The Value Of β-hCG Activin A Inhibin A In The Early Diagnosis Of Ectoic Pregnancy

objective:Ectopic pregnancy(EP) is a frequent surgical abdomen of obstetrics and gynecology, the incidence of which is rising in the recent twenty years. The developing of diagnostic techniques can reduce the rate of misdiagnosis and missed diagnosis, in order to create favorable conditions for better reserve fertility and conservative treatment of EP. The most common methods of early diagnosis of ectopic pregnancy are using ultrasound with serial measurements of human chorionic gonadotropin (β-hCG). However, these cannot find the embryo as early as gestational 4-5weeks,not only for EP, but also for intrauterine pregnnacy. .The objective of this study was to explore the possibility that an isolated measurement of Activin,Inhibin rather thanβ-hCG could be used as a single test for ectopic pregnancy, And the significant of compound of Activin,Inhibit,β-hCG in the diagnosis of ectopic pregnancy.Methods:From November 2008 to October 2009, There were 80 cases that met the criteria altogether,serum samples were collected in the Second Hospital of Shanxi Medical University. The blood samples were centrifuged 3000r/min for 10 minutes and placed in-70℃refrigerator kept for inspection.Activin,Inhibin and P-hCG was determined by ELISA.The data was analyzed by SPSS 11.5 of windows statistical package.Data of Normal distribution were described with mean and Standard deviation.The comparison of the difference of Means of two groups was processed by student't-test and ROC curve which was drawn concerning serum Activin A,Inhibin A,β-hCG. The area below the cuvre was calculated. Youden index was used to determine the cut-off Point of Activin A,Inhibin A and their sensitivity, specificity. It meant significant if P<0.05. Endometrial tissue was determined by immunohistochemistry method, Calculated positive rate of endometrial tissues. It meant significant if P<0.05.Results:1. There was no significant diffrence on age, height, weight, gravidity, Abortion times, menelipsis weeks, menstrual cycle between the two groups(P>0.05).2.The value of ACT a,INH a,β-hCGwere 0.24±0.17ng/ml,26.4±4.33 pg/ml,6673.2±3636.4mlu/ml in the tubal pregnancy group.They were 0.51±0.31ng/ml,44.85±6.22 pg/ml, 10112.2±7600.7mIu/ml in the intrauterine pregnancy group.There were difference between the two groups(P<0.05).3..Determined by ROC, The best cut off value of ACT A was 0.35 ng/ml with the sensitivity specificity was 93%,20%. The best cut off value of INH A was 28.6 ng/ml with the sensitivity specificity was 90%,32%;The best cut off value ofβ-hCG was 3236.6 mlu/ml with the sensitivity specificity was 88%,60%.4. ACT A and INH A are expressed in the endometrial tissues of intrauterine pregnancy and tubal pregnancy, ACT A and INH A of the endometrial tissues has no value in the diagnosis of early tubal pregnancy.Conclusions:1. ACT A and INH A has some value in the diagnosis of early ectopic pregnancy.2. The best cut off value of ACT A was 0.35 ng/ml with the sensitivity specificity was 93%,20%. The best cut off value of INH A was 28.6 ng/ml with the sensitivity specificity was 90%,32%; The best cut off value ofβ-hCG was 3236.6 mIu/ml with the sensitivity specificity was 88%,60%.3. The diagnostie of the combination ACT A,INH A andβ-hCG has no value.4. ACT A and INH A are expressed in the endometrial tissues of intrauterine pregnancy and ectopic pregnancy, ACT A and INH A of the endometrial tissues has no value in the diagnosis of early ectopic pregnancy.