Evaluation of serum and urinary angiogenic factors in patients with endometriosis

Problem The aim of this study was to evaluate serum and urinary levels of vascular endothelial growth factors, tumor necrosis factor-alpha (TNF-alpha), and soluble fms-like tyrosine kinase (sFlt-1) in patients with endometriosis. Method of study During surgery for pelvic pain, pelvic mass or infertility, serum and urine were collected. Of 70 patients, 46 had histology-proven endometriosis and 24 patients without endometriosis participated as controls. Results Serum TNF-alpha levels and urinary sFlt-1 levels corrected for creatinine excretion were significantly increased in the endometriosis group (P = 0.001 and P = 0.011 respectively). Serum sFlt-1 levels and urinary sFlt-1 levels corrected for creatinine were significantly higher in patients with minimal-to-mild disease (P = 0.014 and P = 0.015 respectively), where serum TNF-alpha levels were increased in moderate-to-severe endometriosis (P < 0.001). Conclusion The pathogenesis of minimal-to-mild endometriosis and moderate-to-severe endometriosis seems to be different. Increased sFlt-1 levels in serum and urine of minimal-to-mild disease indicate that sFlt-1 may have an important role in inhibiting angiogenic process of the disease.