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Endometriosis is a chronic inflammatory disease associated with pelvic pain, dyspareunia, and impaired ovarian reserve. Cancer antigen-125 (CA-125) is widely studied but limited by low specificity, while angiopoietin-like protein-4 (ANGPTL4) has emerged as a potential biomarker due to its role in angiogenesis and inflammation. In the current study it was aimed to investigate serum and peritoneal fluid ANGPTL4 levels in women with endometriosis compared to healthy controls, and to evaluate their associations with clinical symptoms, serum CA-125, and anti-Müllerian hormone levels.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Endometriosis group (Study group) | The study group included women with endometriosis. The study group consisted of women diagnosed with endometriosis who consecutively underwent laparoscopic endometriosis surgery. |
| |
| Healthy women (Control group) | Control group consisted of healthy women. The control group consisted of women who consecutively visited the outpatient clinic for routine gynecologic examinations and had no known diseases. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Angiopoietin-like protein-4 (ANGPTL4) Peritoneal Fluid Level | Other | Measurement of peritoneal fluid levels of Angiopoietin-like protein-4 (ANGPTL4) level by ELISA method. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Serum and peritoneal fluid Angiopoietin-like protein-4 level | Nanogram/milliliter | day 1 |
| Measure | Description | Time Frame |
|---|---|---|
| Serum cancer antigen 125 level | Unit/milliliter | day 1 |
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Inclusion Criteria:
Exclusion Criteria:
Endometriosis is characterized by the presence of endometrial tissue outside the uterus, including the ovaries, fallopian tubes, peritoneal membrane, or abdominal cavity, and it is diagnosed exclusively in females.
Study population includes a total of 80 participants. The study group consists of 40 women with the diagnosis of endometriosis, and the control group consists of 40 healthy women.
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| Name | Affiliation | Role |
|---|---|---|
| Merve Didem Eşkin Tanrıverdi, MD | Ankara City Hospital Bilkent | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ankara Bilkent City Hospital | Ankara | Not Valid | 06100 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40024324 | Background | Campara K, Rodrigues P, Viero FT, da Silva B, Trevisan G. A systematic review and meta-analysis of advanced oxidative protein products levels (AOPP) levels in endometriosis: Association with disease stage and clinical implications. Eur J Pharmacol. 2025 Jun 5;996:177434. doi: 10.1016/j.ejphar.2025.177434. Epub 2025 Feb 28. | |
| 40028674 |
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IPD are available which may be shared in necessary conditions.
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| ID | Term |
|---|---|
| D004715 | Endometriosis |
| D017699 | Pelvic Pain |
| D007249 | Inflammation |
| ID | Term |
|---|---|
| D005831 | Genital Diseases, Female |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
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| ID | Term |
|---|---|
| D000075803 | Angiopoietin-Like Protein 4 |
| D018394 | CA-125 Antigen |
| ID | Term |
|---|---|
| D000075802 | Angiopoietin-like Proteins |
| D042501 | Angiogenic Proteins |
| D036341 | Intercellular Signaling Peptides and Proteins |
| D010455 | Peptides |
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Serum samples were collected through antecubital venous blood sampling. In the study group, serum samples were obtained just before laparoscopy, while peritoneal fluid (PF) samples were collected from the Douglas pouch during trocar insertion into the abdominal cavity. Serum and PF levels of Angiopoietin-like protein-4 were analyzed.
| Cancer Antigen 125 (CA-125) Serum Level | Other | Measurement of venous blood serum level of CA-125 level by ELISA method. |
|
| Angiopoietin-like protein-4 (ANGPTL4) Serum Level | Other | Measurement of venous blood serum level of Angiopoietin-like protein-4 (ANGPTL4) Level level by ELISA method. |
|
| Makoui MH, Fekri S, Makoui RH, Ansari N, Esmaeilzadeh A. The Role of Mast Cells in the Development and Advancement of Endometriosis. Am J Reprod Immunol. 2025 Mar;93(3):e70019. doi: 10.1111/aji.70019. |
| 29420391 | Background | Falcone T, Flyckt R. Clinical Management of Endometriosis. Obstet Gynecol. 2018 Mar;131(3):557-571. doi: 10.1097/AOG.0000000000002469. |
| 19261336 | Background | Brown R, Imran SA, Wilkinson M. Lipopolysaccharide (LPS) stimulates adipokine and socs3 gene expression in mouse brain and pituitary gland in vivo, and in N-1 hypothalamic neurons in vitro. J Neuroimmunol. 2009 Apr 30;209(1-2):96-103. doi: 10.1016/j.jneuroim.2009.02.001. Epub 2009 Mar 3. |
| D000091662 | Genital Diseases |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010335 | Pathologic Processes |
| D000602 | Amino Acids, Peptides, and Proteins |
| D011506 | Proteins |
| D001685 | Biological Factors |
| D009077 | Mucins |
| D009088 | Mucoproteins |
| D006023 | Glycoproteins |
| D006001 | Glycoconjugates |
| D002241 | Carbohydrates |
| D015295 | Antigens, Tumor-Associated, Carbohydrate |
| D000951 | Antigens, Neoplasm |
| D000941 | Antigens |
| D000939 | Epitopes |
| D014408 | Biomarkers, Tumor |
| D015415 | Biomarkers |