title: A disintegrin and metalloprotease protein-12 as a novel marker for the diagnosis of ectopic pregnancy.
abstract: OBJECTIVE
  To evaluate the performance of a novel biomarker, a disintegrin and metalloprotease-12 (ADAM-12), to differentiate an ectopic pregnancy (EP) from normal intrauterine pregnancies (IUPs).
  
  
  METHODS
  Case-control study.
  
  
  METHODS
  Three urban academic centers.
  
  
  METHODS
  Women who were seen in the emergency department with pain or bleeding in the first trimester of pregnancy.
  
  
  METHODS
  Sera from women with diagnosed EP or IUP were evaluated via proteomics and an ADAM-12 dissociation-enhanced lanthanide fluoroimmunoassay.
  
  
  METHODS
  Differences between groups, area under the receiver operating curve, sensitivity, and specificity.
  
  
  RESULTS
  Via a proteomics evaluation, we found a statistically significant decrease in ADAM-12 in the sera of patients with EP, which we confirmed in a larger group of 199 patients (median IUP 18.6 ng/mL versus median EP 2.5 ng/mL with good discrimination between the groups as assessed by receiver operating characteristics [area under the curve = 0.82]). At a low cut-point, the sensitivity was 70% and specificity 84%, but, at a higher cut-point optimizing sensitivity, the ADAM-12 test demonstrated a sensitivity of 97%.
  
  
  CONCLUSIONS
  ADAM-12 is a promising marker for the diagnosis of EP in women with symptoms in the first trimester, validating the proteomics findings. Further studies in additional patient populations and in combination with other biomarkers are needed.
authors.affiliation: Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
authors.forename: Mary E
authors.initials: ME
authors.lastname: Rausch
authors.forename: Lynn
authors.initials: L
authors.lastname: Beer
authors.forename: Mary D
authors.initials: MD
authors.lastname: Sammel
authors.forename: Peter
authors.initials: P
authors.lastname: Takacs
authors.forename: Karine
authors.initials: K
authors.lastname: Chung
authors.forename: Alka
authors.initials: A
authors.lastname: Shaunik
authors.forename: David
authors.initials: D
authors.lastname: Speicher
authors.forename: Kurt T
authors.initials: KT
authors.lastname: Barnhart
mesh_terms: D051722:ADAM Proteins / Q000097:blood*; D000072199:ADAM12 Protein; D000328:Adult; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D019483:Disintegrins / Q000097:blood*; D005260:Female; D006801:Humans; D053508:Matrix Metalloproteinase 12 / Q000097:blood; D008565:Membrane Proteins / Q000097:blood*; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood; D011271:Pregnancy, Ectopic / Q000097:blood* / Q000175:diagnosis*; D040901:Proteomics / Q000379:methods; D055815:Young Adult
chemical_list: D015415:Biomarkers; D019483:Disintegrins; D008565:Membrane Proteins; D051722:ADAM Proteins; D000072199:ADAM12 Protein; C000606480:ADAM12 protein, human; D053508:Matrix Metalloproteinase 12