血清钙调蛋白 2 是输卵管异位妊娠的新型生物标志物。

Serum calponin 2 is a novel biomarker of tubal ectopic pregnancy.

机构信息

Department of Obstetrics and Gynecology, Shanghai ZhongShan Hospital, Shanghai FuDan University School of Medicine, Shanghai, China.

Department of Gynecology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China.

出版信息

Fertil Steril. 2021 Oct;116(4):1020-1027. doi: 10.1016/j.fertnstert.2021.05.101. Epub 2021 Jul 1.

DOI:10.1016/j.fertnstert.2021.05.101

PMID:34217487

Abstract

OBJECTIVE

To evaluate serum protein calponin 2 (CNN2) as a candidate biomarker for tubal ectopic pregnancy (EP).

DESIGN

Retrospective study.

SETTING

Single University affiliated tertiary hospital.

PATIENT(S): Serum samples were obtained from 84 patients with EP, 39 with viable intrauterine pregnancy (vIUP), and 42 with miscarriage. Moreover, 10 fallopian tube and corresponding villous tissue samples from patients with EP, 6 villous tissue samples from patients with vIUP, and 10 villous tissue samples from patients with miscarriage were collected.

INTERVENTION(S): Serum CNN2 concentrations were measured using enzyme-linked immunosorbent assay; CNN2 expression in tissues was evaluated via immunohistochemistry and quantitative real-time polymerase chain reaction analysis.

MAIN OUTCOME MEASURE(S): The diagnostic performance of serum CNN2 to discriminate an EP from vIUP and miscarriage.

RESULT(S): CNN2 was highly expressed in villous stromal cells isolated from patients with EP, and CNN2 messenger ribonucleic acid expression was upregulated in villous tissues from women with EP compared with that in women with vIUPs and miscarriages. Serum CNN2 concentration was higher in women with EP than that in women with vIUP and miscarriage. The serum CNN2 predicted EP from vIUP and miscarriage with areas under the curve (AUCs) of 0.931 (95% confidence interval: 0.889-0.975). For discriminating EP from miscarriage only, the AUC was 0.906 (95% confidence interval: 0.835-0.977). In contrast, the AUCs for serum human chorionic gonadotropin were 0.809 and 0.637, respectively.

CONCLUSION(S): Our data highlight the possibility of serum CNN2 as a single biomarker for the diagnosis of EP.

CLINICAL TRIAL REGISTRATION NUMBER

ChiCTR 1900020483.

摘要

目的

评估血清钙调节蛋白 2（CNN2）作为输卵管异位妊娠（EP）候选生物标志物的价值。

设计

回顾性研究。

地点

单所大学附属医院。

患者

收集了 84 例 EP 患者、39 例活宫内妊娠（vIUP）患者和 42 例自然流产患者的血清样本。此外，还收集了 10 例 EP 患者的输卵管及其相应的绒毛组织样本、6 例 vIUP 患者的绒毛组织样本和 10 例自然流产患者的绒毛组织样本。

干预

采用酶联免疫吸附试验测定血清 CNN2 浓度；通过免疫组织化学和实时定量聚合酶链反应分析评估组织中 CNN2 的表达。

主要观察指标

血清 CNN2 鉴别 EP 与 vIUP 和自然流产的诊断性能。

结果

CNN2 在 EP 患者的绒毛间质细胞中高度表达，与 vIUP 患者和自然流产患者相比，EP 患者的绒毛组织中 CNN2 信使核糖核酸表达上调。EP 患者的血清 CNN2 浓度高于 vIUP 和自然流产患者。血清 CNN2 预测 EP 与 vIUP 和自然流产的曲线下面积（AUC）为 0.931（95%置信区间：0.889-0.975）。仅用于鉴别 EP 与自然流产时，AUC 为 0.906（95%置信区间：0.835-0.977）。相比之下，血清人绒毛膜促性腺激素的 AUC 分别为 0.809 和 0.637。