人胎盘催乳素是唐氏综合征孕早期母体血清标志物。

Human placental lactogen is a first-trimester maternal serum marker of Down syndrome.

作者信息

Christiansen Michael, Sørensen Tina Lindvig, Nørgaard-Pedersen Bent

机构信息

Department of Clinical Biochemistry, Statens Serum Institut, Copenhagen, Denmark.

出版信息

Prenat Diagn. 2007 Jan;27(1):1-5. doi: 10.1002/pd.1600.

DOI:10.1002/pd.1600

PMID:17154235

Abstract

BACKGROUND

Human placental lactogen (hPL) is synthesised by the placenta and found in maternal serum. We analysed the potential of hPL as a first-trimester maternal serum-screening marker for fetal Down syndrome (DS).

MATERIALS AND METHODS

hPL was quantified by ELISA in 47 DS pregnancies and 136 controls in gestational weeks 8-13. Distributions of log multiples of the median (MoMs) were established. The quantity of hPL in DS screening was estimated using Monte Carlo simulation methods.

RESULTS

The mean log10 MoM hPL was - 0.1995 (SD: 0.1993) in affected and 0.0026 (SD: 0.2129) in control pregnancies. This corresponds to a MoM of 0.63 in DS pregnancies. hPL correlated significantly with log10 MoM values of hCGbeta (r = 0.320) and PAPP-A (r = 0.590) in controls, but not with hCGbeta (r = 0.228) or PAPP-A (r = 0.090) in DS pregnancies. The inclusion of hPL in the double test (PAPP-A + hCGbeta) increased the detection rate from 67 to 75% for a false-positive rate of 5%.

CONCLUSION

hPL is a DS screening marker that is applicable at weeks 9-13 and could be included in multiple marker first-trimester screening for DS.

摘要

背景

人胎盘催乳素（hPL）由胎盘合成并存在于母体血清中。我们分析了hPL作为孕早期母体血清筛查胎儿唐氏综合征（DS）标志物的潜力。

材料与方法

采用酶联免疫吸附测定法（ELISA）对47例DS妊娠孕妇和136例孕8 - 13周的对照孕妇的hPL进行定量分析。确定了中位数倍数（MoMs）的对数分布。使用蒙特卡罗模拟方法估计DS筛查中hPL的量。

结果

受影响妊娠孕妇的hPL平均log10 MoM为 - 0.1995（标准差：0.1993），对照妊娠孕妇为0.0026（标准差：0.2129）。这相当于DS妊娠孕妇的MoM为0.63。在对照孕妇中，hPL与hCGβ的log10 MoM值（r = 0.320）和妊娠相关血浆蛋白A（PAPP - A）的log10 MoM值（r = 0.590）显著相关，但在DS妊娠孕妇中与hCGβ（r = 0.228）或PAPP - A（r = 0.090）无显著相关性。在双重检测（PAPP - A + hCGβ）中加入hPL后，在假阳性率为5%的情况下，检测率从67%提高到了75%。