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Objective:To investigate the efficacy of laparoscopic uterine curettage combined with uterine artery embolization in the treatment of cesarean scar pregnancy (CSP) after type Ⅲ cesarean delivery.Methods:Sixty patients with type Ⅲ CSP who received treatment in Jinxiang Hospital Affiliated to Jining Medical University from January 2017 to October 2019 were included in this study. They were randomly assigned to undergo either laparoscopic uterine curettage alone (control group, n = 30) or laparoscopic uterine curettage combined with uterine artery embolization (observation group, n = 30). The amount of intraoperative blood loss, length of hospital stay, surgical cure rate, time to beta human chorionic gonadotropin (β-HCG) value returning to normal level, and the incidence of postoperative complications were compared. Results:The amount of intraoperative blood loss in the observation group was significantly less than that in the control group [(42.36 ± 15.03) mL vs. (119.52 ± 21.84) mL, t = 15.941, P < 0.05]. Length of hospital stay [(6.51 ± 2.21) days vs. (19.25 ± 3.43) days] and the time to β-HCG value returning to normal level [(16.25 ± 5.02) days vs. (28.02 ± 9.38) days] in the observation group were significantly shorter than those in the control group ( t = 17.102, 6.060, both P < 0.05). There was no significant difference in surgical cure rate between the observation and control groups [96.67% (29/30) vs. 90.00% (27/30), χ2 = 0.268, P > 0.05]. There were no significant differences in the incidence of postoperative fever [63.33% (19/30) vs. 56.67% (17/30)], pain [56.67% (17/30) vs. 46.67% (14/30)], infection [6.67% (2/30) vs. 10.00% (3/30)] and vaginal bleeding [6.67% (2/30) vs. 13.33% (4/30)] between the observation and control groups ( χ2 = 0.278, 0.601, 0.000, 0.185, all P > 0.05). Conclusion:Laparoscopic uterine curettage combined with uterine artery embolization for the treatment of type Ⅲ CSP is superior to laparoscopic uterine curettage alone in terms of intraoperative blood loss, hospital stay, surgical cure rate, time to β-HCG value returning to normal level and safety. Therefore, the combined method is worthy of clinical application.
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Resumen Introducción: La mola hidatiforme es la forma más común de enfermedad trofoblástica gestacional. La cuantificación de beta-hCG sérica tiene importante valor en su diagnóstico y pronóstico, no obstante en Colombia no se cuenta con referencias de sus niveles según el tipo de mola o factores de riesgo. Objetivo: Estudiar el comportamiento de los valores de beta-hCG según el tipo de mola y los factores de riesgo. Materiales y Métodos: Se estudiaron 74 casos con diagnóstico de mola hidatiforme en el departamento de patología de la Universidad Industrial de Santander entre los años 2005 y 2014. Se registró a partir de los datos proporcionados por la historia clínica: hábito de fumar, hemoclasificación, indicación de régimen EMA-CO, antecedentes sociodemográficos y ginecoobstétricos y la concentración de beta-hCG previa al tratamiento evacuador. Resultados: 63 casos presentaron mediciones válidas de beta-hCG. En el análisis se utilizaron pruebas no paramétricas con un nivel de significancia del 10%. La mediana de beta-hCG para mola completa y parcial fue 270 852 UI/L y 40 379 UI/L respectivamente. Hubo una diferencia significativa para los valores de beta-hCG entre grupos de mola (p<0,0001). Para el diagnóstico de mola completa un punto de corte de 170 000 U/L presentó una sensibilidad del 91,5% y una especificidad del 75%. La indicación de EMA-CO presentó una asociación significativa con los valores de beta-hCG (p=0,066); no alcanzaron significancia las asociaciones con el tabaquismo (p=0,118) y la multiparidad (p=0,111). Conclusión: La cuantificación de beta-hCG ayuda a clasificar el tipo de mola aunque su rendimiento diagnóstico es modesto. MÉD.UIS. 2018;31(1):39-46.
Abstract Introduction: Hydatidiform mole is the most common form of gestational trophoblastic disease. The quantification of serum beta-hCG has important value in its diagnosis and prognosis, however in Colombia there are no references of its values according to the type of mole or risk factors. Objective: To study the behavior of beta-hCG values according to the type of mole and the risk factors. Materials and Methods: 74 cases with diagnosis of hydatidiform mole were studied in the pathology department of the Industrial University of Santander between 2005 and 2014. It was recorded from the data provided by the clinical history: smoking habit, blood sample, indication of the EMA-CO regimen, sociodemographic and gyneco-obstetric antecedents and the beta-hCG concentration prior to the evacuation treatment. Results: 63 cases presented valid measurements of beta-hCG. In the analysis nonparametric tests with a level of significance of 10% were used. The median beta-hCG for complete and partial mole was 270 852 IU / L and 40 379 IU / L respectively. There was a significant difference for beta-hCG values between mola groups (p <0.0001). For the diagnosis of complete mole, a cut-off point of 170,000 U / L showed a sensitivity of 91.5% and a specificity of 75%. The EMA-CO indication showed a significant association with beta-hCG values (p = 0.066); associations with smoking (p = 0.118) and multiparity (p = 0.111) were not significant. Conclusion: The quantification of beta-hCG helps to classify the type of mole although its diagnostic performance is modest. MÉD.UIS. 2018;31(1):39-46.
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Humans , Female , Pregnancy , Hydatidiform Mole , Pregnancy , Risk Factors , Chorionic Gonadotropin, beta Subunit, Human , Gestational Trophoblastic Disease , HistologyABSTRACT
Objective To investigate the human chorionic gonadotropin (β-HCG) and its free β-subunit (fβ-HCG) content change,to observe the 48 hours multiplication factor,combined with progesterone value in the diagnosis of adverse pregnancy for clinical diagnosis and treatment of adverse pregnancy to provide guidance.Methods The chemiluminescence technique was used to detect serum β-HCG,fβ-HCG and progesterone levels in early adverse pregnancy.According to pregnancy,the pregnant women were divided into threatened abortion group (65 cases),missed abortion group (43 cases) and ectopic pregnancy group (62 cases),while 60 normal pregnant women were selected as control group.Theβ-HCG,fβ-HCG,progesterone levels and 48 hours multiplication factor were measured.The results combined with the pregnancy outcomes were analyzed.Results The serum β-HCG,fβ-HCG,progesterone levels in the threatened abortion group,missed abortion group and ectopic pregnancy group were (15 385 ± 4 350) IU/L,(77.2 ± 21.3) IU/L,(20.8 ± 6.3) μg/L; (1 584 ± 362) IU/L,(119.3 ± 34.1) IU/L,(6.1 ± 3.7) μg/L; (1 459 ± 493) IU/L,(132.1 ± 35.7) IU/L,(5.7 ± 3.4) μg/L; the β-HCG levels 48 hour doubling rates in three groups were (1.52 ±0.51),(0.21 ±0.26),(0.13 ±0.08) ;threatened abortion group β-HCG and 48 hours multiplication factor,progesterone levels and missed abortion and ectopic pregnancy group were significantly different (t =7.41,5.17,6.89,all P ＜ 0.05) ; there were no significant differences between missed abortion group and ectopic pregnancy group (t =0.851,0.782,0.864,all P ＞ 0.05) ;fβ-HCG in threatened abortion group was average 30mIU/mL lower than the missed abortion group and ectopic pregnancy group,the difference was statistically significant (t =6.18,P ＜ 0.05).With miscarriage success fβ-HCG showed a decreasing trend.Conclusion β-HCG and progesterone combined 48 hours multiphcation ratio values for monitoring miscarriage of important guiding significance for the diagnosis of missed abortion and ectopic pregnancy has important reference value trimester β-HCG 48 hour doubling rate of less than 0.5,abortion increased risk;fβ-HCG data descending indicates miscarriage treatment is effective.
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Objective To explore the clinical diagnostic value of serum human chorionic gonadotropin beta subunit (β-HCG) and alpha fetoprotein ( AFP) in mediastinal germ cell tumors .Methods A retrospective analysis was conducted on the patients who were definitely diagnosed as mediastinal tumors or mediastinal neoplastic lesions .A total of 133 patients were included for analysis between January 2008 and May 2014, divided into two groups.42 cases of mediastinal germ cell tumor patients were marked as case group while 91 cases of other mediastinal tumor or mediastinal neoplastic lesion patients were marked as control group ( including 31 cases of thymoma , 10 cases of mediastinal neurogenic tumor , 2 cases of intrathoracic goiter , 25 cases of mediastinal cyst , 2 cases of mediastinal lipoma , 11 cases of mediastinal lymphoma and 10 cases of thymic carcinoma ) .AFP was detected by chemiluminescence detection , and -HCG was detected by electrochemical luminescence .K-S test was performed to investigate normality of data , non-normally distributed data were described as Median ( interquartile range ) .Mann-Whitney U test was done for measurement of data between two groups .Logistic regression analysis was performed as multivariate analysis.Receiver operating characteristic curve ( ROC) was used to determine the cut-off values.Results The levels of serum AFP and β-HCG in case group were 13.26 (2.39-48.09) ng/ml and 1.99 (0.10-15.7) IU/L, respectively, significantly higher than those in control group [AFP:2.47 (1.78-3.16) ng/ml,β-HCG:0.10 (0.10-0.55) IU/L].The difference of levels of AFP and β-HCG between the case group and the control group were statistically significant ( P=0.000 ) .There were no significant difference when it comes to β-HCG between the case group and intrathoracic goiter patients in control group .Apart from it, the difference of levels of AFP and β-HCG between the case group and every single control group were statistically significant .Cut-off values of AFP and β-HCG for distinguishing mediastinal germ cell tumors from mediastinal tumors were 5.07 ng/ml and 2.32 IU/L.In this scenario, for AFP and β-HCG, sensitivity were 57.1%and 50%, specificity were 97.8%and 96.7%, accuracy were 54.9%and 46.7%, area under the curve ( AUC ) were 0.773 and 0.755, positive likelihood ratios were 26.00 and 15.17respectively.Parallel experiments contributed to increase the sensitivity to 71.4%. Predictive probability (P) =1/[1+exp ( -0.319AFP-0.253HCG+2.850)] was obtained by logistic regression model.When cut-off value of predictive probability ( P ) was 0.30, specificity, AUC, and positive likelihood ratio were increased to 98.9%, 0.835 and 65.00respectively, negative likelihood ratio was decreased to 0.29, positive predictive value and negative predictive value were increased also (96.8%and 88.2%respectively).Conclusion Serum β-HCG, AFP and predictive probability ( P ) is valuable in the diagnosis of mediastinal germ cell tumor .
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Objective To study whether there was significant difference between pregnant women , data and the results of prenatal screening of single intrauterine fetal death ( sIUFD) when twin pregnancy and singleton pregnancy for guiding the clinical prenatal screening and risk consulting .Methods By comparative study, 56 cases of sIUFD when twin pregnancy were recorded from 2011 to 2014 in Ningbo Prenatal Diagnosis Center , all were natural pregnancy , the sistens gestational weeks were less than 14 weeks , and 4 993 natural singleton pregnancy .The pregnant women , data and the results of serological prenatal screening between sIUFD and singleton pregnancy were analyzed by t-test and rank sum test .Separately , the 56 cases of prenatal screening , risk value was calculated according to the twins and singleton , then the difference were analyzed combined with the results of follow-up.Results Pregnant women , data of two groups were analyzed, there were no statistically significant difference between sIUFD and singleton pregnancy .The age of sIUFD and singleton was (27 ±3)year-old and (27 ±3)year-old respectively, t=2.56, P>0.05; the weight of sIUFD and singleton was (55.2 ±10.23 ) kg and (56 ±10.34) kg, t=4.268, P>0.05.The gestational weeks of sIUFD and singleton were (39.21 ±0.78)weeks and (39.1 ±0.91) weeks, t=1.3, P>0.05;the weight of newborn was (3.38 ±0.41) kg and (3.31 ±0.43) kg, t=1.9, P>0.05.The AFP multiple of median (AFPMOM) of sIUFD and singleton was 1.41(0.99,1.83) and 1.02(0.84,1.24), Z=5.337, P0.05;unconjugated estriol multiple of median of sIUFD and singleton was 1(0.79,1.16) and 1.01(0.85,1.21), Z=1.334, P>0.05.Trisomy 21 risk of sIUFD and singleton was 7 750(2 200,28 000) and 5 300(2 000,12 000), Z=2.093, P<0.05, that had significant difference.The 56 cases of prenatal screening risk value was calculated according to the twins and singleton , among whom 42 cases had the same conclusion , 14 cases had the different conclusion .Among them, according to singleton calculation , 3 cases for high risk, according to the twin calculation of high risk for 17 cases,χ2 =12.1, P <0.05.According to follow-up, all newborns were normal.Conclusions For the natural pregnancy , sIUFD when twin pregnancy , if the sistens gestational weeks less than 14 weeks, the risk of prenatal screening results calculated according to singleton will be more reasonable , as for the prenatal screening for twin pregnancy , the method needs further exploration .
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Objective To investigate the current situation in application of median levels in second trimester in prenatal screening laboratory throughout China and to understand the methods and importance of quality control.Methods Of those laboratories that participated in the national external quality assessment (EQA) for second trimester maternal serum screening in 2013, 442 submitted the medians for α-fetal protein (AFP), human chorionic gonadotropin (hCG), β-hCG, free β-hCG and unconjugated estriol (uE3) and related information.We categorized the medians according to the platform.There were 170, 210, 31, 26, 13, 11 and nine laboratories using the detection systems from Perkin Elmer, Beckman Coulter, Fenghua, Roche, Darui, Siemens and Abbott, respectively.The method of setting up the medians for each laboratory was analyzed.The number of laboratories, which was the outliers, was determined according to the reported medians on the third day of each week from 14th to 20th gestational weeks.Single sample t-test was applied to compare the result of this study with published results from a multi-center study of pregnant women in China.Results Among all laboratories, 19.0％ (84/442) of the recruited laboratories setup the median on their own.And 4.3％ (19/442) did this with their vendors;76.7％ (339/442) used the default median from the software, among them 97.9％ (332/339) did not verify their medians and 84.3％ (280/332) had no idea of how to do.Medians of AFP and uE3 increased with gestational age, while medians of hCG, β-hCG and free β-hCG decreased in all detection systems.More outliers were found for AFP, free β-hCG and uE3 medians in Perkin Elmer system, which scattered in each gestational age.A higher proportion of AFP in Fenghua system, free β-hCG in Darui system and uE3 in Siemens system were reported [9.5％ (20/210), 13.2％ (12/91) and 23.4％ (18/77), respectively].The medians of AFP and β-hCG using Perkin Elmer platform were compared between this study and the previous multi-center study in Chinese women.The results did not show significant difference in AFP median at 14th and 18th week of gestation (both P ＞ 0.05), while higher medians in AFP at 15th, 16th, 17th, 19th and 20th week of gestation (t=-7.257,-3.204,-5.479,-3.253 and-20.089, respectively, all P ＜ 0.05) and higher β-hCG median at 14th to 20th week of gestation (t=-80.749,-199.779,-142.601, -90.732,-72.984,-47.935 and-39.409, respectively, all P ＜ 0.01) were found in the previous study.Conclusion Most laboratories in our country never verify their medians for second trimester screening program and the medians vary among different settings.
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Metastases to skeletal muscle and paraneoplastic syndromes involving beta-human chorionic gonadotropin (HCG) production are an extremely rare manifestation of head and neck squamous cell carcinoma. We report a patient with a beta-HCG-secreting squamous cell carcinoma of the tongue with diffuse metastases involving skeletal muscle. A 47 year old female, who was being treated heavily with palliative chemotherapy for metastatic tongue cancer, was admitted with a palpable thigh mass and pain. A magnetic resonance image showed an intramuscular metastasis in the thigh. Ultrasound-guided biopsy of the thigh mass confirmed metastatic squamous cell carcinoma. She was scheduled for enrollment into a clinical trial; however, a positive serum beta-HCG test was noticed. There was no evidence of pregnancy or a trophoblastic or non-trophoblastic tumor secreting beta-HCG. Finally, she was revealed to have a paraneoplastic syndrome with diffuse metastases and was ultimately referred for palliative care. We review the literature of previously reported cases of an increase of beta-HCG in patients with head and neck cancer.
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Female , Humans , Pregnancy , Biopsy , Carcinoma, Squamous Cell , Chorionic Gonadotropin , Chorionic Gonadotropin, beta Subunit, Human , Drug Therapy , Head , Head and Neck Neoplasms , Muscle, Skeletal , Neck , Neoplasm Metastasis , Palliative Care , Paraneoplastic Syndromes , Thigh , Tongue Neoplasms , Tongue , TrophoblastsABSTRACT
Objective To investigate the predictive value of abnormal multiples of the median (MoM) of second trimester maternal serum triple screening (STMSTS) markers for adverse pregnancy outcomes.Methods 16 000 singleton pregnancies at 15+0 to 20+6 weeks' gestation who underwent STMSTS between July 2010 and January 2013 in the First Hospital of Jilin University were recruited.Maternal serum AFP,free β-hCG (F-β-hCG) and unconjugated estriol (uE3) levels were measured using time-resolved fluoroimmunoassay,and then convened to MoM.LifeCycle 3.2 software was used to calculate risk,and a risk value greater than 1 in 270 or 1 in 350 was considered as high risk for trisomy 21 syndrome (Down syndrome,DS) and trisomy 18 syndrome (Edwards syndrome,ES),respectively.MoM of AFP more than 2.5was considered high risk for open neural tube defect (ONTD).Amniocentesis and karyotyping,ultrasound screening were advised for high risk women.AFP,F-β-hCG higher than 2.0 MoM or uE3 lower than 0.5MoM was considered as abnormal,respectively.The MoM of STMSTS marker between women with adverse pregnancy outcome and with normal outcome was compared.Results (1) The median MoM of AFP,F-β-hCG and uE3 was 0.91 MoM,0.94 MoM and 1.05 MoM,respectively.Of the 16 000 pregnant women,there was no statistical difference in the median MoM of triple screening marker at different weeks of gestation (P＞0.05).The positive rate of DS,ES and ONTD in women ≤35 years old (n=14 972) was 4.03％ (603/14 972),0.36％(54/14 972) and 0.29％(44/14 972) respectively.And in women＞35 years old(n=1 028),the positive rate was 24.51％ (252/1 028),1.95％ (20/1 028) and 0.78％ (8/1 028),respectively.There was a statistically significant difference of positive rate between the two groups(P＜0.05).(2) 9 cases of DS,1 case of ES and 1 ease of ONTD were found in the high risk group,and 2 cases of DS in the low risk group.The detection rate of DS,ES and ONTD was 9/11,1/1 and 1/1 respectively; and the positive predictive value was 1.05％(9/855),1.35％(1/74) and 1.92％(1/52),respectively.(3)The incidence of adverse outcome (group 1) was 1.49 ％(239/16 000).7 760 pregnant women in this study were healthy during pregnancy,so were their fetuses (group 2).There were significant differences in the age at delivery,body weight and markers' MoM of STMSTS between the two groups(P＜0.01).(4) In group 1,the rate of abnormal MoM of AFP or F-β-hCG was 7.95％(19/239) and 23.85％ (57/239),and the abnormal rate of MoM of uE3 was 4.18％(10/239).The rate of two abnormal MoM of markers was 5.02％(12/239); the rate that all three MoM were abnormal was 0.84％(2/ 239).However,in group 2,the rate of two abnormal MoM of markers was 0.14 ％(11/7 760); and the rate that all three MoM were abnormal was 0.There was a significant difference of abnormal MoM of maternal serum marker between the two groups (P＜0.01).Conclusions There is a relationship between abnormal marker of STMSTS and adverse outcomes.STMSTS show a high value in the detection of DS,ES and ONTD.
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Objective To study the dilution model of the early pregnancy test strip for the quantitative detection of serumβ-hu-man chorionic gonadotropin(β-hCG)level by the Abbot AxSYM detection system and its application.Methods The detection re-sults of serumβ-hCG level in 5 612 outpatients and inpatients of the internal medicine department and the gynecology and obstetrics department during 5 years were retrospectively analyzed.In addtion,234 serum samples from the patients were collected for prelimi-narily determining the serumβ-hCG level by the early regnancy test strip and then the quantitative detection of serumβ-hCG level was detected by the Abbot AxSYM detection system.Results The retrospective analysis showed that 241 cases(4.6%)were low-age pregnant women.The qualitative screening was necessary.The screening model was successfully established.But one thing to note was that the part of serum sample needed to be taken out and put into another tube for determination.Conclusion Establishing the rational and effective dilution interpretation model of early pregnancy test strip for screening serumβ-hCG can bring the econom-ic and time benifits for the routine detection work of the Abbot AxSYM detection system.
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Objective To study the copulation of the abnormal level of maternal serum-free β-human chorionic gonadotropin ( β-hCG ) during second-trimester pregnancy and adverse pregnancy outcome.Methods Two hundred and nine pregnant women in second-trimester pregnancy were detected serum β-hCG and followed up ti11 delivery.The correlation of the abnormal level of serum β-hCG and adverse pregnancy outcome were observed.Results In 209 pregnant women,the level of serum β -hCG of 105 cases were over standard [(84.9 ± 11.6) kU/L](over standard group),while the level of the rest 104 cases were (18.6 ± 1.3) kU/L within normal range (normal group).The incidence rate of gestational hypertension,premature deliwery,premature rupture of membranes and suffocation of new born infants in over standard group were all higher than those in normal group [14.3％(15/105 ) vs.0,18.1％(19/105) vs.2.9％ (3/104),11.4％(12/105) vs.0,29.5％(31/105) vs.0,P＜0.05].Conclusions The abnormality of serum β -hCG of women in second-trimester pregnancy can reflect the placenta dysfunction and it is a signal of adverse pregnancy outcome.Therefore,detecting the level of serum β -hCG is useful for preventing adverse pregnancy outcome.
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Objective To evaluate the role of serum progesterone ( P) , β-subunit of human chrionic (β-HCG) and activin A( ACT A) in the diagnosis of ectopic pregnancy (EP). Methods The clinical data of 83 pregnant women were retrospectively reviewed. Serum P,β-HCG and ACT A were measured at visiting day(0 h) ,The values of β-HCG were measured again 48 h later. ROC curve was established and optimal operating point (OOP) of three indexes was ascertained,and the accuracy of each variable was evaluated. Results Serum P( 16.83 ± 15.71) nmol/L,48h/0h β-HCG (1.02 ±0.77) and ACT A(0. 26 ± 0.15)μg/L were significantly lower in ectopic pregnancy group compared with normal pregnancy group[(75. 74 ± 9. 76) nmol/L, (2. 53 ±0. 34) , (0. 49 ± 0. 43) μg/L] (P ＜ 0. 05). ROC curve showed that the highest accuracy rate in the diagnosis of EP was β-HCG 48h/0h( AUC =0.94), the second was progesterone( AUC =0.91) ,the lowest was ACTA( AUC =0.56). In addition,ROC curve showed all OOPs as following:serum P was 31.30nmol/L,48h/0h β-HCG was 1.25 ,ACTA was 0.43μg/L. When the three parameters were in the upper critical value,it had the higher accuracy rate in the diagnosis of EP. The combination of progesterone and β-HCG 48 h/0 h had higher sensitivity(98.4% ) and specificity(66.7% ) than the other two groups in the diagnosis of EP. Conclusion The combination of progesterone and p-HCG 48 h/0 h improved the accuracy rate in the diagnosis of EP, whereas estradiol had no diagnostic value in the diagnosis of EP.
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Objective To evaluate the differences of α-fetoprotein (AFP), ffeeβ-human chorionic gnnadotropin (HCG) indexes in 3 foreign median databases for antepartum risk screening, and establish the median databases of normal pregnant women in Wenzhou for antepartum screening of AFP, free-β-HCG indexes through the suitable median computational models. Methods The levels of AFP and free β-HCG of 20054 normal pregnant women in Wenzhou were detected by time-resolved fluorometry. The data in this paper were compared with the data of 2T-risk ( 2T), Lifecycle-2. 2 (LC2.2 ) and Lifecycle -3.0 (LC3.0) by double-factor ANOVA. The differences between the data in the paper and the data from Shenyang and Ningbo were analyzed. The median database of Wenzhou pregnant women was established by the suitable regression model, with the stability of nonlinear regression models of the 3 software assessed by model correcting fitting, distribution mean of model fitting logarithmic and standard deviation. Results The levels of AFP and freeβ- hCG reported here were 10% and 16% higher than the data of 2T-risk, 15% and 20% higher than that of LC 2. 2, 6% and 17% higher than that of LC 3.0 respectively. The differences were statistically significant. ( FAFP = 161. 757 ,P < 0. 01 ; Ffree-β-HCG = 58. 261, P < 0.01 ). The levels of AFP and free β- hCG in Wenzhou were 2% higher and 3% lower than that of Shenyang, 1% and 2% higher than that of Ningbo. There was no statistical difference of AFP levels among Wenzhou , Shenyang and Ningbo( FAFP = 0. 174 ,P =0. 840) while the differences of free-β-hCG were statistically significant( F<,free-β-HCG> = 13.303 ,P < 0. 01 ). The differences of quadratic equation regression model, exponent quadratic function regression model and exponent quadru-function regression model of 2T, LC-2. 2 and LC-3.0 were not remarkable. The exponent quadru-function regression model was the best. Conclusions There are significant differences between the data from Wenzhou, Shenyang and Ningbo and the data of T-2 risk, LC-2. 2, LC -3.0. The discrepancy is due to the ethnic and different parameters of regression models. So the model parameters and the median databases are urgently required in China. The differences of large sample size of AFP from Wenzhow, Shengyang and Ningbo are not significant, while the differences of free-β- hCG from Wenzhow, Shengyang and Ningbo is remained because of its instability. The levels from Wenzhow and Ningbo are near. It is suggested that the laboratories with small sample size can establish their own laboratory parameters using the reference obtained from large sample size under the same experimental conditions. There are no significant differences of stability among regression computational models in the 3 software. The exponent quadru-function regression model can be used to establish the median databases for the screening with the similar data distribution in the paper.
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Objective To found sensitive and reliable method to identify trophoblastic tumor cells in the peripheral blood of the patients suffered from gestational trophoblastic tumor.Methods Given numbers of JAR cell from ten to million were mixed into 10ml non pregnant peripheral blood as a model. Detection of ? hCG mRNA with fluorescence quantitative reverse transcription polymerase chain reaction (FQ RT PCR) and then estimation of the numbers of tumor cell in the blood. Nine cases of peripheral blood were collected from the pretreatment patients of gestational trophoblastic tumor to assay ? hCG mRNA with FQ RT PCR, then to estimate the numbers of tumor cell in the circulation blood. Results FQ RT PCR could detect ? hCG mRNA when ≥10 2 JAR cells were mixed into 10ml non pregnant peripheral blood. Four cases of bloods had been detected ? hCG mRNA expression in 9 cases of gestational trophoblastic tumor, and the numbers of tumor cell from 10 4 to 10 7 per 10ml blood. Conclusion FQ RT PCR of which primers and probe are designed for ? hCG had been proved to be very sensitive detection means, it could be used to detect gestational trophoblastic tumor cells from patient preipheral blood; With FQ RT PCR the tumor cells had been detected in some patients of gestational trophoblastic tumor.
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Objective To investigate the relationship between ?hCG genes expression and the clinicobiological behavior of bladder cancer. Methods RT-PCR method combined with restriction endonuclease analysis was adopted to detect the expressions of ?hCG mRNA and its subtypes in 37 cases of bladder cancer tissues. Results 26 of 37 cancer tissues (70%) were positive for ?hCG mRNA expression. The positive rate was higher in invasive tumor (T 2～T 4,13/14) compared with that in superficial tumor (Ta～T 1,13/23) ( P 0.05). Most of superficial tumors only expressed ?7 gene, while invasive tumor expressed ?7,?5, ?3, or ?8 . Conclusions The positive rate of ?hCG mRNA expression is related to tumor stage. The expression of hCG gene ?5, ?3 or ?8 in addition to ?7 indicates a worse differentiated or advanced bladder tumor.
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2.4M, PAPP-A2.0M and AFP