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Serum Ca-125, Estradiol And Progesterone Levels In Histopathologically Confirmed Ectopic Pregnancy Cases

Year 2015, Volume: 12 Issue: 4, 140 - 143, 01.07.2015

Abstract

Aim: To compare the serum, estradiol, progesterone, E2-P ratio and cancer antigen 125 levels between intrauterine pregnancy and ectopic pregnancy, to investigate the probable role of these markers for earlu diagnosis of ectopic pregnancy.Material and Methods: 100 patients who had diagnosis of histopathological confirmed ectopic pregnancy were defined as study group. 100 women with intrauterine, single, 6-8 weeks of gestation were defined as control group. Serum levels of CA-125, E2 and P were compared between groups. Ninety patients underwent laparoscopic surgery for ectopic pregnancy and 10 patients underwent laparatomy. Eighty-nine patients had salpingectomy and 11 of them had salpingostomy.Results: When we compared with control group, serum Ca-125, E2, P levels and E2-P ratio were lower in ectopic pregnancy group. The difference between these two groups were statistically significant. There is no statistically significant difference in E2-P ratios, E2, P and Ca-125 levels when the ectopic pregnancy group were divided into two groups as ruptured and non-ruptured.Conclusion: According to our findings, Ca-125, estradiol, progesterone levels and estradiol-progesterone ratio are useful but not satisfactory markers in the early diagnosis of ectopic pregnancy. Moreover, these parameters cannot be used in the diagnosis of rupture in ectopic pregnancy.

References

  • Goldner TE, Lawson HW, Xia Z, Atrash HK. Surveillance for ectopic pregnancy-United States, 1970-1989. MMWR CDC Surveill Summ. 1993;42:73-85.
  • Rocha Filho EA, Santana DS, Cecatti JG, Costa ML, Haddad SM, Parpinelli MA et al. Awareness about a life-threatening condition: ectopic pregnancy in a network for surveillance of severe maternal morbidity in Brazil. Biomed Res Int. 2014:(2014):965724.
  • Kobayashi F, Takashima E, Sagawa N, Mori T, Fujii S. Maternal serum CA125 levels in early intrauterine and tubal pregnancies. Arch Gynecol Obstet 1993;252: 185-9.
  • Katsikis I, Rousso D, Farmakiotis D, Kourtis A, Diamanti-Kandarakis E, Panidis D. Receiver operator characteristics and diagnostic value of progesterone and CA-125 in the prediction of ectopic and abortive intrauterine gestations. Eur J Obstet Gynecol Reprod Biol 2006;125:226- 32.
  • Malatyalioglu E, Ozer S, Kokcu A, Cetinkaya MB, Alper T, Tosun M. CA-125 levels in ruptured and unruptured tubal ectopic pregnancies. J Obstet Gynaecol Res 2006;32:422-7.
  • Shao R, Feng Y, Zou S, Weijdegård B, Wu G, Brännström M et al. The role of estrogen in the pathophysiology of tubal ectopic pregnancy. Am J Transl Res. 2012;4:269-78.
  • Nilsson S, Makela S, Treuter E, Tujague M, Thomsen J, Andersson G, et al. Mechanisms of estrogen action. Physiol Rev. 2001;81:1535–65.
  • Shao R. Understanding the mechanisms of human tubal ectopic pregnancies: new evidence from knockout mouse models. Hum Reprod. 2010;25:584–7.
  • Wang H, Dey SK. Roadmap to embryo implantation: clues from mouse models. Nat Rev Genet. 2006;7:185–99.
  • Stovall TG, Ling FW, Carson SA, Buster JE. Serum progesteron and uterine curettage in differential diagnosis of ectopic pregnancy. Fertil Steril 1992;57:456-7.
  • Mc. Cord ML, Muram D, Buster JE, Arheart KL, Stoval TG, Carson SA: Single progesterone as a screen for ectopic pregnancy: exchanging specifity and sensitivity to obtain optimal test performance. Fertil Steril 1996;66:513-6.
  • Mol BW, Lijmer JG, Ankum WM, Van Der Veen F, Bossuyt PM. The accuracy of single serum progesterone measurment in the diagnosis of ectopic pregnancy: meta analysis. Hum. Reprod. 1998;13:3320-7.
  • James WH. Women’s hormone concentrations and the increasing rates of ectopic pregnancy. Hum Reprod. 1996;11:233–5.
  • Abdul-Hussein MM, Abdul-Rasheed OF, Al-Moayed HA. The Values of CA-125, Progesterone, ß-HCG and Estradiol in the Early Prediction of Ectopic Pregnancy. Oman Med J. 2012;27:124-8.
  • Y. Sadovsky, J. Pineda and J.L. Collins, Serum CA-125 levels in women with ectopic and intrauterine pregnancies, J Reprod Med 1991;36:875-8.
  • Schmidt T, Rein DT, Foth D, Eibach HW, Kurbacher CM, Mallmann P, et al. Prognostic value of repeated serum CA 125 measurements in first trimester pregnancy. Eur J Obstet Gynecol Reprod Biol. 2001;97:168-73.

Histopatolojik Olarak Ektopik Gebe Olduğu Kanıtlanan Hastalarda Serum Ca-125, Östradiol ve Progesteron Düzeyleri

Year 2015, Volume: 12 Issue: 4, 140 - 143, 01.07.2015

Abstract

Amaç: Serum östradiol, progesteron, E2-P oranı ve kanser antijen 125 düzeylerinin normal gebelik ve ektopik gebeliği olan hastalarda karşılaştırılarak, bu parametrelerin ektopik gebeliğin erken tanısında muhtemel etkisinin belirlenmesi amaçlanmaktadır.Gereç ve Yöntemler: Çalışma grubuna; ektopik gebelik tanısı ile opere olup histopatolojik olarak tanısı doğrulanan 100 hasta dahil edildi. Kontrol grubunda ise 6-8 haftalar arasında normal intrauterin gebeliği olan 100 kadın çalışmaya dahil edildi. Gruplar kan Ca-125, E2 ve P seviyesi açısından karşılaştırıldı. Çalışma grubundaki 10 hastaya laparatomik yaklaşım, 90 hastaya laparaskopik yaklaşım yapıldı. Ektopik gebeliklerin 30’unda rüptür saptandı. 89 hastaya salpenjektomi yapılırken, 11 hastaya salpingostomi yapıldı.Bulgular: Kontrol grubuyla karşılaştırıldığında, ektopik gebelik grubunda Ca-125, E2, P ve E2-P oranı istatiksel olarak anlamlı düşük bulunmuştur. Ektopik gebelikler kendi içinde değerlendirildiğinde rüptüre olan ve olmayan ektopik gebelerin E2-P oranı, E2, P ve Ca-125 düzeyi arasında istatistiksel olarak anlamlı bir fark bulunamadı.Sonuç: Çalışmamızda değerlendirdiğimiz E2, P, E2-P oranı ve Ca-125 ölçümü ektopik gebelik tanısında faydalı markerler olmakla birlikte ektopik gebeliğin teşhisinde tek başına yetersizdir. Yine bu parametreler ektopik gebeliğin rüptüre olup olmadığının ayrımında yetersizdir.

References

  • Goldner TE, Lawson HW, Xia Z, Atrash HK. Surveillance for ectopic pregnancy-United States, 1970-1989. MMWR CDC Surveill Summ. 1993;42:73-85.
  • Rocha Filho EA, Santana DS, Cecatti JG, Costa ML, Haddad SM, Parpinelli MA et al. Awareness about a life-threatening condition: ectopic pregnancy in a network for surveillance of severe maternal morbidity in Brazil. Biomed Res Int. 2014:(2014):965724.
  • Kobayashi F, Takashima E, Sagawa N, Mori T, Fujii S. Maternal serum CA125 levels in early intrauterine and tubal pregnancies. Arch Gynecol Obstet 1993;252: 185-9.
  • Katsikis I, Rousso D, Farmakiotis D, Kourtis A, Diamanti-Kandarakis E, Panidis D. Receiver operator characteristics and diagnostic value of progesterone and CA-125 in the prediction of ectopic and abortive intrauterine gestations. Eur J Obstet Gynecol Reprod Biol 2006;125:226- 32.
  • Malatyalioglu E, Ozer S, Kokcu A, Cetinkaya MB, Alper T, Tosun M. CA-125 levels in ruptured and unruptured tubal ectopic pregnancies. J Obstet Gynaecol Res 2006;32:422-7.
  • Shao R, Feng Y, Zou S, Weijdegård B, Wu G, Brännström M et al. The role of estrogen in the pathophysiology of tubal ectopic pregnancy. Am J Transl Res. 2012;4:269-78.
  • Nilsson S, Makela S, Treuter E, Tujague M, Thomsen J, Andersson G, et al. Mechanisms of estrogen action. Physiol Rev. 2001;81:1535–65.
  • Shao R. Understanding the mechanisms of human tubal ectopic pregnancies: new evidence from knockout mouse models. Hum Reprod. 2010;25:584–7.
  • Wang H, Dey SK. Roadmap to embryo implantation: clues from mouse models. Nat Rev Genet. 2006;7:185–99.
  • Stovall TG, Ling FW, Carson SA, Buster JE. Serum progesteron and uterine curettage in differential diagnosis of ectopic pregnancy. Fertil Steril 1992;57:456-7.
  • Mc. Cord ML, Muram D, Buster JE, Arheart KL, Stoval TG, Carson SA: Single progesterone as a screen for ectopic pregnancy: exchanging specifity and sensitivity to obtain optimal test performance. Fertil Steril 1996;66:513-6.
  • Mol BW, Lijmer JG, Ankum WM, Van Der Veen F, Bossuyt PM. The accuracy of single serum progesterone measurment in the diagnosis of ectopic pregnancy: meta analysis. Hum. Reprod. 1998;13:3320-7.
  • James WH. Women’s hormone concentrations and the increasing rates of ectopic pregnancy. Hum Reprod. 1996;11:233–5.
  • Abdul-Hussein MM, Abdul-Rasheed OF, Al-Moayed HA. The Values of CA-125, Progesterone, ß-HCG and Estradiol in the Early Prediction of Ectopic Pregnancy. Oman Med J. 2012;27:124-8.
  • Y. Sadovsky, J. Pineda and J.L. Collins, Serum CA-125 levels in women with ectopic and intrauterine pregnancies, J Reprod Med 1991;36:875-8.
  • Schmidt T, Rein DT, Foth D, Eibach HW, Kurbacher CM, Mallmann P, et al. Prognostic value of repeated serum CA 125 measurements in first trimester pregnancy. Eur J Obstet Gynecol Reprod Biol. 2001;97:168-73.
There are 16 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

And Yavuz

Mehmet Özgür Akkurt This is me

Gökhan Karakoç This is me

Mehmet Muammer Doğan This is me

Yakup Yalçın This is me

Burak Tatar This is me

Publication Date July 1, 2015
Published in Issue Year 2015 Volume: 12 Issue: 4

Cite

Vancouver Yavuz A, Akkurt MÖ, Karakoç G, Doğan MM, Yalçın Y, Tatar B. Histopatolojik Olarak Ektopik Gebe Olduğu Kanıtlanan Hastalarda Serum Ca-125, Östradiol ve Progesteron Düzeyleri. JGON. 2015;12(4):140-3.