International Journal of
Reproductive Biomedicine
Wed, Jul 1, 2026
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Volume 24, Issue 5 (May 2026)
IJRM 2026, 24(5): 445-456 |
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Ethics code: B/091/UN19.5.1.1.8/UEPKK/2021
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Saputra N P K, Samsulhadi S, Hendarto H, Saádi A, Pudjirahardjo W J, Arsana I W, et al . The role of tumor necrosis factor alpha in regulating CYFRA 21-1 as a potential biomarker for endometriosis: A cross-sectional study. IJRM 2026; 24 (5) :445-456
URL: http://ijrm.ir/article-1-3716-en.html
URL: http://ijrm.ir/article-1-3716-en.html
Nicko Pisceski Kusika Saputra *1 
, Samsulhadi Samsulhadi2 , Hendy Hendarto2 , Ashon Saádi2 , Widodo J Pudjirahardjo3 , I Wayan Arsana4 , Relly Yanuari2 , Sri Ratna Dwiningsih2 , Suri Dwi Lesmana5
, Samsulhadi Samsulhadi2 , Hendy Hendarto2 , Ashon Saádi2 , Widodo J Pudjirahardjo3 , I Wayan Arsana4 , Relly Yanuari2 , Sri Ratna Dwiningsih2 , Suri Dwi Lesmana5
1- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Riau, Pekanbaru, Indonesia. , nicko.pisceski@lecturer.unri.ac.id
2- Fertility and Endocrinology Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
3- Department of Public Health, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
4- Fertility and Endocrinology Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia.
5- Department of Parasitology, Faculty of Medicine, Universitas Riau, Pekanbaru, Indonesia. & Lontar Biomedical Laboratory, Faculty of Medicine, Universitas Riau, Pekanbaru, Indonesia.
2- Fertility and Endocrinology Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
3- Department of Public Health, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
4- Fertility and Endocrinology Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia.
5- Department of Parasitology, Faculty of Medicine, Universitas Riau, Pekanbaru, Indonesia. & Lontar Biomedical Laboratory, Faculty of Medicine, Universitas Riau, Pekanbaru, Indonesia.
Abstract: (7 Views)
Background: Endometriosis is one of the most common gynecological conditions, and the gold standard for its diagnosis is laparoscopy. Cytokeratin fragment 21-1 (CYFRA 21-1) has emerged as a potential biomarker candidate due to its strong association with endometriosis. The mechanisms underlying the cleavage of cytokeratin-19 into CYFRA 21-1 remain unclear. Tumor necrosis factor alpha (TNF-α) may play a regulatory role in this process.
Objective: This study aimed to analyze the correlation between intraperitoneal TNF-α levels and CYFRA 21-1 expression levels in women with endometriosis.
Materials and Methods: This was an analytical study with a cross-sectional study design, involving 38 women diagnosed with endometriosis and 35 non-endometriosis women as controls. Both CYFRA 21-1 and TNF-α concentrations were measured using the Enzyme-Linked Immunosorbent Assay method. Urine creatinine was measured using the Electrochemiluminescence Immunoassay method, while clinical data were collected through medical records.
Results: The mean intraperitoneal TNF-α level was significantly higher in the endometriosis group compared to controls (p < 0.001). A significant positive correlation was found between intraperitoneal TNF-α concentrations and CYFRA 21-1 levels (p < 0.001; r 0,662 [95% CI: 0.426-0.814]), indicating a strong association. Furthermore, a strong positive correlation was observed between the urinary CYFRA 21-1 to creatinine ratio and intraperitoneal TNF-α levels, particularly during the proliferative phase of the menstrual cycle.
Conclusion: These findings suggest that TNF-α may influence CYFRA 21-1 expression in a cycle phase-dependent manner, supporting the potential role of CYFRA 21-1 as a non-invasive biomarker for endometriosis, particularly during the proliferative phase.
Objective: This study aimed to analyze the correlation between intraperitoneal TNF-α levels and CYFRA 21-1 expression levels in women with endometriosis.
Materials and Methods: This was an analytical study with a cross-sectional study design, involving 38 women diagnosed with endometriosis and 35 non-endometriosis women as controls. Both CYFRA 21-1 and TNF-α concentrations were measured using the Enzyme-Linked Immunosorbent Assay method. Urine creatinine was measured using the Electrochemiluminescence Immunoassay method, while clinical data were collected through medical records.
Results: The mean intraperitoneal TNF-α level was significantly higher in the endometriosis group compared to controls (p < 0.001). A significant positive correlation was found between intraperitoneal TNF-α concentrations and CYFRA 21-1 levels (p < 0.001; r 0,662 [95% CI: 0.426-0.814]), indicating a strong association. Furthermore, a strong positive correlation was observed between the urinary CYFRA 21-1 to creatinine ratio and intraperitoneal TNF-α levels, particularly during the proliferative phase of the menstrual cycle.
Conclusion: These findings suggest that TNF-α may influence CYFRA 21-1 expression in a cycle phase-dependent manner, supporting the potential role of CYFRA 21-1 as a non-invasive biomarker for endometriosis, particularly during the proliferative phase.
Type of Study: Original Article |
Subject:
Reproductive Endocrinology
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