Evaluation of erythrocyte band 3 phosphotyrosine level, glutathione content, CA-125, and human epididymal secretory protein E4 as combined parameters in endometriosis

Fertil Steril. 2010 Oct;94(5):1616-21. doi: 10.1016/j.fertnstert.2009.10.038. Epub 2010 Feb 13.


Objective: To investigate the biochemical parameters of the erythrocyte response to diamide-induced oxidative stress, alone or as adjuncts to serum values of CA-125 and human epididymal secretory protein E4 (HE4), in the diagnosis and study of endometriosis.

Setting: University of Padova.

Design: Prospective study.

Patient(s): Forty-five patients of reproductive age undergoing laparoscopy.

Intervention(s): All women were studied for endometriotic foci during laparoscopic surgery. Forty-one had laparoscopically and histologically confirmed endometriosis, and four did not. Twenty women with confirmed endometriosis were reassessed 1-4 months later.

Main outcome measure(s): CA-125 and HE4 and two new parameters evaluated in erythrocytes after diamide-induced stress, that is, band 3 tyrosine phosphorylation (Tyr-P) level and decrease in total glutathione content (ΔGSH), were assessed in all patients.

Result(s): In association with serum CA-125 levels but not with HE4, diamide-related erythrocyte band 3 Tyr-P and ΔGSH were significantly higher in patients with endometriosis and were able to discriminate with high sensitivity and specificity between patients before and after surgery.

Conclusion(s): Endometriosis is associated with an increase in systemic oxidative stress, affecting the antioxidative defenses of circulating erythrocytes. All related implications, including evaluation of other oxidative stress-related changes, warrant further study.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Anion Exchange Protein 1, Erythrocyte*
  • Biomarkers / blood
  • CA-125 Antigen / blood*
  • Case-Control Studies
  • Endometriosis / blood*
  • Endometriosis / diagnosis
  • Epididymal Secretory Proteins / metabolism*
  • Erythrocytes / metabolism*
  • Female
  • Glutathione / blood*
  • Humans
  • Oxidative Stress / physiology
  • Phosphotyrosine / blood*
  • Prospective Studies
  • Sensitivity and Specificity
  • Uterine Diseases / blood*
  • Uterine Diseases / diagnosis
  • beta-Defensins


  • Anion Exchange Protein 1, Erythrocyte
  • Biomarkers
  • CA-125 Antigen
  • DEFB126 protein, human
  • Epididymal Secretory Proteins
  • beta-Defensins
  • Phosphotyrosine
  • Glutathione