Non-invasive diagnosis of endometrioma through cervical swabs using Fourier transform infrared spectroscopy

This study aimed to investigate whether Fourier transform infrared (FTIR) spectroscopy applied to cervical swab samples could detect meaningful biochemical differences between women diagnosed with endometriomas and healthy controls, thereby assessing its potential as a non-invasive diagnostic tool.

A total of 104 cervical swab samples-52 from women with endometriomas diagnosed via transvaginal ultrasonography and 52 from healthy controls-were initially collected and processed. Following an optimization process and quality control of spectral data, 24 endometrioma and 20 control samples were included in the final analysis. FTIR spectra were obtained in the 4000-600 cm^-1 range, and the primary outcomes included comparative peak intensities and areas under specific wavenumbers reflecting various bio-organic molecules.

Statistically significant differences were observed at 2350 cm^-1 and 1050 cm^-1, indicative of alterations in carbon dioxide and carbohydrate metabolism, respectively, in the endometrioma group compared with healthy controls (p<0.05). No significant differences were detected in other spectral regions associated with lipids (2950, 1460, 1400 cm^-1) and proteins (e.g., amid-I and amid-II regions), suggesting that endometrioma may primarily affect carbohydrate metabolism and carbon dioxide balance rather than lipid and protein pathways. Both groups were comparable in demographic and hormonal characteristics, thus bolstering the validity of the findings.

FTIR spectroscopy of cervical swab samples revealed distinctive biochemical profiles in women with endometriomas, particularly related to carbon dioxide and carbohydrate metabolism. These data suggest that FTIR analysis, which is rapid and minimally invasive, holds promise for the future development of non-invasive diagnostic strategies for endometrioma. However, larger multicenter studies that include surgical confirmation and disease staging are needed to establish its clinical utility definitively.