Lin Qin, Lin Nan, Wang Gongli, Zheng Xuan, Hua Renyi
International Peace Maternity and Child Health Hospital of China Welfare Institution (IPMCH), School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory of Embryo Original Diseases, Shanghai Municipal Key Clinical Specialty, Shanghai, China.
Ann Transl Med. 2021 Jan;9(2):146. doi: 10.21037/atm-20-7914.
For stable fallopian tube pregnancy (FTP), methotrexate (MTX) therapy is reported to be as effective as laparoscopy. However, some cases would need further treatment, e.g., another dose of MTX or laparoscopy. This study is to investigate the potential factors during the treatment of FTP that may facilitate the prediction of a successful outcome of MTX therapy.
All FTP cases admitted to the International Peace Maternal and Child Health Hospital (IPMCH), Shanghai, China from January 2016 to December 2017 were reviewed. All patients received a single dose of 50 mg/m MTX prior to other treatment. Statistical analysis was performed to determine the correlation between clinical parameters and the success rate of MTX treatment.
The success rate of single-dose MTX was 77.53%. The serum beta-human chorionic gonadotropin (β-hCG) level cut-off value was 452.64 IU/L, with a specificity of 76.7% and sensitivity of 43% [area under the receiver operating characteristic curve (AUC) 0.803; P<0.0001]. In addition, serum β-hCG levels and patient age correlated with the success rate of MTX treatment.
Lower β-hCG levels led to successful MTX treatment for FTP, with a cutoff value of 452.64 IU/L. Younger patients were more sensitive to MTX treatment. These results may help clinicians when deciding the potential therapy for patients with tubal ectopic pregnancies.
对于稳定型输卵管妊娠（FTP），据报道甲氨蝶呤（MTX）治疗与腹腔镜检查效果相当。然而，有些病例需要进一步治疗，例如再用一剂MTX或进行腹腔镜检查。本研究旨在调查FTP治疗期间可能有助于预测MTX治疗成功结果的潜在因素。
回顾了2016年1月至2017年12月在中国上海国际和平妇幼保健院收治的所有FTP病例。所有患者在接受其他治疗前均接受了单剂量50mg/m的MTX。进行统计分析以确定临床参数与MTX治疗成功率之间的相关性。
单剂量MTX的成功率为77.53%。血清β-人绒毛膜促性腺激素（β-hCG）水平的截断值为452.64IU/L，特异性为76.7%，敏感性为43%[受试者操作特征曲线（AUC）下面积为0.803；P<0.0001]。此外，血清β-hCG水平和患者年龄与MTX治疗成功率相关。
较低的β-hCG水平导致MTX治疗FTP成功，截断值为452.64IU/L。年轻患者对MTX治疗更敏感。这些结果可能有助于临床医生为输卵管异位妊娠患者决定潜在的治疗方法。
