Objective: To determine serum levels of TNF-α (tumor necrosis factor alpha) as a prediction of endometriosis. Design: Prospective clinical case control study. Setting: Department of Obstetrics and Gynaecology and Department of Pathology, Jessenius Faculty Hospital, Kollarova 2, Martin, Slovakia. Methods: The serum TNF-α was determined in women who underwent laparoscopy or laparotomy due to pelvic pain, infertility, dysmenorea or pelvic tumor. Endometriosis was confirmed histologically and classified by rAFS. Results: On the basis of entering criteria 65 women were enrolled in this study. In 61 cases serum level of TNF-α was evaluated. The average serum level of TNF-α in the endometriotic group was 73.847 pg/ml (n=30) and without endometriosis was 21.089 pg/ml (n=31). We have found a significant statistical difference between the above mentioned groups in the medium levels of TNF-α (p<0.0001). We did not find statistical significance between TNF-α levels and in the group of women with endometriosis in relation to the stage of the disease (I.–II., III.–IV., adenomyosis). At a cut-off level of TNF-α 30 pg/ml there was a 63.33% sensitivity, 77.42% specificity, a positive prediction value 73.07%, and 68.57% of negative predictive value. Conclusion: TNF-α serum levels are good diagnostic markers of endometriosis in the spectrum of noninvasive methods.

        Key words: TNF-α, endometriosis, adenomyosis, pelvic pain