Placental growth factor, soluble fms-like tyrosine kinase 1 and progesterone as diagnostic biomarkers for ectopic pregnancy and missed abortion
Autor: | José A. Noguera-Velasco, Joaquín Pérez-Fornieles, Ana Martínez-Ruiz, Juan Antonio Vílchez, Isabel Tovar-Zapata, María Desamparados Sarabia-Meseguer |
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Rok vydání: | 2013 |
Předmět: |
Placental growth factor
Adult medicine.medical_specialty Clinical Biochemistry Pregnancy Proteins Diagnosis Differential Young Adult Pregnancy Internal medicine Medicine Humans Progesterone Placenta Growth Factor Retrospective Studies Vascular Endothelial Growth Factor Receptor-1 Ectopic pregnancy Receiver operating characteristic business.industry Area under the curve General Medicine medicine.disease Pregnancy Ectopic Endocrinology ROC Curve Case-Control Studies Gestation Female False positive rate Abortion Missed business Soluble fms-like tyrosine kinase-1 Biomarkers |
Zdroj: | Clinical biochemistry. 47(9) |
ISSN: | 1873-2933 |
Popis: | Objective The aim of this study is to investigate if progesterone, placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt1) serum levels are useful markers to differentiate between ectopic pregnancy (EP), missed abortion (MA) and viable intrauterine implantation pregnancy (IUP). Methods We designed a retrospective case–control study which included 100 pregnant women (50 EP and 50 MA) at 6–8 weeks of gestation with βhCG serum levels between 800 and 3500 UI/L and a viable IUP group. Progesterone, PlGF and sFlt-1 levels were measured with an electrochemiluminescence assay (Roche Diagnostics®, Manheim, Alemania). A non parametric test was used to compare the markers in the different groups and we used receiver operating characteristic (ROC) curve analysis to calculate the area under the curve (AUC). Results When we compared the EP group with the MA group, we didn't find significant differences for PlGF (15.1[13.2–17.4]/16.7[12.8–18.7] pg/mL) ( p = 0.275). We only obtained significant differences for progesterone (9.1[3.1–16.8]/2.6[1.3–6.1] ng/mL) ( p p The AUC for progesterone was 0.756 and the cutoff point with better sensitivity and lower false positive rate was 6 ng/mL (sensitivity = 60%, specificity = 72.7%). The AUC for sFlt-1 was 0.842 and the cutoff point was 93 pg/mL (sensitivity = 84.5%, specificity = 86.3%). The combination of both markers allowed us to increase the AUC to 0.910. Conclusions In conclusion, the present study suggests that sFlt-1 could be a useful marker to differentiate between an EP or a MA when βhCG levels are similar in both groups. The combination of sFlt-1 with progesterone helps to increase the diagnostic performance. |
Databáze: | OpenAIRE |
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