Department of Obstetrics and Gynecology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
Fertil Steril. 2010 Oct;94(5):1595-600. doi: 10.1016/j.fertnstert.2009.10.036. Epub 2009 Dec 11.
To assess the association between the depth of trophoblastic penetration into the tubal wall with serum concentrations of vascular endothelial growth factor (VEGF) and β-hCG and to assess its predictive value.
Prospective study.
Tertiary care university hospital.
PATIENT(S): Thirty patients with ampullary pregnancy undergoing salpingectomy were analyzed.
INTERVENTION(S): Trophoblastic invasion was histologically classified as stage I when limited to the tubal mucosa, stage II when extending to the muscle layer, and stage III in the case of complete tubal wall infiltration.
MAIN OUTCOME MEASURE(S): The relation between depth of trophoblastic infiltration into the tubal wall with VEGF and β-hCG serum concentrations on the day of surgery.
RESULT(S): An association between the depth of trophoblastic invasion and maternal serum concentrations of VEGF and β-hCG was observed. VEGF levels of 297.2 pg/mL showed 100.0% sensitivity and 90.0% specificity for stage I, and levels of 440.1 pg/mL showed 81.8% sensitivity and 88.8% specificity for stage III. Beta-hCG levels of 2590.0 mIU/mL showed 88.9% sensitivity and 80.0% specificity for stage I, and levels of 10,827.0 mUI/mL showed 72.7% sensitivity and 88.9% specificity for stage III.
CONCLUSION(S): Maternal serum VEGF and β-hCG concentrations are associated with depth of trophoblastic penetration into the tubal wall.
评估滋养细胞侵入输卵管壁的深度与血清血管内皮生长因子(VEGF)和β-hCG 浓度之间的关系,并评估其预测价值。
前瞻性研究。
三级保健大学医院。
30 例接受输卵管切除术的壶腹部妊娠患者进行分析。
滋养细胞侵犯组织学上分为 I 期,局限于输卵管黏膜;II 期,延伸至肌层;III 期,完全穿透输卵管壁。
手术当天滋养细胞浸润输卵管壁的深度与 VEGF 和β-hCG 血清浓度之间的关系。
观察到滋养细胞侵犯的深度与母血清 VEGF 和β-hCG 浓度之间存在相关性。VEGF 水平为 297.2pg/ml 时,对 I 期的敏感性为 100.0%,特异性为 90.0%;VEGF 水平为 440.1pg/ml 时,对 III 期的敏感性为 81.8%,特异性为 88.8%。β-hCG 水平为 2590.0mIU/ml 时,对 I 期的敏感性为 88.9%,特异性为 80.0%;β-hCG 水平为 10827.0mIU/ml 时,对 III 期的敏感性为 72.7%,特异性为 88.9%。
母血清 VEGF 和β-hCG 浓度与滋养细胞侵入输卵管壁的深度有关。