Endometriosis affects 10% of women in France. His diagnosticdiagnostic it is complex and almost all women undergo a diagnostic process for several years before they can be treated. To date, there is no test that can make a quick and reliable diagnosis. Currently the diagnosis is based on two tests:ultrasoundultrasound Abdominopelvic and pelvic MRI. In order to carry out this type of exam, the waiting lists are sometimes long. Also, women sometimes have to travel far from home because not all medical centers are equipped.
To facilitate the course of women, a to bootto boot The Lyonnaise named Ziwig designed a saliva test to diagnoseendometriosisendometriosis. This test is called Endotest and was developed with the support of the Collège des gynecologistsgynecologists and French obstetricians. The results of a clinical trialclinical trial involving 200 patients were published in the journal New England Journal of Medicine.
The principle of the saliva test
The test consists in sequencing the micro-RNAs present in the salivasaliva. To date, 2,600 human microRNAs have been identified. It turns out that Ziwig’s teams managed to prove that 109 of them are involved in endometriosis. The presence of these microRNAs constitutes a signature of the disease.
After collecting the patient’s saliva in a test tube, it is analyzed with a state-of-the-art sequencer. It is then a artificial intelligenceartificial intelligence which processes the large amount of data obtained.
The test has many advantages. He is not invasiveinvasive, easy to do and fast. In a few days all women aged 18 to 43 who want it will be able to find out whether or not they have endometriosis. However, the test must have been prescribed by a doctor.
Promising test reliability
According to the published results, the test has a sensitivity of 96.2% and a specificity of 95.1%. For the record, sensitivity measures the ability of the test to give a positive result when the patient is sick, while specificity measures the ability of the test to give a negative result when the patient is not sick. In other words, false negatives and false positives are very rare.
Furthermore, the test is able to identify very early forms of endometriosis, which does not happen with currently available diagnostic methods (imaging).
More work needs to be done before this test can be marketed as a larger patient trial randomized trialsrandomized trials double blind. One of the weaknesses of the saliva test against imaging is that it allows neither to localize endometriosis (ovaries or uterus) nor to specify the degree of severity. Nonetheless, this is an interesting discovery that will no doubt lead the way bringsbrings to the diagnosis of others pathologiespathologies through saliva.
Endometriosis: towards rapid diagnosis thanks to the saliva test
Article by Stephanie LeGuillouStephanie LeGuillou released February 15, 2022
In France, one in ten women of childbearing age is affected by endometriosis. Diagnosis is always long and difficult; women experience an average of eight years of diagnostic drift. The French have developed a rapid diagnostic test that could be a game changer!
L’endometriumendometrium it’s a mucosamucosa which lines the inside of the uterus. With each cycle, the endometrium thickens to accommodate a possible embryo. If it wasn’t there fertilizationfertilization, excess endometrium is evacuated in the form of blood – these are the rules. In some women, portions of the endometrium grow in abnormal places such as in the digestive system, bladderbladderovaries or peritoneumperitoneum. This pathology causes painspains important during the menstrual cycle, too often considered “normal” by the medical profession and by women themselves. Endometriosis can also cause difficulty conceiving or even infertility. Depending on the woman, other symptoms are possible, such as digestive disorders or urinary disorders.
Thanks to the work of patient associations, this pathology is now better known by the medical profession and the general public. You have just been diagnosed with ALD (long-term illness) durationduration). One of the problems of the disease is the delay in diagnosis: eight years on average! The French have developed a test that could revolutionize disease management.
A very powerful diagnostic test
A squad highlighted the link between some microRNAs and the onset of the disease. MicroRNAs are regulatorsregulators which circulate in the majority liquidsliquids of the body such as blood, urine or saliva. There are more than 2,600 identified microRNAs. But which ones are involved in endometriosis? To find out, the authors analyzed the saliva of 153 women with the disease and 47 healthy women. They were thus able to identify 109 involved microRNAs, a sort of signature of the disease. Based on these results, a rapid diagnostic test was developed. And the test performance is outstanding. It is able to detect:
- 96.7% of positive cases (very few false negatives);
- 100% of cases negative (no false positives).
Furthermore, the test has the ability to diagnose all forms of endometriosis, from the most superficial to the deepest.
A revolution for patients
Until now, the gold standard for diagnosing endometriosis was laparoscopy. This invasive exam is distressing for patients, they demand it General anesthesiaGeneral anesthesia and represents a significant cost. The saliva test is delivered at the pharmacy, on prescription. It involves putting some saliva in a tube and mailing it to a lab. A few days later, the patient goes to the doctor to show her the results.
The current misdiagnosis represents a lost opportunity for patients. Indeed, in addition to the pain suffered, the injuries can worsen in the absence of treatment. We therefore hope that this test will soon be available to all women.