流产时检测外周血自然杀伤细胞的价值有多大？
How valuable is measurement of peripheral blood natural killer cells at the time of abortion?
作者信息
Paparistidis Nikolaos, Papadopoulou Chryssa, Chioti Athanassia, Papaioannou Demetrios, Tsekoura Christina, Keramitsoglou Theodora, Kontopoulou-Antonopoulou Virginia, Agapitos Emmanouel, Balafoutas Christos, Varla-Leftherioti Marighoula
机构信息
Department of Obstetrics and Gynaecology, Helena Venizelou Maternity Hospital of Athens, Athens, Greece.
出版信息
Am J Reprod Immunol. 2008 Apr;59(4):306-15. doi: 10.1111/j.1600-0897.2007.00547.x. Epub 2008 Feb 21.
PROBLEM
Increased peripheral blood natural killer (NK) cells are associated to immune-mediated abortion, but their diagnostic value when measured at the time of miscarriage is unknown.
METHOD OF STUDY
In women with therapeutic (A = 79) or elective (C = 34) pregnancy termination, the NK-cell percentage was measured before and 5 days after curettage. Additionally, immune-mediated lesions (scored 0-3) and CD56(+) and CD16(+) decidual NKs (scored 1-3) were detected on the abortion material.
RESULTS
Aborters differed from controls in histological scores (P = 0.000) and in NK percentage (>12%) only in the measurement 5 days after the operation (P = 0.038). In comparison to histological lesions, NK measurement was found to have sensitivity 70%, specificity 73.68%, positive prognostic value 89.39% and negative prognostic value 43.75%.
CONCLUSION
An Increased NK-cell percentage 5 days after the pregnancy termination could be a marker of immune aetiology of miscarriage, as the probability of an aborter with NK >12% to have an immune-mediated abortion is almost 90%.
问题
外周血自然杀伤（NK）细胞增多与免疫介导的流产有关，但流产时检测其诊断价值尚不清楚。
研究方法
在接受治疗性（A组 = 79例）或选择性（C组 = 34例）终止妊娠的女性中，在刮宫术前及术后5天测量NK细胞百分比。此外，在流产组织中检测免疫介导的病变（评分0 - 3分）以及CD56(+)和CD16(+)蜕膜NK细胞（评分1 - 3分）。
结果
流产者与对照组在组织学评分（P = 0.000）以及仅在术后5天的NK细胞百分比（>12%）方面存在差异（P = 0.038）。与组织学病变相比，NK细胞检测的敏感性为70%，特异性为73.68%，阳性预测值为89.39%，阴性预测值为43.75%。
结论
妊娠终止后5天NK细胞百分比升高可能是流产免疫病因的一个标志物，因为NK>12%的流产者发生免疫介导流产的概率近90%。
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