| Summary: | <b>Backgroud:</b> Endometriosis remains a diagnostic challenge, both clinically and economically, affecting 6% to 15% of women of child-bearing potential. We have attempted to determine whether testing serum concentrations and activity of arginase isoenzymes could be useful for the non-invasive diagnosis of endometriosis. <b>Methods:</b> This study involved 180 women (105 endometriosis subjects—study group B; 22 subjects with other benign gynaecological conditions—control group 1—K1, both undergoing surgery; and 53 healthy subjects without features of endometriosis—control group 2—K2). <b>Results:</b> Preoperative and postoperative arginase-1 (Arg-1) concentrations were significantly higher in patients, as compared with the control groups K1 (<i>p</i> < 0.0001 and <i>p</i> = 0.0005, respectively) and K2 (both <i>p</i> < 0.0001). Similarly, arginase activity was significantly higher in patients than in the control group K1 before surgery and higher than in both control groups after surgery. No significant differences in either Arg-1 concentrations or arginase activity were noted between the operated control group K1 and the non-operated control group K2. A significant postoperative decrease in Arg-1 concentration was observed within both patient (<i>p</i> < 0.0001) and control group K1 (<i>p</i> = 0.0043). Diagnostic performance was assessed using the receiver operating characteristic (ROC) method. The threshold for differentiation between endometriosis patients and healthy non-operated controls was 42.3 ng/mL, with a sensitivity of 90% and specificity of 81%. For differentiation of patients and operated controls with benign gynaecological conditions, the threshold was 78.4 ng/mL, with a sensitivity of 61% and specificity of 95%. <b>Conclusions:</b> We, therefore, conclude that Arg-1 serum concentrations and arginase activity could be considered potential biomarkers for endometriosis but require further studies on larger cohorts of patients.
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