Elevated Serum CD95/FAS and HIF-1 alpha Levels, but Not Tie-2 Levels, May Be Biomarkers in Patients With Severe Endometriosis: A Preliminary Report

Study Objective: To evaluate serum values of cluster of differentiation 95 (CD95/FAS), hypoxia-inducible factor 1-alpha (HIF-1 alpha), and tyrosine kinase receptor 2 (Tie-2) as possible biomarkers of disease presence and severity in women with endometriosis, and to characterize the changes in these values in women with stage I/II and stage III/IV endometriosis. Design: Prospective study (Canadian Task Force classification I). Setting: University hospital. Patients: Thirty women with endometriosis and 30 healthy women without endometriosis. Intervention: For the diagnosis of endometriosis and prediction of its severity, we measured the serum levels of CD95/FAS, which assess apoptotic conditions, and of HIF-1 alpha and Tie-2, which assess angiogenesis. Endometriosis was diagnosed and staged through surgical laparoscopy and later confirmed histologically. During the surgery, the patients with endometriosis were divided into 2 groups based on disease stage. Eleven patients had stage I/II endometriosis, and 19 had stage III/IV endometriosis. Measurements and Main Results: Endometriosis was associated with increased serum CD95/FAS and HIF-1 alpha levels, but not Tie-2 levels. We also determined that stage III/IV endometriosis was associated with higher serum CD95/FAS and HIF-1 alpha levels, but not Tie-2 levels, compared with stage I/II endometriosis. Conclusion: Endometriosis, in accordance with its severity, increases serum CD95/FAS and HIF-1 alpha levels, but not Tie-2 levels. These biomarkers may be useful for reproductive surgeons to improve the quality of counseling women about the presence and severity of endometriosis. (C) 2016 AAGL. All rights reserved.