Washington University School of Medicine, Pathology and Immunology, St. Louis, MO 63110, United States.
Clin Chim Acta. 2012 Apr 11;413(7-8):707-11. doi: 10.1016/j.cca.2011.12.018. Epub 2012 Jan 5.
To evaluate the diagnostic accuracy of activin A alone or in a multi-marker panel for the prediction of ectopic pregnancy (EP).
A retrospective analysis was performed on a cohort of 289 women who presented to the emergency department (ED) with vaginal bleeding and/or abdominal pain/cramping and were diagnosed with EP, spontaneous abortion, or viable intrauterine pregnancy. Serum progesterone, hCG, and activin A concentrations were measured on the samples obtained in the ED. Statistical analysis was performed to determine the clinical utility of these biomarkers as single measurement and as a multi-marker panel test for ectopic pregnancy. Women ≥18 y with vaginal bleeding or abdominal pain/cramping.
Progesterone (<10 ng/ml), hCG (<6,699 IU/l), and activin A (<0.26 ng/ml) cutoffs were optimized by ROC analysis. These demonstrated sensitivities of 62.9%, 74.2%, and 59.6%, and specificities of 60.5%, and 63.0%, and 61.0% respectively for detecting EP. The multi-marker panel utilizing all three biomarkers had a sensitivity of 70% and specificity of 69%.
Serum activin A cannot be used as a single measurement or in a multi-marker panel with progesterone and hCG to predict EP.
评估激活素 A 单独或在多标志物面板中用于预测异位妊娠 (EP) 的诊断准确性。
对 289 名因阴道出血和/或腹痛/痉挛而到急诊科就诊并被诊断为 EP、自然流产或活宫内妊娠的女性进行了回顾性分析。在急诊科采集的样本中测量血清孕激素、hCG 和激活素 A 浓度。进行统计分析以确定这些生物标志物作为单一测量值和作为异位妊娠的多标志物面板测试的临床效用。
通过 ROC 分析优化了孕激素（<10ng/ml）、hCG（<6699IU/l）和激活素 A（<0.26ng/ml）的截断值。这些指标检测 EP 的敏感性分别为 62.9%、74.2%和 59.6%，特异性分别为 60.5%、63.0%和 61.0%。利用所有三种生物标志物的多标志物面板的敏感性为 70%，特异性为 69%。
血清激活素 A 不能作为单一测量值或与孕激素和 hCG 联合使用的多标志物面板用于预测 EP。
