Daponte Alexandros, Deligeoroglou Efthimios, Pournaras Spyros, Hadjichristodoulou Christos, Garas Antonios, Anastasiadou Foteini, Messinis Ioannis E
Department of Obstetrics and Gynecology, University of Thessaly Medical School, University Hospital Larissa, Biopolis, 41110 Larissa, Greece.
Clin Dev Immunol. 2013;2013:637513. doi: 10.1155/2013/637513. Epub 2013 Jan 17.
Given the present lack of clinically useful tests for the accurate diagnosis of ectopic pregnancy (EP), there is a need to select out those immunological factors measured in the maternal serum, as potential biomarkers. Our assumption was that C1q/anti-C1q antibody complexes and serum levels of interleukin-15 (IL-15) may play a role in differentiating abortions (MAs) and EPs and normal pregnancies. We assessed whether their measurement could set the diagnosis in a case control study at 6-8 weeks consisting of 60 women with failed early pregnancy (30 EPs, 30 MAs) and 33 women with intrauterine pregnancies. Normal pregnancies contain anti-C1q antibodies more frequently compared to women with failed pregnancies, the lowest levels being found in EPs, but this lacked statistical significance and anti-C1q could not serve as a marker. However EP pregnancies had elevated IL-15 levels that could statistically significantly differentiate them from MAs and IUPs. Furthermore, when assessing IL-15 for the clinically important differentiation between IUP and EP, we found at a cut-off of 16 pg/mL a negative predictive value of 99 with a sensitivity for diagnosing an EP of 92%. According to these results, serum IL-15 is a promising marker differentiating an MA from an EP.
鉴于目前缺乏用于准确诊断异位妊娠(EP)的临床实用检测方法,有必要筛选出母血清中检测到的那些免疫因素,作为潜在的生物标志物。我们的假设是,C1q/抗C1q抗体复合物和白细胞介素-15(IL-15)的血清水平可能在鉴别流产(MA)、异位妊娠和正常妊娠中发挥作用。我们在一项病例对照研究中评估了对它们的检测是否有助于诊断,该研究纳入了60例早期妊娠失败的女性(30例异位妊娠、30例流产)和33例宫内妊娠女性,妊娠时间为6至8周。与妊娠失败的女性相比,正常妊娠女性更频繁地含有抗C1q抗体,异位妊娠女性的抗C1q抗体水平最低,但这缺乏统计学意义,抗C1q不能作为标志物。然而,异位妊娠女性的IL-15水平升高,这在统计学上可以将她们与流产和宫内妊娠显著区分开来。此外,在评估IL-15对宫内妊娠和异位妊娠的重要临床鉴别时,我们发现,在临界值为16 pg/mL时,阴性预测值为99,诊断异位妊娠的灵敏度为92%。根据这些结果,血清IL-15是鉴别流产和异位妊娠的一个有前景的标志物。