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Serum follistatin-like-3 levels in the diagnosis of tubal ectopic pregnancy
Işıl Ayhan1, Ahter Tanay Tayyar2, Ismail Dağ3, Melike Altıntaş4, Hakan Bilgesoy5, Betül Yılmazer61Department of Obstetrics and Gynecology, University of Health Sciences, Turkey. Zeynep Kamil Maternity and Children’s Training and Research Hospital, İstanbul, Türkiye2Department of Reproductive Endocrinology and Infertility, Medical Park Hospital, İstanbul, Türkiye
3Department of Clinical Biochemistry, Eyüp State Hospital, İstanbul, Türkiye
4Department of Obstetrics and Gynecology, Medipol University Çamlıca Hospital, İstanbul, Türkiye
5Department of Obstetrics and Gynecology, Gaziantep Cengiz Gökçek Women and Children’s Diseases Hospital, Gaziantep, Türkiye
6Department of Obstetrics and Gynecology, Akyurt State Hospital, Ankara, Türkiye
INTRODUCTION: Activin is necessary for maintaining normal pregnancy; follistatin and follistatin-like-3 (FSTL3) are known antagonists of activin. FSTL3 also has a role in the migration and invasion of trophoblasts. We aim to measure the value of serum FSTL3 levels in the diagnosis of tubal ectopic pregnancy.
METHODS: Seventy-six pregnant women including 39 women with surgically confirmed tubal ectopic pregnancy and 37 healthy, singleton controls whose gestational ages were between 5 and 8 weeks. Serum FSTL3 levels were measured in both groups through ELISA. Receiver operator characteristic (ROC) curve analysis was performed for the prediction of tubal ectopic pregnancy using serum FSTL3.
RESULTS: Serum FSTL3 levels were significantly lower in the ectopic pregnancy group than in controls (p<0.001). ROC analysis showed that the area under the curve in the curve (AUC) was 0.811 (0.713–0.909; 95% confidence interval). The highest value of the sum of sensitivity and specificity in the ROC curve is the point where the FSTL3 level was 2160.7535 (cutoff value) with a sensitivity and specificity of 75.7% and 79.5%, respectively. Furthermore, the subset analysis of patients with prior ectopic pregnancy showed that serum FSTL3 was the highest in patients without any previous ectopic pregnancy (p<0.001).
DISCUSSION AND CONCLUSION: Low levels of serum FSTL3 may be a potential biomarker in the early diagnosis of tubal ectopic pregnancy.
Manuscript Language: English
