RESUMEN
Seventy-four patients had ectopic pregnancies proven by surgery. Three of them had a serum beta-HCG test for pregnancy that was reported as negative (less than 25-35 mIU/ml). We sought a threshold for positive in the serum beta-HCG test that would maximize its usefulness in diagnosing ectopic pregnancy. Sera from 52 of the patients were available for reanalysis. Quantitative values of beta-HCG were determined. Lowering the threshold for positive from 25-35 to 10 mIU/ml might increase the test's sensitivity without sacrificing specificity but would still not ensure detection of all ectopic pregnancies. Of 445 cases of ectopic pregnancy described in the literature, 6 had serum beta-HCG values reported as negative. In the published reports and in our own cases, clinical histories and histologies indicated that a nonviable ectopic pregnancy can be expected to have an associated serum concentration of beta-HCG that may be below the sensitivity of detection even with current, commercially available quantitative tests.
Asunto(s)
Gonadotropina Coriónica/sangre , Fragmentos de Péptidos/sangre , Embarazo Ectópico/diagnóstico , Adulto , Gonadotropina Coriónica Humana de Subunidad beta , Femenino , Humanos , Laparoscopía , Embarazo , Pruebas Inmunológicas de EmbarazoRESUMEN
This study shows that microscopic image analyses of nuclear DNA have common characteristics among fixation methods and tissue types. We find that microscopic imaging measurements require both nuclear area and DNA concentration to properly convey diagnostic information. Algorithms are developed which enable infiltrating lymphocytes to act as internal DNA controls for each sample. The DNA content and patterns measured by microscopic imaging were found to be related to patient survival and to cytologic diagnosis.