Uterine epithelioid trophoblastic tumor with the main manifestation of increased human chorionic gonadotropin:A case report

BACKGROUND Epithelioid trophoblastic tumor(ETT)is an extremely rare malignant gestational trophoblastic neoplasm commonly presenting with abnormal vaginal bleeding,abdominal pain,and increased human chorionic gonadotropin(hCG).This study reported a case of uterine ETT with the main manifestation being increased hCG.CASE SUMMARY A 39-year-old female was referred to the Ningbo Maternal and Child Hospital of China in December 2022,complaining of increased hCG levels for 1 month.Magnetic resonance imaging revealed gestational trophoblastic tumor,and hysteroscopic electrotomy and curettage of intrauterine hyperplasia were performed.The patient was diagnosed with uterine ETT through postoperative pathological examination and immunohistochemical results.Total laparoscopic hysterectomy and bilateral salpingectomy were performed,and hCG levels returned to normal.The patient was without recurrence during the postoperative 3-month follow-up.CONCLUSION This study reported a case of uterine ETT with the main manifestation being increased hCG,highlighting that ETT should be considered in the presence of abnormal hCG.A total laparoscopic hysterectomy is recommended.

Expression of Beta-Human Chorionic Gonadotropin Genes in Renal Cell Cancer and Benign Renal Disease Tissues

To study the expression of beta-human chorionic gonadotropin (βhCG) genes in renal cell carcinomas (RCC) and benign renal disease tissues, nested reverse transcription-polymerase chain reaction (RT-PCR) and restriction endonuclease analysis were employed to detect the expression of βhCG genes in 44 cases of RCC tissues and 24 cases of benign renal disease tissues It was found that 52% RCC samples revealed positive for βhCG mRNA expression Positive rate in advanced stage and poorly differentiated RCC was higher, but there was no significant difference The positive rate of βhCG mRNA expression was 54% in 24 cases of benign renal tissues, including 3 cases out of 6 polycystic kidneys, 7 cases out of 13 renal atrophies, 2 cases out of 2 oncocytomas and 1 case out of 2 pyonephrotic kidneys β7 was most frequently transcribed subtype gene independent on the histology These findings suggested βhCG gene transcription is not only involved in RCC but also in benign renal diseases

Effects on Cell Viability and on Apoptosis in Tumoral(MCF-7)and in Normal(MCF10A)Epithelial Breast Cells after Human Chorionic Gonadotropin and Derivated-Angiotensin Peptides Treatments

Angiotensin-(1 - 7) [Ang-(1 - 7)] is an endogenous heptapeptide hormone of the renin-angiotensin system that has antiproliferative properties. The aim of this work was to evaluate the anti-proliferative and pro-apoptotic properties of Ang-(1 - 7) and of Ang-(1 - 7)-substituents 9-fluorenylmethyloxycarbonyl (Fmoc) e Ang II-derivatives containing the TOAC (2,2,6,6-tetramethylpiperidine-N-oxyl-4-amino-4-carboxylic acid) in normal (MCF10A) and in tumoral (MCF7) epithelial mammary cell lines. Both cell lines received an hCG and angiotensin peptides 24-hour treatment, in combination or alone followed by cell viability, apoptosis and cell cycle assays performed by flow cytometer (GUAVA). After hCG, Ang-(1 - 7), hCG + Ang-(1 - 7) and hCG + Ang-(1 - 7)-Fmoc treatments, MCF7 displayed cell viability decrease and mid-apoptosis increase. We also observed cell viability decrease in MCF10A after Ang-(1 - 7), Ang-(1 - 7) Fmoc and hCG + AngII Toac treatments. These cells had an increase in late apoptosis and necrosis after AngII Toac, hCG + Ang-(1 - 7) and hCG + Ang-(1 - 7)-Fmoc treatments. Regarding the cell cycle analysis, we did not observed any changes in cell cycle phases. In summary, cell viability was decreased and apoptosis (initial, mid and late) was increased after hCG and/or Ang-(1 - 7) peptides treatments. These results point out hCG and Ang-(1 - 7) as effective compounds to inhibit cell proliferation, since they decrease cell viability and increase apoptosis in both normal and in tumoral breast cells, being the effect more pronounced in the tumoral cell line. Our results support the idea of investigating more closely the putative use of these compounds as novel therapeutic agents for breast cancer.

The Study on Immuno-response and Antisera Properties of Recombinant β-subunit of Human Chorionic Gonadotropin in C57 Black Mouse

In this study, the immuno-response of recombinant hCG-β and natural hCGβ was comparatively investigated by using Freund's adjuvant. The results showed that, the properties and merits of the antibodies elicited by both kinds of hCG-β were similar. The antisera had high affinity for binding with hCG (Kαγβ≈5.86×108/mol/L, Kαβ≈8.18×108/mol/L), and were found to be effective in inhibiting the binding of 125I-hCG to receptors in rat testes. Results also indicated that, similar to the antisera induced by natural hCG-β, the recombinant hCG-β induced antisera had capacity of neutralizing the biological activities of hCG. Recombinant hCG-β could be used as an immunogen for contraceptive vaccine.

Predictive Value of Initial Serum Human Chorionic Gonadotropin Levels for Pregnancies after Single Fresh and Frozen Blastocyst Transfer

As one of the earliest markers for predicting pregnancy outcomes, human chorionic gonadotropin(h CG) values have been inconclusive on reliability of the prediction after frozen and fresh embryo transfer(ET). In this retrospective study, patients with positive h CG(day 12 after transfer) were included to examine the h CG levels and their predictive value for pregnancy outcomes following 214 fresh and 1513 vitrified-warmed single-blastocyst transfer cycles. For patients who got clinical pregnancy, the mean initial h CG value was significantly higher after frozen cycles than fresh cycles, and the similar result was demonstrated for patients with live births(LB). The difference in h CG value existed even after adjusting for the potential covariates. The area under curves(AUC) and threshold values calculated by receiver operator characteristic curves were 0.944 and 213.05 m IU/m L for clinical pregnancy after fresh ET, 0.894 and 399.50 m IU/m L for clinical pregnancy after frozen ET, 0.812 and 222.86 m IU/m L for LB after fresh ET, and 0.808 and 410.80 m IU/mL for LB after frozen ET with acceptable sensitivity and specificity, respectively. In conclusion, single frozen blastocyst transfer leads to higher initial h CG values than single fresh blastocyst transfer, and the initial h CG level is a reliable predictive factor for predicting IVF outcomes.

How and Why Do Gestational Trophoblastic Neoplasms Overproduce Human Chorionic Gonadotropin?

From the published data, the present mini-review attempts to answer two fundamental questions about the gestational trophoblastic neoplasms. In addition, it extrapolates the findings to other cancers that produce small amounts of hCG and how a novel therapies could be developed.

Effect of different fertilization time after human chorionic gonadotropin injection on fertilization outcome of patients in vitro fertilizationembryo transfer

Objective:To explore the effect of different fertilization time after human chorionic gonadotropin(HCG)injection on the outcome of fertilization in vitro fertilization-embryo transfer(IVF-ET).Methods:One thousand one hundred and forty IVF-ET cycles from January 2016 to August 2018 were analyzed retrospectively.According to the different fertilization time after injection of HCG divided into four groups:Group A(38.0 h~39.0 h),Group B(39.1 h~40.0 h),Group C(40.1 h~41.0 h),and Group D(41.1 h~42.0 h).The normal fertilization rate,the normal cleavage rate,the embryo utilization rate,the high-quality embryo rate,the clinical pregnancy rate,the implantation rate,and the spontaneous abortion rate were analyzed among the groups.Then we investigated the effect of different promotion methods on the outcome of fertilization during the optimal fertilization time.Results:There was no significant difference in 2PN cleavage rate,available embryo rate,clinical pregnancy rate,implantation rate and abortion rate among the four groups(P>0.05).The high-quality embryo rate in Group D(44.6%)was the highest,and was significantly different among the four groups(P<0.05).The normal fertilization rate in Group D(71.6%)was the highest,and was significantly different among the four groups(P<0.05).The normal fertilization rate(78.1%)of antagonist group was significantly higher than other groups(P<0.05).Conclusion:The different fertilization time after HCG injection have effects on high-quality embryo rate and normal fertilization rate of patients in IVF-ET.The appropriate fertilization time of patients in IVF-ET was 41 h~42 h after HCG injection in our reproductive center,improved the clinical pregnancy rate and reduced the early abortion rate.The GnRH-ant protocol is superior to other protocol in IVF-ET.

超声“四切面”法联合妊娠中期产妇血清Freeβ-hCG和uE3筛查胎儿严重先天性心脏病的研究

目的:探究超声“四切面”法联合妊娠中期孕妇血清游离人绒毛膜促性腺激素(Freeβ-hCG)和雌三醇(uE3)筛查胎儿严重先天性心脏病(CHD)的临床应用价值。方法:选择2020年1月到2021年6月我院行妊娠中期CHD筛查的孕妇97例,检测孕妇血清Freeβ-hCG和uE3水平,采用超声“四切面”法筛查CHD,分析超声“四切面”法联合血清Freeβ-hCG和uE3水平对CHD的诊断价值。结果:97例孕妇随访确诊为严重CHD 9例(9/97,9.28%);超声“四切面”法检查提示高危胎儿25例,其中4例确诊为严重CHD(4/25,16.00%);孕妇血清学检测提示高危胎儿36例,其中6例最终确诊为严重CHD(6/36,16.67%);超声“四切面”法联合孕妇血清学检测提示高危胎儿9例,其中5例确诊为严重CHD(5/9,55.56%)。超声“四切面”法筛查严重CHD的敏感度、特异度、准确度、阳性预测值和阴性预测值分别为16.00%、93.51%、74.51%、44.44%和77.22%。孕妇血清Freeβ-hCG和uE3水平筛查严重CHD的敏感度、特异度、准确度、阳性预测值和阴性预测值分别为55.56%、95.31%、92.08%、66.67%和64.00%,二者联合筛查严重CHD的敏感度、特异度、准确度、阳性预测值和阴性预测值分别为55.56%、95.65%、92.08%、55.56%和91.09%。二者联合检测的诊断情况高于单一检测方法(P<0.05)。结论:超声“四切面”法对妊娠中期孕妇筛查严重CHD具有较高的诊断价值,联合孕妇血清Freeβ-hCG和uE3水平能进一步提高诊断准确度,具有较好的临床应用价值。

河北省免费NIPT联合PAPP-A、F-β-HCG 及超声检查诊断孕中期胎儿染色体异常的意义

目的 评价河北行免费的无创产前DNA检测(NIPT),联合血清妊娠相关血浆蛋白-A(PAPP-A)、游离β-人绒毛膜促性腺激素(F-β-HCG)检测及超声对孕中期染色体异常的诊断价值。方法 选取衡水市第二人民医院2019年1月至2023年1月接收的3 591例拟行染色体检测的孕中期妇女,均行免费NIPT联合血清学指标(PAPP-A、F-β-HCG)及超声检查。将羊水穿刺染色体核型分析结果记为金标准,采用受试者工作特征曲线(ROC)评价不同方法诊断孕中期染色体异常的价值。结果 经随访,在3 591例中,共有39例染色体异常,其中,32例经超声检查有染色体异常,34例经NIPT检测有染色体异常。在3 552例染色体正常的胎儿中,34例经超声检查有染色体异常,36例经NIPT检测有染色体异常;染色体异常胎儿的母体PAPP-A、F-β-HCG水平均高于染色体正常胎儿的母体(P<0.05)。PAPP-A、F-β-HCG共同诊断胎儿染色体异常的敏感度及ROC曲线下方的面积(AUC)均高于母体PAPP-A、F-β-HCG单独诊断(P<0.05);NIPT,PAPP-A、F-β-HCG及超声的联合诊断的敏感度及AUC均高于NIPT,PAPP-A、F-β-HCG,超声的单独诊断(P<0.05),且不同方法诊断染色体异常的特异度对比差异均无统计学意义(P>0.05)。结论 孕中期胎儿染色体异常的母体PAPP-A、F-β-HCG水平高,且NIPT联合PAPP-A、F-β-HCG及超声诊断染色体异常有较好的价值。

荧光免疫法和2种化学发光法检测血清总β-HCG结果的比对分析

目的:通过比较同一实验室3种不同方法学(荧光免疫法(星童Pylon3D)、电化学发光法(罗氏e601)和酶促化学发光法(迈瑞CL-6000i))测定血清总β-HCG的结果,探讨3种方法检测β-HCG的结果是否具有可比性,为不同仪器测定实验结果互认提供依据。方法:选取不同浓度常规血清标本186份,先在罗氏e601电化学发光系统进行检测,再用星童Pylon3D荧光免疫法和迈瑞CL-6000i酶促化学发光法检测系统进行检测。以罗氏e601电化学发光检测系统作为参考仪器进行数据比对。结果:3种方法学之间检测结果的相关性都在0.99以上,相关性良好。随着β-HCG浓度范围的增高,3种方法学检测结果的相关性,都呈现出越来越高的趋势。总体一致性分析,迈瑞的数值与罗氏较为靠近,偏倚均数Bias=-528.3mIU/mL,P<0.05,是最低的,另外两组的偏倚均数都在-1000mIU/mL以上。结论:3种检测系统对总β-HCG检测结果之间具有良好的相关性和一致性。

NT与血清β-hCG、PAPP-A、ADAM12单独及联合检测对孕早期DS的诊断价值

目的:探讨颈部透明层厚度(NT)与血清人绒毛膜促性腺激素(β-hCG)、妊娠相关蛋白A(PAPP-A)及解整合素金属蛋白酶12(ADAM12)单独及联合检测对孕早期唐氏综合征(DS)的诊断价值。方法:选取2019年1月—2023年1月在厦门大学附属第一医院杏林分院经羊膜穿刺确诊的47例DS孕妇作为DS组,另选取同期49例产前检查正常的孕产妇作为对照组,检测并比较两组NT及血清β-hCG、PAPP-A、ADAM12水平,并采用受试者工作特征(ROC)曲线分析NT与血清β-hCG、PAPP-A、ADAM12单独及联合检测对DS的诊断价值。结果:DS组NT及血清β-hCG水平高于对照组,PAPP-A、ADAM12水平均低于对照组,差异有统计学意义(P<0.05)。ROC曲线分析显示,NT与血清β-hCG、PAPP-A、ADAM12联合检测诊断DS的曲线下面积为0.993,预测敏感度、特异度分别为95.7%、98.0%,均高于上述指标单独检测。结论:NT与血清β-hCG、PAPP-A、ADAM12检测对孕早期DS均具有一定的诊断价值,且联合应用诊断效果更高,可作为孕早期DS筛查的有效指标。

血清β-hCG、甲状腺激素水平与剖宫产瘢痕妊娠子宫动脉栓塞术后再妊娠的关系

目的:探究剖宫产瘢痕妊娠患者血清β-人绒毛膜促性腺激素(β-hCG)、三碘甲状腺原氨酸(T)、甲状腺素(T)水平与子宫动脉栓塞术后再妊娠的关系。方法:选取2019年11月-2020年11月本院143例剖宫产瘢痕妊娠患者作为研究对象,依据术后3年再妊娠情况分为再妊娠组86例和未妊娠组57例,记录患者临床资料,采用化学发光法测定术前、术后第1、第3个月经周期血清β-hCG水平,采用ELISA法检测T_(3)、T_(4)水平。血清β-hCG、甲状腺激素水平与剖宫产瘢痕妊娠子宫动脉栓塞术后再妊娠的关系行logistic回归分析;绘制ROC曲线分析血清β-hCG、甲状腺激素水平预测剖宫产瘢痕妊娠子宫动脉栓塞术后再妊娠的价值。结果:血清β-hCG、T_(3)、T_(4)水平在未妊娠组和再妊娠组及术后不同时间点存在交互效应(均P<0.05);术后血清β-hCG水平呈下降趋势,血清T_(3)、T_(4)水平呈上升趋势。术后第1、第3个月经周期再妊娠组的血清β-hCG水平均低于未妊娠组,血清T_(3)、T_(4)水平均高于未妊娠组(均P<0.05)。术后第1个月经周期血清β-hCG、T_(3)、T_(4)水平预测剖宫产瘢痕妊娠子宫动脉栓塞术后再妊娠的AUC分别为0.827、0.816、0.830,低于三者联合预测的AUC为0.933(Z=2.543、2.807、2.471,均P<0.05)。术后第1、第3个月经周期的血清β-hCG、T_(3)、T_(4)水平均与剖宫产瘢痕妊娠子宫动脉栓塞术后再妊娠有关,其中术后第1、第3个月经周期β-hCG为独立危险因素,T_(3)、T_(4)为保护因素(均P<0.05)。结论:子宫动脉栓塞术后第1个月经周期血清β-hCG、Ts、T4水平联合检测可一定程度预测再妊娠情况,进而指导临床治疗。

腹腔镜下单侧输卵管切除术对输卵管妊娠患者血清β-hCG、Netrin-1及术后妊娠影响

目的:探讨腹腔镜下单侧输卵管切除术对输卵管妊娠患者血清β-人绒毛膜促性腺激素(β-hCG)、神经轴突导向因子-1(Netrin-1)水平及对术后妊娠的影响。方法:选取2021年1月-2022年11月本院行腹腔镜下单侧输卵管切除术患者40例(观察组)、腹腔镜下单侧输卵管开窗取胚术患者40例(对照组),统计手术相关指标、并发症,手术前后血清β-hCG、Netrin-1水平以及术后卵巢储备功能指标,随访术后1年内妊娠情况。结果:观察组术中出血量(72.1±4.8ml)多于对照组(66.1±12.4ml),术后并发症发生率(7.5%)和术后继续异位妊娠率(0)低于对照组(25.0%、17.5%);术后6个月,血清促黄体激素(6.15±1.12mU/ml)高于对照组(5.63±0.95mU/ml),抗缪勒管激素(3.33±0.58ng/ml)低于对照组(3.64±0.79ng/ml)(均P<0.05)。两组术后第3dβ-hCG、Netrin-1水平及术后β-hCG、Netrin-1降低至正常水平时间也无差异(均P>0.05)。结论:腹腔镜下单侧输卵管切除术、输卵管开窗取胚术均能有效清除异位着床组织,但腹腔镜下单侧输卵管切除术术后并发症和再次异位妊娠风险更低,但存在术中出血量多、损伤卵巢储备功能风险。

拮抗剂方案双扳机次日血清β-hCG水平对新鲜胚胎移植结局的影响

目的:探讨拮抗剂方案双扳机次日血清β-人绒毛膜促性腺激素(β-human chorionic gonadotropin,β-hCG)水平对体外受精/卵胞质内单精子注射(in vitro fertilization/intracytoplasmic sperm injection,IVF/ICSI)新鲜胚胎移植周期妊娠结局的预测价值。方法:回顾性分析2017年1月-2024年1月于南京医科大学附属妇产医院生殖中心行拮抗剂方案促排卵患者共717个周期的临床资料,所有周期均采用双扳机(hCG+促性腺激素释放激素激动剂)诱导排卵,按照扳机次日血清β-hCG水平分为5组,A组(42个周期)β-hCG≤50 U/L,B组(282个周期)50 U/L<β-hCG≤100 U/L,C组(250个周期)100 U/L<β-hCG≤150 U/L,D组(92个周期)150 U/L<β-hCG≤200 U/L,E组(51个周期)β-hCG>200 U/L。比较各组的促排卵实验室结局及妊娠结局。结果:5组间体质量指数、基础卵泡刺激素、促性腺激素天数及总量、hCG日雌孕激素水平及高评分囊胚数的差异均有统计学意义(均P<0.05),其中体质量指数越高,扳机次日β-hCG水平越低。5组可利用胚胎数、高评分囊胚率、临床妊娠率、流产率及活产率比较,差异均无统计学意义(均P>0.05)。结论:在拮抗剂方案新鲜胚胎移植周期中,双扳机次日血清β-hCG水平并不能预测IVF/ICSI治疗周期的妊娠结局。

西藏地区宫外孕患者经腹彩色超声联合血清β-hCG、ALP、CA125的诊断价值探讨

目的检测β-人绒毛促性腺激素(β-hCG)、碱性磷酸酶(ALP)、癌胚抗原125(CA125)在宫外孕(EP)患者血清中表达水平,探讨经腹彩色超声联合β-hCG、ALP、CA125对EP的诊断价值。方法选取2023年6月—2024年4月西藏自治区人民医院妇产科门诊就诊的EP患者79例作为病例组,另选正常宫内妊娠孕早期女性82例作为对照组。测定2组受试者血清β-hCG、ALP、CA125水平,腹部彩色超声检查子宫内膜厚度、盆腔积液;采用Pearson相关分析病例组血清β-hCG、ALP、CA125与腹部彩色超声参数相关性;多因素Logistic回归分析EP发生的影响因素;受试者工作特征(ROC)曲线分析经腹彩色超声联合血清β-hCG、ALP、CA125对EP的诊断价值。结果病例组β-hCG、ALP低于对照组(t=21.390、19.690,P<0.001),CA125高于对照组(t=33.390,P均<0.001);与对照组比较,病例组子宫内膜厚度变薄(t=14.440,P<0.001);子宫内膜厚度与血清β-hCG、ALP呈正相关,与CA125水平呈负相关(r=0.685、0.632、-0.701,P均<0.001);多因素Logistic回归分析,子宫内膜增厚、血清β-hCG高以及ALP高水平是宫外孕发生的保护因素[OR(95%CI)=0.937(0.896~0.972)、0.873(0.804~0.948)、0.077(0.034~0.097)],血清CA125高水平、盆腔积液增多是宫外孕发生的危险因素[OR(95%CI)=1.232(1.161~1.307)、2.955(1.887~4.626)];子宫内膜厚度、盆腔积液、β-hCG、ALP、CA125及5项联合预测EP的AUC分别为0.843、0.802、0.942、0.843、0.916、0.988,5项联合优于各自单独预测效能(Z/P=2.370/0.018、2.147/0.032、2.001/0.039、1.990/0.046、2.676/0.007)。结论EP患者子宫内膜变薄、盆腔积液增多、血清β-hCG水平低、ALP水平低、CA125水平高,腹部彩色超声联合血清β-hCG、ALP、CA125水平检测可提高EP的诊断效能。

经阴道三维彩超联合血β-人绒毛膜促性腺激素对早期宫外孕的诊断价值

目的探讨经阴道三维彩超联合血β-人绒毛膜促性腺激素(β-hCG)对早期宫外孕的诊断价值。方法选取2020年8月至2023年9月安庆市第一人民医院收治的80例早期宫外孕患者作为研究对象,设为观察组。另选取同期80例宫内孕孕妇设为对照组。分析两组超声指标与血β-hCG水平;绘制超声指标、血β-hCG单独及联合诊断早期宫外孕的受试者工作特征(ROC)曲线;通过病理结果分析经阴道三维彩超联合血β-hCG诊断的准确性。结果两组阻力指数、搏动指数、收缩期峰值流速比较,差异无统计学意义(P>0.05);观察组子宫内膜厚度、血β-hCG水平均小于对照组,差异具有统计学意义(P<0.05)。ROC曲线结果显示,子宫内膜厚度、血β-HCG及两者联合诊断宫外孕的曲线下面积分别为0.833、0.877及0.975(P<0.05)。与病理结果比较,经阴道三维彩超联合血β-hCG诊断漏诊、误诊5例,诊断准确率为93.75%。结论经阴道三维彩超联合血β-hCG对早期宫外孕具有较高的诊断价值,可为临床快速准确诊断早期宫外孕提供可靠信息。

Live births from in vitro fertilization-embryo transfer following the administration of gonadotropin-releasing hormone agonist without gonadotropins:Two case reports

BACKGROUND The prevalence of female infertility between the ages of 25 and 44 is 3.5%to 16.7%in developed countries and 6.9%to 9.3%in developing countries.This means that infertility affects one in six couples and is recognized by the World Health Organization as the fifth most serious global disability.The International Committee for Monitoring Assisted Reproductive Technology reported that the global total of babies born as a result of assisted reproductive technology procedures and other advanced fertility treatments is more than 8 million.Advancements in controlled ovarian hyperstimulation procedures led to crucial accomplishments in human fertility treatments.The European Society for Human Reproduction and Embryology guideline on ovarian stimulation gave us valuable evidence-based recommendations to optimize ovarian stimulation in assisted reproductive technology.Conventional ovarian stimulation protocols for in vitro fertilization(IVF)–embryo transfer are based upon the administration of gonadotropins combined with gonadotropin-releasing hormone(GnRH)analogues,either GnRH agonists(GnRHa)or antagonists.The development of ovarian cysts requires the combination of GnRHa and gonadotropins for controlled ovarian hyperstimulation.However,in rare cases patients may develop an ovarian hyper response after administration of GnRHa alone.CASE SUMMARY Here,two case studies were conducted.In the first case,a 33-year-old female diagnosed with polycystic ovary syndrome presented for her first IVF cycle at our reproductive center.Fourteen days after triptorelin acetate was administrated(day 18 of her menstrual cycle),bilateral ovaries presented polycystic manifestations.The patient was given 5000 IU of human chorionic gonadotropin.Twenty-two oocytes were obtained,and eight embryos formed.Two blastospheres were transferred in the frozen-thawed embryo transfer cycle,and the patient was impregnated.In the second case,a 37-year-old woman presented to the reproductive center for her first donor IVF cycle.Fourteen days after GnRHa administration,the transvaginal ultrasound revealed six follicles measuring 17-26 mm in the bilateral ovaries.The patient was given 10000 IU of human chorionic gonadotropin.Three oocytes were obtained,and three embryos formed.Two high-grade embryos were transferred in the frozen-thawed embryo transfer cycle,and the patient was impregnated.CONCLUSION These two special cases provide valuable knowledge through our experience.We hypothesize that oocyte retrieval can be an alternative to cycle cancellation in these conditions.Considering the high progesterone level in most cases of this situation,we advocate freezing embryos after oocyte retrieval rather than fresh embryo transfer.

超声检查联合BMI、血清β-hCG预测输卵管妊娠甲氨蝶呤保守治疗效果

目的:探究超声影像学指标联合体质指数(BMI)、β-人绒毛膜促性腺激素(β-hCG)检测对输卵管妊娠甲氨蝶呤保守治疗效果的预测价值。方法:选取2021年1月-2024年4月本院治疗的120例输卵管妊娠患者,均采用甲氨蝶呤保守治疗。统计保守治疗效果,比较不同疗效患者基线资料,分析输卵管妊娠保守治疗效果的影响因素,受试者工作特征(ROC)评价超声指标联合BMI、血清β-hCG对输卵管妊娠保守治疗效果的预测价值。结果:120例经保守治疗成功76例(成功组)、失败44例(失败组),失败组BMI、附件包块容积、β-hCG及血流平均速度高于成功组,阻力指数低于成功组(均P<0.05);logistic回归分析显示,输卵管妊娠患者BMI、β-hCG及超声指标血流平均速度、附件包块容积、阻力指数均为影响保守治疗效果的因素(均P<0.05);ROC曲线分析,血流平均速度、阻力指数、附件包块容积、BMI、β-hCG预测输卵管妊娠保守治疗效果的曲线下面积(AUC)分别为0.802、0.800、0.754、0.701、0.672,各指标联合预测时AUC为0.960,预测价值最佳。结论:BMI、血清β-hCG及超声指标血流平均速度、阻力指数、附件包块容积均可用于预测输卵管妊娠甲氨蝶呤保守治疗效果,且各指标联合预测效能最高,可为临床治疗方案制定及调整提供参考。

β-人绒毛膜促性腺激素快速高灵敏化学发光POC检测方法的建立及评价

目的:建立β-人绒毛膜促性腺激素(β-HCG)快速高灵敏化学发光POC检测法(POC-CLIA)并进行评价。方法:采用碱性磷酸酶(Alp)-AMPPD发光体系,以磁微粒(Mps)为固相载体构建POC-CLIA,并评估其灵敏度、精密度、准确度、线性范围、特异性、稳定性、钩状效应和临床应用。结果:β-HCG最低检测限为0.71 mU/ml,线性检测范围为0.710~1.092×10^(4) mU/ml,且在1.7×10^(5) mU/ml内无钩状效应影响。批内和批间变异系数均<10%,可在37℃稳定保存10 d。准确度偏差在±10%之内,结果可靠。干扰物质与β-HCG均无交叉反应。对100例临床血清标本进行检测,与临床标准方法检测结果高度相关(R^(2)=0.997 0)。单个样品检测时间<15 min,且测试通量可达到200 T/h。结论:该方法具有较高应用价值,可广泛用于基层社区,助力基层医疗中妊娠及相关疾病筛查。

血清β-人绒毛膜促性腺激素、视黄醇结合蛋白4在子宫内膜增生患者中的水平变化及检测意义

目的:探讨血清β-人绒毛膜促性腺激素(β-HCG)、视黄醇结合蛋白4(RBP4)在子宫内膜增生患者中的水平变化及检测意义。方法:选取105例子宫内膜增生患者为研究组,65例体检健康者为对照组。比较研究组和对照组血清β-HCG、RBP4水平。比较不同病理类型以及内膜增生程度患者血清β-HCG、RBP4水平。测量患者子宫内膜厚度,采用Pearson法分析血清β-HCG、RBP4水平与患者子宫内膜厚度的相关性。绘制受试者特征工作(ROC)曲线分析血清β-HCG、RBP4对非典型子宫内膜增生的预测价值。结果:研究组血清β-HCG、RBP4水平高于对照组(均P<0.05)。非典型子宫内膜增生患者血清β-HCG、RBP4水平高于单纯及复杂性子宫内膜增生患者(均P<0.05)。内膜增生过长患者血清β-HCG、RBP4水平高于增生及分泌期患者(均P<0.05)。血清β-HCG、RBP4水平与患者子宫内膜厚度呈正相关(均P<0.05)。血清β-HCG、RBP4单独及联合预测非典型子宫内膜增生的AUC分别为0.758、0.660、0.926,且两者联合预测的AUC高于各指标单独预测AUC(均P<0.05)。结论:子宫内膜增生患者血清RBP4、β-HCG水平升高,两者与病理类型、内膜增生程度以及子宫内膜厚度有关,联合检测对非典型子宫内膜增生的预测价值较高。