Novel marker to predict rupture risk in tubal ectopic pregnancies: the systemic immune-inflammation index


DİNÇ K., Issın G.

Ginekologia Polska, vol.94, no.4, pp.320-325, 2023 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 94 Issue: 4
  • Publication Date: 2023
  • Doi Number: 10.5603/gp.a2023.0010
  • Journal Name: Ginekologia Polska
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Central & Eastern European Academic Source (CEEAS), EMBASE, Gender Studies Database, MEDLINE, Directory of Open Access Journals
  • Page Numbers: pp.320-325
  • Keywords: ectopic pregnancy, NLR, PLR, Systemic Immune-inflammation Index, trophoblastic invasion
  • Erzincan Binali Yildirim University Affiliated: Yes

Abstract

Objectives: Ectopic pregnancy is a life-threatening condition; delaying treatment can result in mortality or serious complications. Identification of a biomarker that can predict tubal rupture may be helpful for guiding treatment. In this study, we evaluated the association between serum β-hCG, biochemical markers, Systemic Immunity-inflammation Index (SII) score, and the trophoblastic invasion stage. Material and methods: Tubal pregnancy was classified into three groups based on the depth of trophoblastic infiltration: stage I — limited to the mucosa; stage II — invaded the muscular layer, and stage III — invaded the serosa/subserosa of the tuba uterine. The association between groups, serum β-hCG, biochemical markers, and the SII score were assessed. Results: There was no significant difference between the groups, hemoglobin, platelet count, MPV, RDW, NLR or PLR values (p > 0.05). A ROC analysis was performed to evaluate the accuracy of serum β-hCG predictions for infiltration level. At a 95% confidence interval upper limit, cut-off value of the serum β-hCG that best predicted stage III trophoblastic infiltration, was 2799 mIU/mL, with 78.9% sensitivity, 53.8% specificity (positive predictive value was 71.4%, and a negative predictive value was 63.6%). Moreover, ROC curve analysis showed that The SII value of 792 was the best predictor of trophoblastic infiltration at stage III, with a sensitivity of 92.3% and a specificity of 63.1%. Conclusions: A linear relationship exists between depth of trophoblastic infiltration and serum β-hCG and the SII were observed. These findings suggested that the SII score can be used for predicting tubal ectopic pregnancy rupture