title: Novel placental and nonplacental serum markers in ectopic versus normal intrauterine pregnancy.
abstract: OBJECTIVE
  To evaluate whether the serum concentrations of novel placental markers and nonplacental markers differ in ectopic pregnancy when compared with normal intrauterine pregnancy.
  
  
  METHODS
  Prospective clinical study.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Patients with confirmed ectopic pregnancy (EP) and control population with normal intrauterine pregnancy (IUP).
  
  
  METHODS
  Laparoscopy.
  
  
  METHODS
  Serum concentrations of placental markers: pregnancy-associated plasma protein A (PAPP-A), pregnancy-specific beta(1)-glycoprotein (SP1), human placental lactogen (HPL), and HCG; and nonplacental markers: glycodelin, vascular endothelial growth factor (VEGF), and P.
  
  
  RESULTS
  The multiples of median of all markers (except VEGF) were decreased in EP when compared with the control group. Conversely, the serum values of VEGF were significantly increased in EP. VEGF showed a negative correlation with HCG and SP1, but not with PAPP-A, P, or the nonplacental markers. HCG, PAPP-A, SP1, and HPL strongly correlated with each other. But, in contrast to the above, P only correlated with HCG and, in contrast to the controls, with glycodelin. The combination of three independent markers in the formula VEGF/(PAPP-A x P) was found to be largely superior to the measure of any single marker.
  
  
  CONCLUSIONS
  The "triple marker analysis" [VEGF/(PAPP-A x P] allows a clear discrimination between normal IUP and EP.
authors.affiliation: Department of Obstetrics and Gynecology, University of Bern, Bern, Switzerland. michel.mueller@insel.ch
authors.forename: Michael D
authors.initials: MD
authors.lastname: Mueller
authors.forename: Luigi
authors.initials: L
authors.lastname: Raio
authors.forename: Stephan
authors.initials: S
authors.lastname: Spoerri
authors.forename: Fabio
authors.initials: F
authors.lastname: Ghezzi
authors.forename: Ekkehard
authors.initials: E
authors.lastname: Dreher
authors.forename: Nick A
authors.initials: NA
authors.lastname: Bersinger
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D010920:Placenta / Q000378:metabolism*; D011247:Pregnancy / Q000097:blood*; D011271:Pregnancy, Ectopic / Q000097:blood* / Q000175:diagnosis; D011266:Pregnancy-Associated Plasma Protein-A / Q000032:analysis*; D011374:Progesterone / Q000097:blood*; D011446:Prospective Studies; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*
chemical_list: D015415:Biomarkers; D042461:Vascular Endothelial Growth Factor A; D011374:Progesterone; D011266:Pregnancy-Associated Plasma Protein-A