确定胃肠道肌电活动（GIMA）生物标志物在子宫内膜异位症诊断中的作用。

IF 3.3 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Journal of minimally invasive gynecology Pub Date : 2025-10-22 DOI:10.1016/j.jmig.2025.09.027

P Tanos , F Donders , A Massaro , S Philippe , S Karampelas

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引用次数: 0

摘要

我们的研究旨在验证胃肠道肌电活动（GIMA）生物标志物检测子宫内膜异位症的效果，并将其与MRI、经阴道超声检查（TV-US）和腹腔镜检查进行比较。DesignMRI和TV-US在诊断浅表性子宫内膜异位症方面有局限性，在诊断深部子宫内膜异位症时显示出操作员和翻译人员的依赖性。GIMA生物标记物，例如那些由新型EndoSure设备测量的，已经显示出有希望的初步结果。子宫内膜异位症病变分泌前列腺素E2 （PGE2）和前列腺素F2α (PGF2α)，在壶腹和十二指肠壁产生独特的运动模式，导致小肠肌电能量升高。EndoSure是一种非侵入性的30分钟临床决策支持工具，旨在检测这些模式。连续的患者被纳入我们的专业子宫内膜异位症中心（bruugmann大学医院，比利时布鲁塞尔）。患者或参与者在2024年12月至2025年5月期间招募了100名疑似子宫内膜异位症的成年女性患者。平均年龄30.9岁（SD±15.5），平均BMI为24.2 kg/m²（SD±9.0）。干预措施：前瞻性地为参与者提供EndoSure测试以及MRI或TV-US。EndoSure阳性但MRI/TV-US阴性的患者也行诊断性腹腔镜检查。35例患者行MRI检查，45例行TV-US检查，12例行诊断性腹腔镜检查。EndoSure检测深部和浅表子宫内膜异位症的敏感性为100%，特异性为5%，诊断准确性为96%（初步数据，2025年5月）。值得注意的是，GIMA生物标志物在常规影像学未发现的病例中发现了浅表性子宫内膜异位症。此外，60%的患者更喜欢EndoSure而不是TV-US（1%）。结论ima生物标志物是一种很有前景的新型子宫内膜异位症筛查工具。需要进一步的研究来评估该测试是否能改善浅表性子宫内膜异位症患者的资源利用和管理。

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Defining the Role of the Gastrointestinal Myoelectrical Activity (GIMA) Biomarker in the Diagnosis of Endometriosis.

Study Objective

Our research aimed to validate the gastrointestinal myoelectrical activity (GIMA) biomarkers for detecting endometriosis compared to MRI, transvaginal ultrasonography (TV-US) and laparoscopy using the validated #Enzian classification.

Design

MRI and TV-US have limitations in diagnosing superficial endometriosis and show operator and interpreter dependency for deep endometriosis. GIMA biomarkers, such as those measured by the novel EndoSure device, have shown promising preliminary results. Endometriotic lesions secrete prostaglandin E2 (PGE2) and prostaglandin F2α (PGF2α), which generate distinctive motility patterns in the ampulla of Vater and duodenal wall, leading to elevated small bowel myoelectrical energy. EndoSure is a non-invasive, 30-minute clinical decision support tool designed to detect these patterns.

Setting

Consecutive patients referred to our specialised endometriosis centre (Brugmann University Hospital, Brussels, Belgium) were enrolled into the study.

Patients or Participants

One hundred adult female patients with suspected endometriosis were enrolled between December 2024 and May 2025. The mean age was 30.9 years (SD ±15.5), and mean BMI was 24.2 kg/m² (SD ±9.0).

Interventions

Participants were prospectively offered EndoSure testing along with MRI or TV-US. Patients with a positive EndoSure result but negative MRI/TV-US findings also underwent diagnostic laparoscopy.

Measurements and Primary Results

Thirty-five patients underwent MRI, 45 underwent TV-US, and 12 underwent diagnostic laparoscopy. EndoSure demonstrated sensitivity of 100%, specificity of 5% and diagnostic accuracy of 96% in detecting both deep and superficial endometriosis (preliminary data, May 2025). Notably, GIMA biomarkers identified superficial endometriosis in cases missed by conventional imaging. Additionally, 60% of patients preferred EndoSure over TV-US (1%).

Conclusion

GIMA biomarkers represent a promising new primary screening tool for patients with suspected endometriosis. Further research is warranted to evaluate if the test can improve resource utilization and management in patients with superficial endometriosis.

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来源期刊

Journal of minimally invasive gynecology 医学-妇产科学

CiteScore

5.00

自引率

7.30%

发文量

272

审稿时长

37 days

期刊介绍： The Journal of Minimally Invasive Gynecology, formerly titled The Journal of the American Association of Gynecologic Laparoscopists, is an international clinical forum for the exchange and dissemination of ideas, findings and techniques relevant to gynecologic endoscopy and other minimally invasive procedures. The Journal, which presents research, clinical opinions and case reports from the brightest minds in gynecologic surgery, is an authoritative source informing practicing physicians of the latest, cutting-edge developments occurring in this emerging field.