title: Trophoblastic infiltration in tubal pregnancy evaluated by immunohistochemistry and correlation with variation of Beta-human chorionic gonadotropin.
abstract: Objective. To evaluate trophoblastic cell proliferation and angiogenesis in tubal pregnancy assessed by immunohistochemical study and their correlation with an average variation of β -hCG in an interval of 48 hours before surgery. Methods. A prospective study was conducted on 18 patients with a diagnosis of tubal pregnancy. The patients were divided into two groups of ectopic pregnancy of which 11 showed rise of β -hCG levels and 7 patients showed declining β -hCG levels in an interval of 48 hours prior to surgery. Trophoblastic cell proliferation and angiogenesis were assessed by Ki-67 and VEGF, respectively. Trophoblastic cell proliferation was assessed by Ki-67 and was classified into three groups (grade I: less than 1/3 of stained nuclei, grade II: 1/3 to 2/3 of the stained nuclei, and grade III: more than 2/3 of the nuclei stained). The cases analyzed for VEGF were divided into three groups (grade I: less than 1/3 of the stained cytoplasm; grade II: 1/3 to 2/3 of the stained cytoplasm; grade III: more than 2/3 of the stained cytoplasm). Statistical analysis was performed using the chi-square, ANOVA, and Kruskal-Wallis tests. Results. The mean variation in the serum β -hCG levels in 48 hours in tubal pregnancy patients correlated with trophoblastic cell proliferation assessed by Ki-67 and showed a decline of 13.46% in grade I, a rise of 45.99% in grade II, and ascension of 36.68% in grade III (P = 0.030). The average variation in the serum β -hCG in 48 hours, where angiogenesis was evaluated by VEGF, showed a decline of 18.35% in grade I, a rise of 32.95% in grade II, and ascension of 37.55% in grade III (P = 0.047). Conclusions. Our observations showed a direct correlation of increased levels of serum β -hCG in 48h period prior to surgery with higher trophoblastic cell proliferation assessed by Ki-67 and angiogenesis assessed by VEGF in tubal pregnancy.
authors: Department of Obstetrics, São Paulo Federal University (UNIFESP), Rua Carlos Weber 956, Apartamento 113 Visage, Alto da Lapa, São Paulo, SP, Brazil.
authors: Danyelle Farias
authors: DF
authors: Ferreira
authors: Department of Obstetrics, São Paulo Federal University (UNIFESP), Rua Carlos Weber 956, Apartamento 113 Visage, Alto da Lapa, São Paulo, SP, Brazil.
authors: Julio
authors: J
authors: Elito Júnior
authors: Department of Obstetrics, São Paulo Federal University (UNIFESP), Rua Carlos Weber 956, Apartamento 113 Visage, Alto da Lapa, São Paulo, SP, Brazil.
authors: Edward
authors: 0000-0002-6145-2532
authors: E
authors: Araujo Júnior
authors: Department of Pathology, São Paulo Federal University (UNIFESP), São Paulo, SP, Brazil.
authors: João Norberto
authors: JN
authors: Stavale
authors: Department of Obstetrics, São Paulo Federal University (UNIFESP), Rua Carlos Weber 956, Apartamento 113 Visage, Alto da Lapa, São Paulo, SP, Brazil.
authors: Luiz
authors: L
authors: Camano
authors: Department of Obstetrics, São Paulo Federal University (UNIFESP), Rua Carlos Weber 956, Apartamento 113 Visage, Alto da Lapa, São Paulo, SP, Brazil.
authors: Antonio Fernandes
authors: AF
authors: Moron