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血管内皮生长因子和β-人绒毛膜促性腺激素与宫外孕中滋养细胞侵入管壁有关。

Vascular endothelial growth factor and β-human chorionic gonadotropin are associated with trophoblastic invasion into the tubal wall in ectopic pregnancy.

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.

出版信息

Fertil Steril. 2010 Oct;94(5):1595-600. doi: 10.1016/j.fertnstert.2009.10.036. Epub 2009 Dec 11.

Abstract

OBJECTIVE

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.

DESIGN

Prospective study.

SETTING

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.

摘要

目的

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。

设计

前瞻性研究。

地点

三级保健大学医院。

患者

30 例接受输卵管切除术的壶腹部妊娠患者进行分析。

干预措施

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。

主要观察指标

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。

结果

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%。

结论

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。

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