The value of a single combined measurement of VEGF, glycodelin, progesterone, PAPP-A, HPL and LIF for differentiating between ectopic and abnormal intrauterine pregnancy.
BACKGROUND
To evaluate whether serum concentrations of the non-placental markers vascular endothelial growth factor (VEGF), glycodelin (GLY) and progesterone (P) and the novel placental markers pregnancy-associated plasmaprotein A (PAPP-A), human placental lactogen (HPL) and leukaemia inhibiting factor (LIF) differ in ectopic pregnancy (EP) when compared with abnormal intrauterine pregnancy (aIUP).


METHODS
A prospective clinical study was conducted at the University Hospital of Larissa, Greece. The study included 50 patients admitted with failed pregnancy and suspected ectopic pregnancy that were treated with curettage or laparoscopy and classified as histologically confirmed EPs (n = 27) or histologically confirmed aIUPs (n = 21) (mean gestational age of 7.15 and 7.3 weeks, respectively). Two suspected EPs proved to be normal IUPs and were excluded. VEGF, GLY, P, beta-HCG, PAPP-A, HPL and LIF were measured by enxyme-linked immunosorbent assay (ELISA) methods in a single pre-operative blood sample.


RESULTS
The median VEGF concentration was 227.2 pg/ml in the EP group versus 107.2 pg/ml in the aIUP group (P < 0.001), with a suggested threshold value of 174 pg/ml for their differential diagnosis. LIF, P, PAPP-A, HPL and GLY serum measurements did not differ significantly between EP and aIUP.


CONCLUSIONS
VEGF serum levels might be a useful marker in differentiating between EPs and aIUPs.
Daponte
A
A
Department of Obstetrics and Gynaecology, University of Thessalia, Larissa, Greece.
Pournaras
S
S
Zintzaras
E
E
Kallitsaris
A
A
Lialios
G
G
Maniatis
A N
AN
Messinis
I E
IE
D015415:Biomarkers / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D000071816:Glycodelin; D006023:Glycoproteins / Q000097:blood; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D053605:Leukemia Inhibitory Factor; D010928:Placental Lactogen / Q000097:blood; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D011257:Pregnancy Proteins / Q000097:blood; D011271:Pregnancy, Ectopic / 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; D000071816:Glycodelin; D006023:Glycoproteins; D015850:Interleukin-6; C507837:LIF protein, human; D053605:Leukemia Inhibitory Factor; C045246:PAEP protein, human; D011257:Pregnancy Proteins; D042461:Vascular Endothelial Growth Factor A; D011374:Progesterone; D010928:Placental Lactogen; D011266:Pregnancy-Associated Plasma Protein-A