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Zeynep Kamil Medical Journal
Serum Follistatin Like 3 Levels In The Diagnosis Of Tubal Ectopic Pregnancy [Zeynep Kamil Med J]
Zeynep Kamil Med J. Ahead of Print: ZKMJ-71601 | DOI: 10.14744/zkmj.2022.71601

Serum Follistatin Like 3 Levels In The Diagnosis Of Tubal Ectopic Pregnancy

Isil Ayhan1, Ahter Tanay Tayyar2, Ismail DAG3, Melike Altıntaş4, Hakan Bilgesoy5, Betül Yılmazer6
11. Zeynep Kamil Women and Children’s Health Training and Research Hospital, Department of Perinatology, Istanbul, Turkey
22. Medical Park Hospital, Department of Reproductive Endocrinology and Infertility, Istanbul,Turkey
33. Eyup State Hospital, Department of Clinical Biochemistry, Istanbul, Turkey
44. Surmene State Hospital, Department of Obstetrics and Gynecology, Trabzon, Turkey
55. Gaziantep Cengiz Gökçek Women and Children’s Diseases Hospital, Department of Obstetrics and Gynecology, Gaziantep, Turkey
66. Akyurt Devlet Hastanesi, Department of Obstetrics and Gynecology, Ankara, Turkey

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 migration and invasion of trophoblasts. We aim to measure value of serum follistatin like 3 levels in the diagnosis of tubal ectopic pregnancy.
METHODS: 76 pregnant women including: 39 women with surgically confirmed tubal ectopic pregnancy and 37 healthy, singleton controls whose gestational ages were between 5 to 8 weeks. Serum FSTL3 levels were measured in both groups via ELISA. ROC curve analysis was performed for the prediction of tubal ectopic pregnancy by using serum FSTL3.
RESULTS: Serum FSTL3 levels were significantly lower in the ectopic pregnancy group then controls (p <0.001). ROC analysis showed the area under the curve in the curve (AUC) was 0.811 (0.713-0.909; 95% confidence interval (CI)). The highest value of the sum of sensitivity and specificity in the ROC curve is the point where the FSTL3 level was 2160.7535 (cut-off value) with a sensitivity and specificity of 75.7% and 79.5%, respectively. Furthermore, in the subset analysis of patients with prior ectopic pregnancy showed 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.

Keywords: Follistatin like 3, tubal ectopic pregnancy, biomarker, transforming growth factor family

Corresponding Author: Isil Ayhan, Türkiye
Manuscript Language: English
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