Diagnostic utility of Synuclein gamma (SNCG) and b-cell Lymphoma 6 (BCL6) as potential non-invasive dual biomarkers for endometriosis.

OBJECTIVE

This pilot study evaluated Synuclein gamma (SNCG) and B-Cell Lymphoma 6 (BCL6) proteins as potential non-invasive biomarkers in serum and menstrual fluid (MF) to differentiate endometriosis patients from non-endometriosis and healthy individuals.

METHODS

This observational single-center case-control pilot study was conducted at a tertiary care centre Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS)-Lucknow (U.P) India. The study included 103 participants: 65 endometriosis patients (minimal-severe stages), 15 non-endometriosis patients, and 23 healthy controls, meeting the inclusion criteria. Serum and menstrual fluid samples were obtained from participants during their outpatient gynecological consultations, following informed consent. SNCG and BCL6 levels were measured via ELISA. Statistical comparisons and diagnostic accuracy (AUROC, sensitivity, specificity) were assessed using SPSS.

RESULTS

Clinical parameters (age, BMI, hematological/kidney/liver function) showed no significant differences except elevated serum bilirubin and ALP in endometriosis patients. Both SNCG and BCL6 were significantly elevated in endometriosis patients' serum and MF compared to controls. Serum SNCG differentiated endometriosis from non-endometriosis (AUROC: 0.78), while serum BCL6 distinguished endometriosis from healthy/non-endometriosis groups (AUROC: 0.75/0.78). In MF, individual biomarkers achieved exceptional diagnostic accuracy (AUROC: 0.92-1) for differentiating endometriosis from controls. Combined biomarker analysis yielded strong accuracy in serum (AUROC: 0.79-0.80) and MF (AUROC: 0.95-1). Cut-off values provided > 50 % sensitivity and specificity. Although SNCG/BCL6 levels did not vary significantly across disease stages, both markers remained elevated in early stages (minimal/mild) versus controls, highlighting early-detection potential.

CONCLUSION

SNCG and BCL6 demonstrate strong potential as dual non-invasive biomarkers for early endometriosis detection, particularly in menstrual fluid. Their combined use enhances diagnostic accuracy, offering a promising alternative to invasive methods. Further validation is needed to advance clinical translation and address urgent needs for timely diagnosis.