Mueller Michael D, Raio Luigi, Spoerri Stephan, Ghezzi Fabio, Dreher Ekkehard, Bersinger Nick A
Department of Obstetrics and Gynecology, University of Bern, Bern, Switzerland.
Fertil Steril. 2004 Apr;81(4):1106-11. doi: 10.1016/j.fertnstert.2003.08.049.
To evaluate whether the serum concentrations of novel placental markers and nonplacental markers differ in ectopic pregnancy when compared with normal intrauterine pregnancy.
Prospective clinical study.
University hospital.
PATIENT(S): Patients with confirmed ectopic pregnancy (EP) and control population with normal intrauterine pregnancy (IUP).
INTERVENTION(S): Laparoscopy.
MAIN OUTCOME MEASURE(S): Serum concentrations of placental markers: pregnancy-associated plasma protein A (PAPP-A), pregnancy-specific beta(1)-glycoprotein (SP1), human placental lactogen (HPL), and HCG; and nonplacental markers: glycodelin, vascular endothelial growth factor (VEGF), and P.
RESULT(S): The multiples of median of all markers (except VEGF) were decreased in EP when compared with the control group. Conversely, the serum values of VEGF were significantly increased in EP. VEGF showed a negative correlation with HCG and SP1, but not with PAPP-A, P, or the nonplacental markers. HCG, PAPP-A, SP1, and HPL strongly correlated with each other. But, in contrast to the above, P only correlated with HCG and, in contrast to the controls, with glycodelin. The combination of three independent markers in the formula VEGF/(PAPP-A x P) was found to be largely superior to the measure of any single marker.
CONCLUSION(S): The "triple marker analysis" [VEGF/(PAPP-A x P] allows a clear discrimination between normal IUP and EP.
评估与正常宫内妊娠相比，异位妊娠时新型胎盘标志物和非胎盘标志物的血清浓度是否存在差异。
前瞻性临床研究。
大学医院。
确诊为异位妊娠（EP）的患者以及正常宫内妊娠（IUP）的对照人群。
腹腔镜检查。
胎盘标志物的血清浓度：妊娠相关血浆蛋白A（PAPP-A）、妊娠特异性β1-糖蛋白（SP1）、人胎盘催乳素（HPL）和人绒毛膜促性腺激素（HCG）；以及非胎盘标志物：糖蛋白1、血管内皮生长因子（VEGF）和P。
与对照组相比，EP组中所有标志物（VEGF除外）的中位数倍数均降低。相反，EP组中VEGF的血清值显著升高。VEGF与HCG和SP1呈负相关，但与PAPP-A、P或非胎盘标志物无相关性。HCG、PAPP-A、SP1和HPL之间强烈相关。但是，与上述情况相反，P仅与HCG相关，且与对照组不同，与糖蛋白1相关。发现公式VEGF/（PAPP-A×P）中的三种独立标志物组合在很大程度上优于任何单一标志物的测量。
“三联标志物分析”[VEGF/（PAPP-A×P）]能够清晰地区分正常IUP和EP。
