycle.

      Results

      The hs-CRP serum levels did not statistically differ between women with endometriosis and controls (median in ng/mL [range]: 0.82 [0.04–42.89] vs 0.9 [0.03–43.73], respectively; P = .599). Moreover, subgroup analysis revealed no difference among superficial peritoneal endometriosis, endometrioma, deep infiltration endometriosis, and controls: 0.8 (0.15–13.35), 0.81 (0.04–38.82), 0.83 (0.09–42.89), and 0.9 (0.03–43.73), respectively; P = .872. Furthermore, no effect was observed regarding hormonal treatment or menstrual cycle.

      Conclusion

      Although endometriosis is an inflammatory disease, we failed to identify any systemic changes in hs-CRP serum levels. Therefore, hs-CRP analysis appears to be irrelevant to the diagnosis and staging of endometriosis.

      Key words

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