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.

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.

Second-trimester maternal β-human chorionic gonadotropin level associated with subsequent development of pregnancy-induced hypertension

Objective:To determine whether maternal β-human chorionic gonadotropin(β-hCG) level in second-trimester may be associated with subsequent development of pregnancy-induced hypertension(PIH).Methods:Seven hundred and sixty-two women in mid-trimester were to have maternal urine β-hCG standardized concentrations and maternal serum β-hCG measurements.Their case histories were recorded and reviewed from mid-trimester to delivery.The relation was observed between maternal urine,serum markers and subsequent development of PIH.Results:Among 762 women,504 cases were normal pregnancies,42 cases had PIH,94 cases had premature rupture of membrane (PROM),69 cases had preterm delivery (PD),53 other cases were excluded by various reasons.The levels of maternal urine,serum β-hCG in PIH were (61.75±9.78) IU/L and (304.56±54.17) ng/mg respectively,which were higher significantly than normal pregnancy group ([20.65±7.61] IU/L and [146.34±47.81] ng/mg,P<0.05).When maternal serum,urine β-hCG levels ≥2 MOM(multiple of mean),the incidences of developing PIH were increased significantly as compared with those of β-hCG <2 MOM women.The incidence of PIH increased from 5.1% in pregnancies with urine β-hCG ≥2 MOM to 11.7% in cases with urine β-hCG ≥4 MOM.Conclusion:The elevation of maternal mid-trimester urine,serum β-hCG levels is not only an early signal for dysfunction of placenta but also a dangerous signal for development of PIH.Second-trimester maternal urine β-hCG measurement proves to be superior to serum marker in clinical prediction.

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.

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.

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.

宫腔灌注HCG联合地屈孕酮对复发性流产患者外周血淋巴细胞水平和妊娠结局的影响

目的:了解宫腔灌注人绒毛膜促性腺激素(HCG)联合地屈孕酮对复发性流产(RSA)患者的外周血淋巴细胞水平变化和妊娠结局的影响。方法:选取2019年1月~2020年10月深圳市宝安区妇幼保健院就诊的RSA患者43例作为研究对象,分为研究组(n=19)与对照组(n=24),对照组给予地屈孕酮,研究组在对照组基础上给予宫腔灌注HCG,分析两组治疗前后着床期外周血淋巴细胞、雌二醇(E2)、孕酮(P)及3个周期的临床妊娠结局。结果:两组患者在年龄、不良孕产次数以及排卵日子宫内膜厚度上比较差异无统计学意义(P>0.05);治疗前两组在着床期E_(2)及P比较差异无统计学意义(P>0.05),治疗后研究组与对照组的血清E_(2)、P均较治疗前升高,且治疗后的研究组的E_(2)及P较对照组升高,差异均有统计学意义(P<0.05);治疗前及治疗后两组在着床期外周血B淋巴细胞、NK细胞、CD3^(+)T细胞、CD3^(+)CD8^(+)T细胞以及CD4^(+)/CD8^(+)T细胞比较差异均无统计学意义(P>0.05),但研究组外周血CD3^(+)CD4^(+)T细胞百分比较治疗前升高,差异均有统计学意义(P<0.05);研究组的临床妊娠率高于对照组,孕早期自然流产率低于对照组,两组比较差异均有统计学意义(P<0.05)。结论:宫腔灌注HCG联合地屈孕酮治疗RSA可以通过提升着床期的雌、孕激素值以及增加外周血淋巴细胞中的CD3^(+)CD4^(+)T细胞百分比提升RSA患者临床妊娠率及降低流产的风险。

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。

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。

拮抗剂方案中HCG扳机日直径16~18 mm卵泡比例对PCOS患者IVF-ET结局的影响

目的探讨拮抗剂方案中人绒毛膜促性腺激素(HCG)扳机日直径16~18 mm卵泡比例对接受拮抗剂方案的多囊卵巢综合征(PCOS)患者体外受精-胚胎移植(IVF-ET)结局的影响。方法回顾性分析2016年1月至2021年12月于南京医科大学附属妇产医院行IVF-ET助孕的PCOS患者的临床资料。根据HCG扳机日双侧卵巢直径16~18 mm卵泡比例以三分位法将患者分为三组,该比例<0.43为A组(262例),0.43~0.56为B组(267例),≥0.56为C组(247例)。比较三组一般临床资料、超促排卵周期情况、胚胎发育情况、体外受精周期后首次冻融胚胎移植(FET)情况以及妊娠、围产期结局。结果B组基础促黄体生成素(LH)、基础LH与基础促卵泡激素(FSH)比值显著高于A组和C组,差异有统计学意义(P<0.05)。A组促性腺激素(Gn)使用总量高于B组和C组,HCG扳机日雌二醇(E_(2))水平低于B组、C组,差异有统计学意义(P<0.05)。B组和C组获卵数、2原核(PN)数、卵裂数、囊胚形成数以及可移植胚胎数高于A组,差异有统计学意义(P<0.05)。C组囊胚形成率高于A组和B组,高评分囊胚率高于B组,差异有统计学意义(P<0.05)。三组移植胚胎数、移植胚胎天数、内膜准备方案及内膜厚度比较差异无统计学意义(P>0.05)。三组胚胎着床率、生化妊娠率、临床妊娠率、流产率、活产率、妊娠期糖尿病发生率及妊娠期高血压发生率等比较差异无统计学意义(P>0.05)。结论在拮抗剂方案中,HCG扳机日直径16~18 mm卵泡比例可反映卵母细胞发育潜能,当该比例≥0.56时可获得较好的获卵数、2PN数、卵裂数、囊胚形成数以及可移植胚胎数,在一定程度上可作为PCOS患者HCG扳机时机的参考指标,但该比例并不影响后续首次FET的妊娠结局。

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。

阴道超声结合容积对比成像C平面检查联合HCG、孕酮测定在异位妊娠诊断中的价值

目的探讨阴道超声结合容积对比成像C平面(VCI-C)检查联合人绒毛膜促性腺激素(HCG)、孕酮测定在异位妊娠诊断中的价值。方法根据纳入及排除标准,回顾性纳入2019年1月至2023年1月收治的停经6~8周且伴有腹痛、阴道流血的80例患者的病历资料,所有患者均接受阴道超声结合VCI-C检查及HCG和孕酮测定。分析阴道超声结合VCI-C检查联合HCG、孕酮测定在异位妊娠诊断中的价值。结果术后病理诊断结果显示,80例患者中有异位妊娠74例,占比92.50%。以术后病理诊断结果作为金标准,阴道超声结合VCI-C检查诊断异位妊娠结果与术后病理诊断结果的一致性一般(Kappa=0.586,P=0.001);HCG联合孕酮检测诊断异位妊娠结果与术后病理诊断结果的一致性差(Kappa=0.355,P=0.001);阴道超声结合VCI-C检查联合HCG、孕酮检测诊断异位妊娠结果与术后病理诊断结果的一致性较好(Kappa=0.820,P<0.001)。阴道超声结合VCI-C检查联合HCG、孕酮检测诊断异位妊娠的灵敏度、准确度均显著高于阴道超声结合VCI-C检查与HCG联合孕酮检测(P<0.05)。结论阴道超声结合VCI-C检查联合HCG、孕酮检测诊断结果与术后病理诊断结果一致性好,对于异位妊娠的诊断价值高,可为该疾病的临床诊治提供参考依据。

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。

早期经阴道彩超检查子宫内膜厚度联合血清β-HCG检测在宫外孕临床诊断中的应用

目的:探讨早期经阴道彩超检查子宫内膜厚度联合血清β-人绒毛膜促性腺激素(β-human chorionic gonadotropin,β-HCG)检测在宫外孕临床诊断中的应用。方法:选取2018年3月至2021年3月收治的156例宫外孕患者作为宫外孕组,另同期选取在本院行体检的健康孕妇156例作为对照组。收集两组的临床资料,两组均行早期经阴道彩超检查记录子宫内膜厚度、收缩期最大血流速度(Peak systolic velocity,VS)、舒张末期流速(Enddiastolic velocity,VD)和阻力指数(Resistance index,RI),采用化学发光免疫法检测血清β-HCG水平。对比两组上述指标差异,并采用受试者工作曲线(Receiver operating characteristic,ROC)分析上述指标联合检测对宫外孕的诊断价值。结果:宫外孕组患者VS、VD和RI水平均高于对照组(P<0.05),子宫内膜厚度和血清β-HCG水平均低于对照组(P<0.05)。ROC分析显示,子宫内膜厚度、VS、VD、RI、血清β-HCG及其联合检测的曲线下面积(Receiver operating characteristic,AUC)分别为0.780、0.743、0.733、0.746、0.793和0.934,(P均<0.05)。结论:早期经阴道彩超检查子宫内膜厚度联合血清β-HCG检测可以提高宫外孕诊断的准确度,有助于及时发现异常并治疗。

血清β-hCG、AFP对前置胎盘合并胎盘植入的诊断价值

目的探讨血清β-人绒毛膜促性腺激素(β-hCG)、甲胎蛋白(AFP)对前置胎盘合并胎盘植入的诊断价值。方法选取84例2020年5月至2022年5月于该院就诊的前置胎盘患者作为研究对象,根据临床及产后病理检查结果分为植入组(38例)、无植入组(46例),比较两组及不同胎盘植入类型患者产前血清β-hCG、AFP水平及产前超声征象评分,分析血清β-hCG、AFP水平与胎盘植入类型及产前超声征象评分的相关性,采用受试者工作特征(ROC)曲线分析产前血清β-hCG、AFP水平对前置胎盘合并胎盘植入的诊断价值。结果与无植入组比较,植入组产前血清β-hCG、AFP水平及超声征象评分较高(P<0.05);不同胎盘植入类型患者产前血清β-hCG、AFP水平比较:粘连性胎盘<植入性胎盘<穿透性胎盘,两两比较,差异均有统计学意义(P<0.05);产前血清β-hCG、AFP水平与超声征象评分、胎盘植入类型具有相关性(P<0.05);产前血清β-hCG、AFP诊断前置胎盘合并胎盘植入的曲线下面积(AUC)分别为0.741、0.838,2项指标联合诊断的AUC为0.938,大于各指标单独诊断的AUC。结论血清β-hCG、AFP对于前置胎盘合并胎盘植入及胎盘植入类型均具有较高评估价值。

异位妊娠患者血清β-hCG、P、E2、CA125水平及阴道超声特征与病情严重程度的关系

目的探讨异位妊娠患者血清β-人绒毛膜促性腺激素(β-HCG)、孕酮(P)、雌二醇(E2)、糖类抗原125(CA125)水平及阴道超声特征与病情严重程度的关系。方法选择2020年5月至2023年12月上海市嘉定区南翔医院接诊的90例异位妊娠患者为研究对象,根据患者的病情严重程度进行划分,其中轻度组30例、中度组35例、重度组25例。比较各组患者的血清β-hCG、P、E2、CA125、阴道超声特征[阻力指数(RI)、舒张末期流速(VD)、收缩期最大血流速度(VS)]水平情况,并采用Pearson相关分析法分析血清β-hCG、P、E2、CA125检测及阴道超声特征与病情严重程度的相关性。结果重度组异位妊娠患者的血清β-hCG水平为(1020.13±110.36)U/L,明显低于中度组和轻度组患者,P、E2、CA125水平分别为(34.22±3.50)ng/mL、(250.79±37.24)pg/mL、(52.14±7.69)IU/mL,明显高于中度组和轻度组患者,中度组异位妊娠患者的血清β-hCG水平为(1120.15±114.24)U/L,明显低于轻度组患者的(1235.60±124.33)U/L,P、E2、CA125水平分别为(28.03±2.83)ng/mL、(230.15±35.56)pg/mL、(40.73±6.04)IU/mL,均明显高于轻度组患者的(20.10±2.15)ng/mL、(218.33±32.50)pg/mL、(33.56±4.25)IU/mL,组间比较差异均有统计学意义(P<0.05);重度组异位妊娠患者的RI、VD、VS水平分别为0.88±0.21、(59.26±5.72)cm/s、(76.15±8.41)cm/s,均明显高于中度组和轻度组患者,中度组异位妊娠患者的RI、VD、VS水平分别为0.67±0.15、(54.41±5.00)cm/s、(73.42±7.19)cm/s,均明显高于轻度组患者的0.54±0.12、(48.77±4.25)cm/s、(70.09±5.37)cm/s,组间比较差异均有统计学意义(P<0.05);Pearson相关分析结果显示,血清β-hCG水平与病情严重程度呈负相关(r=-0.418,P<0.05),P、E2、CA125、RI、VD、VS水平与病情严重程度均呈正相关(r=0.582、0.435、0.504、0.456、0.613、0.724,P<0.05)。结论异位妊娠患者血清β-hCG、P、E2、CA125水平及阴道超声特征与病情严重程度关系密切,监测上述指标有助于及时评估病情。

β-hCG联合阴道超声诊断异位妊娠临床价值及检出影响因素

目的:分析血清人绒膜促性腺激素(β-hCG)联合阴道超声诊断异位妊娠价值.方法:回顾性收集2020年2月-2023年2月本院诊治的90例疑似异位妊娠患者临床资料,分析血清β-hCG、阴道超声结果,将手术病理学诊断为金标准;分析血清β-hCG、阴道超声及其联合检测诊断异位妊娠价值;多因素logistic回归分析影响异位妊娠检出影响因素.结果:β-hCG、阴道超声及其联合检测诊断异位妊娠阳性值分别为71.1%、71.4%、84.8%,阴性预测值分别为75.6%、72.9%、90.9%.β-hCG、阴道超声对异位妊娠均有一定诊断价值,曲线下面积分别为0.74、0.732,但2项联合检测的诊断曲线下面积(0.890)更高(P<0.05);多因素logistic回归分析显示,β-hCG阴性、阴道超声阴性均为影响异位妊娠检出危险因素.结论:β-hCG、阴道超声联合检测诊断异位妊娠效能提高,有更高敏感度及特异度,且β-hCG阴性、阴道超声阴性均影响异位妊娠检出.