Sahin Cagdas, Uygun Zihni Onur, Hortu Ismet, Akdemir Ali, Kocamanoglu Meltem, Ergenoglu Ahmet M, Akcay Yasemin
Department of Obstetrics and Gynecology, Ege University, Faculty of Medicine, Izmir, Turkey.
Department of Biochemistry, Ege University, Faculty of Medicine, Izmir, Turkey.
J Obstet Gynaecol Res. 2021 Mar;47(3):921-927. doi: 10.1111/jog.14616. Epub 2020 Dec 17.
Ectopic pregnancy is a life-threatening problem in reproductive ages. Diagnosing ectopic pregnancy in the early period provides to reducing mortality and morbidity and gives an opportunity for medical treatment to preserve fallopian tubes. Evaluation of cervical fluid for determining ectopic pregnancy with new promising markers provided different aspects for diagnosing ectopic pregnancy in the present study.
In this prospective clinical study, ectopic pregnant patients as ectopic pregnancy group (n = 46), intrauterine pregnant patients as intrauterine pregnancy group (n = 29) and not-pregnant patients as nonpregnancy group (n = 10) participated to study. Cervical fluid samples were collected with using merocel sponge. In addition, serum samples were obtained from patients. Dynein heavy chain 5 (DNAH5) and creatine kinase (CK) levels were determined by enzyme-linked immunosorbent assay kits in samples.
Reduced cervical fluid DNAH5 levels was diagnosed in ectopic pregnancy group compared to intrauterine pregnancy group (median 3.42 ng/mL; 25-75% percentile 0-9.56 ng/mL vs median 6.14 ng/mL; 1.40-8.31 ng/mL; P < 0.001). On the other hand, DNAH5 protein was not detected in nonpregnant patients' samples. In addition, statistical significant increased cervical fluid CK levels were diagnosed in ectopic pregnancy group compared to intrauterine pregnancy group (median 4477.61 IU/L; 0-64 925.37 IU/L vs 0 IU/L; 0-6832.30 IU/L; P = 0.006).
Measuring of CK and DNAH5 in cervical fluid could be promising markers for early diagnosing of ectopic pregnancy. Decreased DNAH5 levels in cervical fluid might be result from abnormal cilia function in ectopic pregnant patients. ClinicalTrials.gov ID. NCT02995356.
异位妊娠是育龄期危及生命的问题。早期诊断异位妊娠有助于降低死亡率和发病率，并为保留输卵管的药物治疗提供机会。在本研究中，评估宫颈液中用于确定异位妊娠的新的有前景的标志物为诊断异位妊娠提供了不同方面的依据。
在这项前瞻性临床研究中，异位妊娠组（n = 46）的异位妊娠患者、宫内妊娠组（n = 29）的宫内妊娠患者和非妊娠组（n = 10）的未妊娠患者参与了研究。使用美罗海绵收集宫颈液样本。此外，从患者处获取血清样本。通过酶联免疫吸附测定试剂盒测定样本中的动力蛋白重链5（DNAH5）和肌酸激酶（CK）水平。
与宫内妊娠组相比，异位妊娠组宫颈液DNAH5水平降低（中位数3.42 ng/mL；25 - 75%百分位数0 - 9.56 ng/mL，对比中位数6.14 ng/mL；1.40 - 8.31 ng/mL；P < 0.001）。另一方面，在未妊娠患者的样本中未检测到DNAH5蛋白。此外，与宫内妊娠组相比，异位妊娠组宫颈液CK水平在统计学上显著升高（中位数4477.61 IU/L；0 - 64925.37 IU/L，对比0 IU/L；0 - 6832.30 IU/L；P = 0.0（此处原文可能有误，推测应为P = 0.006））。
检测宫颈液中的CK和DNAH5可能是早期诊断异位妊娠的有前景的标志物。异位妊娠患者宫颈液中DNAH5水平降低可能是由于异位妊娠患者纤毛功能异常所致。ClinicalTrials.gov标识符：NCT02995356。
