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Evaluation of leukemia inhibitory factor as a marker of ectopic pregnancy
1Department of Obstetrics and Gynecology, College of Medicine, University of Cincinnati, Ohio, USA.
Insights
Serum leukemia inhibitory factor (LIF) is lowest in ectopic pregnancies. While a LIF cutoff of 6.2 pg/mL shows promise, it is not yet clinically discriminative for diagnosing ectopic pregnancy.
Area of Science:
- Reproductive Endocrinology
- Clinical Biochemistry
- Cytokine Signaling
Background:
- Ectopic pregnancy is a life-threatening condition requiring early diagnosis.
- Leukemia inhibitory factor (LIF) is a cytokine crucial for implantation.
- Accurate diagnostic markers for ectopic pregnancy are essential.
Purpose of the Study:
- To evaluate the diagnostic utility of serum leukemia inhibitory factor (LIF) for ectopic pregnancy.
- To compare LIF concentrations across different pregnancy outcomes.
Main Methods:
- Serum samples from 40 women with positive beta-human chorionic gonadotropin were analyzed.
- Leukemia inhibitory factor (LIF) concentrations were measured using enzyme-linked immunosorbent assay.
- Patients were categorized into normal intrauterine pregnancy, threatened abortion, spontaneous abortion, and ectopic pregnancy groups.
Main Results:
- All patients exhibited detectable serum LIF levels (2.44–8.25 pg/mL).
- Mean serum LIF concentrations were significantly lower in ectopic pregnancies compared to abortion groups (P <.05).
- A serum LIF cutoff of <6.2 pg/mL yielded 73% sensitivity and 72% specificity for ectopic pregnancy detection.
Conclusions:
- Serum LIF concentrations are lowest in ectopic pregnancy cases.
- The proposed LIF cutoff of 6.2 pg/mL offers moderate diagnostic accuracy but requires further validation.
- Serum LIF measurement alone is not sufficiently discriminatory for routine clinical diagnosis of ectopic pregnancy.
Objective:
Our purpose was to determine the utility of measuring serum leukemia inhibitory factor, a cytokine expressed in the process of pregnancy implantation, for the diagnosis of ectopic pregnancy.
Study Design:
Serum samples from 40 patients with positive serum quantitative beta-human chorionic gonadotropin levels were used for leukemia inhibitory factor determination. The serum leukemia inhibitory factor concentration was determined by enzyme-linked immunosorbent assay in the following 4 groups: (1) normal intrauterine pregnancies, (2) threatened abortions, (3) spontaneous abortions, and (4) ectopic pregnancies.
Results:
All patients had detectable concentrations of leukemia inhibitory factor in serum, ranging from 2.44 to 8.25 pg/mL. Mean leukemia inhibitory factor concentrations for ectopic pregnancy were significantly lower (P <.05) than those of both the spontaneous abortion and threatened abortion groups by 1-way analysis of variance. When a cutoff point of serum leukemia inhibitory factor <6.2 pg/mL is assigned as diagnostic of ectopic pregnancy, leukemia inhibitory factor in patients with ectopic pregnancies versus all other groups predicted ectopic pregnancy with a sensitivity of 73%, specificity of 72%, positive predictive value of 50%, and negative predictive value of 88%.
Conclusion:
Serum leukemia inhibitory factor concentration is lowest in patients with ectopic pregnancy. A cutoff point of 6.2 pg/mL maximizes the sensitivity and specificity of the test; however, it is not sufficiently discriminatory to be used clinically for the diagnosis of ectopic pregnancy.
