Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China.
J Transl Med. 2013 Feb 19;11:44. doi: 10.1186/1479-5876-11-44.
Several peripheral proteins that might be useful for detecting the presence of ectopic pregnancy (EP) have been evaluated, but none have been proven entirely useful in the clinic. We investigated the presence and the possible changes in circulating molecules that distinguish between normal intrauterine pregnancy (IUP) and tubal ectopic pregnancy.
Non-pregnant women during the menstrual cycle, women with IUP, and women with tubal EP after informed consent. Serum levels of 17β-estradiol (E2), progesterone (P4), testosterone (T), beta-human chorionic gonadotropin (β-hCG), vascular endothelial growth factor-A (VEGF-A), placental growth factor (PIGF), and a distintegrin and metalloprotease protein 12 (ADAM12) were analyzed. Receiver operating characteristic analysis was used to assess the diagnostic discrimination of EP and gestational age-matched IUP.
E2, P4, PIGF, and ADAM12 levels increased and β-hCG decreased throughout IUP. E2 and VEGF-A levels were significantly different between women with tubal EP and IUP. However, using a serum β-hCG cut-off of less than 1000 mIU/mL, P4 was significantly lower in women with tubal EP compared to IUP. Although E2 was inversely correlated with VEGF-A in women in the early stages of IUP, E2 was not correlated with VEGF-A in women with EP prior to tubal surgery. There were no significant differences in either PIGF or ADAM12 alone between women with tubal EP or IUP. Although no significant correlations were seen between E2 and PIGF or P4 and ADAM12 in women in the early stages of IUP, E2 was positively correlated with PIGF and P4 was positively correlated with ADAM12 in women with EP prior to tubal surgery. Our studies defined associations but not causality.
Individual measurements of serum E2 or VEGF-A levels are strongly related to early pregnancy outcomes for women with IUP and EP, and pregnancy-associated E2 and VEGF-A levels provide diagnostic accuracy for the presence of tubal EP. This study demonstrates that correlation analysis of E2/VEGF-A and E2/PIGF serum levels may be able to distinguish a tubal EP from a normal IUP.
已经评估了几种可能有助于检测异位妊娠（EP）存在的外周蛋白，但没有一种在临床上被证明完全有用。我们研究了区分正常宫内妊娠（IUP）和输卵管异位妊娠的循环分子的存在和可能变化。
非妊娠女性在月经周期中，有 IUP 的女性，以及知情同意后有输卵管 EP 的女性。分析血清 17β-雌二醇（E2）、孕酮（P4）、睾酮（T）、β-人绒毛膜促性腺激素（β-hCG）、血管内皮生长因子-A（VEGF-A）、胎盘生长因子（PIGF）和 a 解整合素和金属蛋白酶 12（ADAM12）的水平。使用受试者工作特征分析评估 EP 和与妊娠龄匹配的 IUP 的诊断鉴别。
E2、P4、PIGF 和 ADAM12 水平在 IUP 期间升高，β-hCG 降低。输卵管 EP 和 IUP 女性之间的 E2 和 VEGF-A 水平有显著差异。然而，使用血清β-hCG 截断值小于 1000 mIU/mL，与 IUP 相比，输卵管 EP 女性的 P4 显著降低。尽管 E2 在 IUP 早期阶段与 VEGF-A 呈负相关，但在输卵管手术前的 EP 女性中，E2 与 VEGF-A 无关。输卵管 EP 或 IUP 女性之间，PIGF 或 ADAM12 单独均无显著差异。尽管 IUP 早期阶段 E2 与 PIGF 或 P4 与 ADAM12 之间未见显著相关性，但在输卵管手术前的 EP 女性中，E2 与 PIGF 呈正相关，P4 与 ADAM12 呈正相关。我们的研究定义了关联，但不是因果关系。
血清 E2 或 VEGF-A 水平的个体测量与 IUP 和 EP 女性的早期妊娠结局密切相关，妊娠相关的 E2 和 VEGF-A 水平为输卵管 EP 的存在提供了诊断准确性。本研究表明，E2/VEGF-A 和 E2/PIGF 血清水平的相关分析可能能够区分输卵管 EP 和正常 IUP。
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