Placental mRNA in maternal plasma as a predictor of ectopic pregnancy.
Placental mRNA in maternal plasma as a predictor of ectopic pregnancy.
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DOI：
10.1016/j.ijgo.2011.12.011
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发表时间：
2012-05
影响因子：
3.8
通讯作者：
Barnhart, Kurt
中科院分区：
文献类型：
--
作者：
Takacs, Peter;Jaramillo, Sindy;Datar, Ram;Williams, Anthony;Olczyk, Joseph;Barnhart, Kurt
目的：检测和比较宫内妊娠和宫外孕妇女外周血中胎盘mRNA的表达。血浆采集自有宫外孕风险的早孕患者。临床信息被前瞻性地收集并输入一个专门的数据库。提取母体血浆中人促性腺激素(HCG)和人胎盘催乳素(HPL)的mRNA，用定量RT-PCR方法检测hCG和HPL的表达。以GAPDHmRNA的表达作为内对照。入选宫外孕妇女12例，宫内妊娠妇女13例。异位妊娠患者未检测到hpl基因表达水平的可能性是后者的6倍(相对风险[RR]6.36；95%可信区间[CI]1.70-23.20；P<；0.01)。未检测到hCG信使核糖核酸水平的可能性也高出8倍(RR 8.64，95%CI，1.30-57.10；P<；0.01)。异位组hPL和hCG的mRNA拷贝数(经GAPDH归一化)显著低于宫内组。宫外孕与宫内妊娠相比，胎盘mRNA在母体循环中的拷贝数明显减少。检测母体循环中的胎盘信使核糖核酸有助于区分宫内和宫外孕。
To measure and compare placental mRNA expression in the maternal circulation among women with intrauterine and ectopic pregnancies. Plasma was collected from patients in early pregnancy at risk of ectopic pregnancy. Clinical information was prospectively collected and entered into a dedicated database. mRNA was isolated from maternal plasma and quantitative RT-PCR was performed to measure mRNA for human gonadotropin (hCG) and human placental lactogen (hPL). GAPDH mRNA expression was used as an internal control. Twelve women with ectopic pregnancy and 13 women with intrauterine pregnancy were enrolled. Patients with ectopic pregnancy were 6 times more likely to have undetectable levels of hPL mRNA (relative risk [RR] 6.36; 95% confidence interval [CI], 1.70–23.20; P<0.01). They were also 8 times more likely to have undetectable levels of hCG mRNA (RR 8.64, 95% CI, 1.30–57.10; P<0.01). mRNA copy numbers for hPL and hCG (normalized by GAPDH) were significantly lower in the ectopic group than in the intrauterine group. Placental mRNA is present in the maternal circulation in significantly lower copies in cases of ectopic pregnancy compared with cases of intrauterine pregnancy. Measurement of placental mRNA in the maternal circulation may help to distinguish between intrauterine and ectopic pregnancies.
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