ENDOMETRIOSIS - IDENTIFICATION BY CARBONIC-ANHYDRASE AUTOANTIBODIES AND CLINICAL-FEATURES

Reliably diagnosing endometriosis traditionally requires surgery. To e valuate a possible non-surgical method, a case-control series of unexp lained infertility patients undergoing diagnostic laparoscopy were sco red by clinical criteria and reactivity to human carbonic anhydrase II by Western blotting. The CA II autoantibodies were found in none of t he fertile controls, 38 percent of infertile controls, 55 percent of s tage 1, 50 percent of stage 2, 73 percent of stage 3, and 85 percent o f stage 4 endometriosis patients. Advanced endometriosis was associate d with more intense reactivity. Combining clinical and antibody scores for infertile groups showed a positive association with disease stage with positive predictive values of 76 to 95 percent, negative predict ive values of 90 to 60 percent, and a likelihood ratio of 18.3. It is concluded by us that CA II immunoreactivity, clinical, and combined sc ores all identified stages 2 to 4 endometriosis patients. However, bas ed on predictive values and likelihood ratios, the combined score is b est at identifying endometriosis non-surgically.