Endometriosis Diagnosis

Salivary MicroRNA Signature for Diagnosis of Endometriosis

Bendifallah S, Suisse S, Puchar A, Delbos L, Poilblanc M, Descamps P, Golfier F, Jornea L, Bouteiller D, Touboul C, Dabi Y, Daraï E

Published January 26, 2022 Journal of clinical medicine
DOI 10.3390/jcm11030612 PMID 35160066 PMC PMC8836532

RRM Academy Synopsis

Saliva microRNA signature separated endometriosis in 200 women

A saliva test of small RNA molecules, called microRNAs, told women with endometriosis apart from women without it. The study followed 200 women with chronic pelvic pain. The test's best run found 96.7% of the women who had endometriosis.

About 8 in 10 women with chronic pelvic pain were found to have endometriosis
About 8 in 10 women with chronic pelvic pain were found to have endometriosis. Source: Bendifallah S et al., 2022, PMID 35160066.
Study at a glance, prospective ENDO-miRNA study: Saliva microRNA signature separated endometriosis in 200 women
Study at a glance, prospective ENDO-miRNA study of 200 women with chronic pelvic pain: Saliva microRNA signature separated endometriosis in 200 women. Source: Bendifallah S et al., 2022, PMID 35160066.

Key Findings

  • The study enrolled 200 women with chronic pelvic pain suggestive of endometriosis: 153 (76.5%) had endometriosis and 47 (23.5%) did not (controls).
  • Sequencing of the 200 saliva samples mapped reads to 2561 known miRNAs, and Random Forest feature selection produced a signature of 109 miRNAs.
  • Across 10 randomly composed internal datasets, the most accurate split reached sensitivity 96.7%, specificity 100% and AUC 98.3%.
  • The lowest sensitivity across the 10 datasets was 80%.
  • Endometriosis was confirmed by surgery in 83 women (54.2%) and by MRI in 70 (45.8%). All 47 controls had surgery.

Interpretation

This study followed 200 women with chronic pelvic pain from January to June 2021, testing a saliva signature of microRNAs against each woman's final diagnosis. The authors note the signature needs testing in new, outside groups. The findings support larger studies of this saliva test for endometriosis.

RRM Context

Restorative reproductive medicine starts by finding the cause. In this group, women with endometriosis waited an average of 14.8 years from first symptoms to diagnosis. The authors suggest a saliva test could help find it sooner, once proven. Excision is the surgical standard once endometriosis is found.

Abstract

Background

Endometriosis diagnosis constitutes a considerable economic burden for the healthcare system with diagnostic tools often inconclusive with insufficient accuracy. We sought to analyze the human miRNAome to define a saliva-based diagnostic miRNA signature for endometriosis.

Methods

We performed a prospective ENDO-miRNA study involving 200 saliva samples obtained from 200 women with chronic pelvic pain suggestive of endometriosis collected between January and June 2021. The study consisted of two parts: (i) identification of a biomarker based on genome-wide miRNA expression profiling by small RNA sequencing using next-generation sequencing (NGS) and (ii) development of a saliva-based miRNA diagnostic signature according to expression and accuracy profiling using a Random Forest algorithm.

Results

Among the 200 patients, 76.5% (n = 153) were diagnosed with endometriosis and 23.5% (n = 47) without (controls). Small RNA-seq of 200 saliva samples yielded ~4642 M raw sequencing reads (from ~13.7 M to ~39.3 M reads/sample). Quantification of the filtered reads and identification of known miRNAs yielded ~190 M sequences that were mapped to 2561 known miRNAs. Of the 2561 known miRNAs, the feature selection with Random Forest algorithm generated after internally cross validation a saliva signature of endometriosis composed of 109 miRNAs. The respective sensitivity, specificity, and AUC for the diagnostic miRNA signature were 96.7%, 100%, and 98.3%.

Conclusions

The ENDO-miRNA study is the first prospective study to report a saliva-based diagnostic miRNA signature for endometriosis. This could contribute to improving early diagnosis by means of a non-invasive tool easily available in any healthcare system.

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Topics

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Related research

Endometriosis › Diagnosis › Biomarkers · General Gynecology › Pelvic Pain › Chronic Pelvic Pain · Diagnostics › Genetic and Immune Testing › Karyotype and Genetic Panels
Sofiane Bendifallah, Stéphane Suisse, Anne Puchar, Léa Delbos, Mathieu Poilblanc, Philippe Descamps, Francois Golfier, Ludmila Jornea, Delphine Bouteiller, Cyril Touboul, Yohann Dabi, Emile Daraï
S Bendifallah, S Suisse, A Puchar, L Delbos, M Poilblanc, P Descamps, F Golfier, L Jornea, D Bouteiller, C Touboul, Y Dabi, E Daraï
PMID 35160066 35160066 DOI 10.3390/jcm11030612 10.3390/jcm11030612 Bendifallah et al. 2022, Bendifallah 2022