Angiogenesis and
inflammation are pivotal processes in developing
endometriosis in the peritoneal cavity. The aim of the present study was to evaluate these two processes in women with
endometriosis who had been treated with
danazol to determine the sensitivity of a non-invasive test in diagnosing
endometriosis. The clinical follow-up study was conducted in a group of 103 women diagnosed laparoscopically with
endometriosis. Thirty-five patients qualified for
danazol treatment.
Pain was assessed using a visual analogue scale, whereas
endometriosis was assessed using the revised American Society of Reproductive Medicine (rASRM) scale.
Cancer antigen (CA)-125 and
C-reactive protein (CRP) concentrations in plasma and peritoneal fluid were determined by immunoenzymatic methods, whereas
vascular endothelial growth factor (
VEGF) and
interleukin (IL)-1β concentrations in plasma and peritoneal fluid were determined by ELISA. Endometrial expression of
IL-8 and
platelet-derived growth factor alpha
polypeptide (
PDGF-A) was determined using real-time polymerase chain reaction (PCR). Women with
endometriosis (68.9% of patients) had higher plasma concentrations of CA-125, as well as higher concentrations of both CA-125 and
VEGF in the peritoneal fluid. Endometrial expression of
IL-8 mRNA was significantly higher, whereas that of
PDGF-A was significantly lower, in contrast. After
danazol treatment the patients reported lower
pain scores; in addition, CA-125 concentrations in the plasma were decreased (P<0.001), whereas
VEGF concentration in the plasma increased (P=0.009). For the diagnosis of
endometriosis, none of the combinations of given markers had a sensitivity >60%.
Danazol treatment is highly effective in relieving
pain and decreasing CA-125 concentrations in the plasma. Higher plasma concentrations of
VEGF after treatment could imply stimulation of angiogenesis.