Sørensen F B, Marcussen N, Daugaard H O, Kristiansen J D, Møller J, Ingerslev H J
University Institute of Pathology, Aarhus Kommunehospital, Denmark.
Br J Obstet Gynaecol. 1991 May;98(5):463-9. doi: 10.1111/j.1471-0528.1991.tb10341.x.
Immunohistological demonstration of human placental lactogen (hPL) in non-villous, mononuclear intermediate trophoblastic cells may be of routine diagnostic value, when chorionic villi are absent in endometrial curettings from patients suspected of miscarriage of an intrauterine pregnancy. The histological presence and distribution of hPL was investigated in endometrial curettings from 90 patients studied retrospectively (47 had ectopic pregnancies, 14 miscarriages, and 29 legal abortions), and a consecutive, prospective series of 50 patients (40 had miscarriages and 10 had ectopic pregnancies) without chorionic villi in their endometrial curettings. Non-specific background staining was not a problem. The retrospective survey disclosed that hPL was a highly sensitive marker of intrauterine pregnancy (sensitivity = 0.98). In the prospective series, the predictive value of positive staining for hPL for intrauterine pregnancy was 1.00, and the sensitivity of hPL, as an indicator of uterine gestation, was 0.62. In absence of specific hPL-staining, the risk of ectopic pregnancy was about 50%. The immunohistochemical demonstration of hPL is a useful tool for identifying patients who are suspected of having had a miscarriage, but for whom evidence in the form of chorionic villi in endometrial curettings is lacking.
在怀疑宫内妊娠流产的患者的子宫内膜刮片中绒毛膜绒毛缺失时，在非绒毛、单核中间滋养层细胞中免疫组织学显示人胎盘催乳素（hPL）可能具有常规诊断价值。对90例患者的子宫内膜刮片进行回顾性研究（47例为异位妊娠，14例为流产，29例为合法堕胎），以及对50例连续的前瞻性患者系列（40例为流产，10例为异位妊娠）进行研究，这些患者的子宫内膜刮片中均无绒毛膜绒毛。非特异性背景染色不是问题。回顾性调查显示，hPL是宫内妊娠的高度敏感标志物（敏感性 = 0.98）。在前瞻性系列中，hPL阳性染色对宫内妊娠的预测价值为1.00，hPL作为子宫妊娠指标的敏感性为0.62。在没有特异性hPL染色的情况下，异位妊娠的风险约为50%。hPL的免疫组织化学显示是识别疑似流产但子宫内膜刮片中缺乏绒毛膜绒毛证据的患者的有用工具。
