Redwlne
`
`
`
`ognition of these manifestations is important in caring
`for patients with endometriosis and may result in fun-
`damental changes in conventional wisdom with regard
`to the disease.
`
`REFERENCES
`
`l Redwinc DB Age-related evolutionin color appearance of
`endometriosis Fertil Steril 1987;423:10623.
`
`2. Martin CD. Hubert GD, VanderZwaag R, El—Zeky FA. Lap—
`aroscopie appearances of peritoneal endometriosis. Fertil
`Steril l989;5l:63-7.
`
`
`
`Elevated serum levels of endometrial secretory protein PP14 in
`
`patients with advanced endometriosis
`
`Suppression by treatment with danazol and high-dose
`medroxyprogesterone acetate
`
`Sakari Telirnaa, MD,‘ Antti Kauppila, MD,‘ Lars Ronnberg, MD,‘
`Anne-Maria Suikkari, MD,h and Markku Sepptilii, MDh
`Oulu, Helsinki, and Mikkcli, Finland
`
`The circulating concentration of endomeirtal protetn PP14 varied during the menstrual cycle In patients
`with endometrioels. The highest levels ware found on days 1 to 4 of the cycle (We i 123 (Lg/L;
`mean x SD). and the lowest on days 5 to 20 (44.1 t 29.7 (Lg/L). Rising levels were observed on days 21
`to 30 (58.3 t 62.6 pug/L). On days 5 to 20 (Le, during period of the lowest levels) patients with advanced
`endometriosis had higher PP14 levels (83.9 i 39.0 rig/L) than those with mild endometrtcsls
`(29.3 t 13.2 tag/L; p < 0.01). Patients with mild endcmetrtosis had slightly higher serum PP14 levels than
`apparently healthy control subjects (p < 0.05), but cveriapping of values between the two groups is
`remarkable. Conservative surgical eiirninetlon oi endometrlcsls significantly decreased the serum PP14
`levels. Treatment with danazol (600 mglday), or with medroxyprogesterone acetate (100 mg/day} after
`Iaparoscopy also resulted in significant decreases in the serum PP14 concentration. After 6 months of
`treatment. conservative surgery in combination with danezci or with medroxyprogesterone acetate, yielded
`more pronounced declines in serum PP14 level than conservative surgery plus placebo. No significant
`difference was observed beiwaen the effects of danezot and medroxypregestercne acetate. We conclude
`that endometrtosis tissue contributes to the circulating PPM level, and the decline in PP14 level during
`danazot and medtoxyprogestercne acetate treatments reflects regression of intrauterine and ectopic
`endometrlal tissues. (AM J Oasrer GYNECOL 1989;161:866-7t.)
`
`Key words: Endometrial protein, endometriosis, danazol, medroxyprogesterone acetate,
`placental protein t4
`
`From the Department ofObstetrics and Gynecology, University Central
`Hospital of Onto,“ and Department I of Obstetrics and Gynecology,
`University Central Hospital ochlsmki.’
`Supported by grants from the Cultural Foundalron of Koshe-
`Pohjanmaa, Finland (S. T), flee Research and Science Foundolion
`of Fumes Ltd, Turku, Finland (S. T.), the Sigfidjmélius Foun-
`dation (M. S.),
`the Academy of Finland (M. 8.), and the Social
`Insurance Institution (M. S. rmdA.-M. 3.).
`Receivedfor publication October 7, 1988; revised March 10, 1989;
`accepted April 5, 1989.
`Reprint requests: Dr. Salami Telimaa, MD, Department of Obstetrics
`and Ggmecnlogy, Mikkelin Keslrmmiraala, Pawasstilmmk. 35-3 7,
`SF-50101 Mikkcli, Finland.
`6]! l12986
`
`866
`
`Human secretory endometrium synthesizes endo-
`metrial protein P1314.l This protein is immunologically
`related to progestin—dependent endometriai protein2
`and ag-pregnancy-associated endometrial globulin.3
`Synthesis of this protein occurs in the glandular epi-
`thelium of secretory endomotrium.‘ The amino acid
`sequence of PP14 shows significant homology.with B-
`
`
`
`