The Study Of Diagnosis And Treatment In Ectopic Pregnancy From PCNA, B Ultrasonography And Biochemical Indexes

Objective 1. To observe the expression of Proliferating Cell Nuclear Antigen(PCNA) which reflect trophoblast cells proliferation and differentiation, we assessed the difference of PCNA between different treatments. From then, it can guide to choose some reasonable treatments. 2. To analysis relative indicative indexes of pregnancy β -human chorionic gonadotrophin(β-hCG), Cancer Antigen 125(CA125), Vascular Endothelial Growth Factor (VEGF) and B ultrasonography in some special time, combining the benefit and clinical conditions. We offer to the evidences of clinical treatments and hope to reserve fertility ability of patients in maximum. Methods 1. Obtaining serum from blood, partly detected the level of β -hCG, CA 125 , VEGF. β -hCG be seen regularly at least 1-2 times in 48-72 hours, between these time fixed doctors examine uterus, adnexa and pelvic condition by B ultrasonography, record the pregnancy days, the time of haemorrhage, infertility and so on. 2. Villi samples from the methotrexate(MTX) treatment failure and surgery treatment were embedded in paraffin, specimen was stain by HE (regular pathological evaluation) and by immunohistochemistry DAB stain (to detect the expression ofPCNA in trophoblast cells). Results 1. Two times MTX treatments failures(67. 42 + 13. 25)% had a much lower proliferation index than surgery treatment groups (78. 85±7. 57)%. The size of the ectopic mass has nothing to do with the outcome of MTX treatment. 2. We found that low concentration CA125(<28U/ml) has higher successful in conservative treatment of ectopic pregnancy, we also found VEGF increased(>275pg/ml) in all ectopic pregnancy cases, VEGF almost decreased after success of conservative treatment in ectopic pregnancy, but VEGF have no fixed tendency after surgery treatment. Conclusions 1. It appeared possibly to restrain or even destroy the trophoblast cells proliferation in the mechanism of MTX, it may also induce the change of DNA, so it should be careful to choose MTX treatment. 2. It has a different characteristic in choosing diagnosis and treatment from detecting predictors J3-hCG, CA125, VEGF and B ultrasonography. Combining with each other can strengthen the function of guidance.