title: Vascular endothelial growth factor and β-human chorionic gonadotropin are associated with trophoblastic invasion into the tubal wall in ectopic pregnancy.
abstract: OBJECTIVE
  To assess the association between the depth of trophoblastic penetration into the tubal wall with serum concentrations of vascular endothelial growth factor (VEGF) and β-hCG and to assess its predictive value.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Tertiary care university hospital.
  
  
  METHODS
  Thirty patients with ampullary pregnancy undergoing salpingectomy were analyzed.
  
  
  METHODS
  Trophoblastic invasion was histologically classified as stage I when limited to the tubal mucosa, stage II when extending to the muscle layer, and stage III in the case of complete tubal wall infiltration.
  
  
  METHODS
  The relation between depth of trophoblastic infiltration into the tubal wall with VEGF and β-hCG serum concentrations on the day of surgery.
  
  
  RESULTS
  An association between the depth of trophoblastic invasion and maternal serum concentrations of VEGF and β-hCG was observed. VEGF levels of 297.2 pg/mL showed 100.0% sensitivity and 90.0% specificity for stage I, and levels of 440.1 pg/mL showed 81.8% sensitivity and 88.8% specificity for stage III. Beta-hCG levels of 2590.0 mIU/mL showed 88.9% sensitivity and 80.0% specificity for stage I, and levels of 10,827.0 mUI/mL showed 72.7% sensitivity and 88.9% specificity for stage III.
  
  
  CONCLUSIONS
  Maternal serum VEGF and β-hCG concentrations are associated with depth of trophoblastic penetration into the tubal wall.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil. fabiocabar@uol.com.br
authors.forename: Fábio Roberto
authors.initials: FR
authors.lastname: Cabar
authors.forename: Pedro Paulo
authors.initials: PP
authors.lastname: Pereira
authors.forename: Regina
authors.initials: R
authors.lastname: Schultz
authors.forename: Rossana Pulcineli
authors.initials: RP
authors.lastname: Francisco
authors.forename: Marcelo
authors.initials: M
authors.lastname: Zugaib
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D006063:Chorionic Gonadotropin / Q000097:blood*; D005260:Female; D006801:Humans; D011237:Predictive Value of Tests; D011247:Pregnancy; D011274:Pregnancy, Tubal / Q000097:blood* / Q000503:physiopathology; D011446:Prospective Studies; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013997:Time Factors; D014327:Trophoblasts / Q000502:physiology*; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D006063:Chorionic Gonadotropin; D042461:Vascular Endothelial Growth Factor A