The promising role of placental growth factor in association with cyclooxygenase-2 as predictive markers for recurrent ovarian endometriosis

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Various risk factors, both patient dependent and surgeon dependent, have been involved in the recurrence of ovarian endometriosis. Identification of an ideal biomarker to predict the recurrence of ovarian endometriosis is essential for a proper treatment plan, as it could allow the use of targeted therapy to postpone or even prevent recurrence altogether and prevent unnecessary medication, thus attaining effectiveness and diminishing healthcare costs.

Patients and methods

In all, 95 suspected patients with ovarian endometriosis, who were admitted to Tanta Gynecology and Obstetrics Department for laparoscopy or laparotomy from June 2014 to June 2017, were included in the study. Blood samples for serum placental growth factor (PlGF) tests were taken from patients at the time of admission. Postoperatively, all specimens were subjected to histopathological evaluation in the Tanta Pathology Department; 88 of 95 patients were confirmed to have endometriosis. Afterwards, the diagnosed cases were immunostained for both PlGF and cyclooxygenase-2 (COX-2).


There was a statistically significant relation between PlGF, COX-2 overexpression, high PlGF serum level, and the disease recurrence in the studied cases (P<0.01, 0.025, and <0.05, respectively).


The panel of PlGF and COX-2 holds a promise for ovarian endometriosis: as a predictive marker for recurrence and as a potential therapeutic target. Our current analysis provides a link between high PlGF serum levels and recurrence of ovarian endometriosis. However, still further studies are needed to establish the use of serum PlGF as a screening test for prediction of recurrence among women with ovarian endometriosis.

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