Novel placental and nonplacental serum markers in ectopic versus normal intrauterine pregnancy.
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.
Mueller
Michael D
MD
Department of Obstetrics and Gynecology, University of Bern, Bern, Switzerland. michel.mueller@insel.ch
Raio
Luigi
L
Spoerri
Stephan
S
Ghezzi
Fabio
F
Dreher
Ekkehard
E
Bersinger
Nick A
NA
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*
D015415:Biomarkers; D042461:Vascular Endothelial Growth Factor A; D011374:Progesterone; D011266:Pregnancy-Associated Plasma Protein-A