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一种新标志物ADAM12对孕早期筛查中唐氏综合征风险数据的影响。

Effect of a new marker, ADAM12, on Down risk figures in first trimester screening.

作者信息

Valinen Yrtti, Laitinen Paivi, Ranta Jenni, Ignatius Jaakko, Jarvela Ilkka, Ryynänen Markku

机构信息

Department of Obstetrics and Gynecology, Oulu University Hospital, Finland.

出版信息

J Matern Fetal Neonatal Med. 2009 Jul;22(7):602-7. doi: 10.1080/14767050902755478.

Abstract

OBJECTIVE

To investigate whether incorporating the measurement of ADAM12 in the risk calculation program LifeCycle, can improve Down screening in the first trimester.

METHODS

In a retrospective case control study, maternal serum ADAM12 concentrations were measured and compared in Down syndrome cases (n = 53) and in controls (n = 226) obtained from first trimester (9-12 weeks) screening samples in Oulu and Kuopio University Hospitals. Median concentration ( microg/l), observed and regressed (weight corrected) MoMs of ADAM12 were calculated.

RESULTS

There was a significant difference in ADAM12 levels between Downs and controls during the pregnancy weeks 9 + 0 to 10 + 6, but not thereafter. By adding ADAM12 to the marker set used in the risk calculation program, one screening false negative Down syndrome case occurred in the affected population, which did not alter false positive rate.

CONCLUSION

Adding ADAM12 as a parameter in Down screening did not cause radical changes in the risk value. The test might be useful at 9 and 10 weeks in which it might have the potential to improve the performance of the risk assessment especially for women receiving a result close to the high-risk cut-off. The real influence of ADAM12 remains to be elucidated in larger studies incorporating ADAM12 to the risk calculation program.

摘要

目的

研究将ADAM12的检测纳入风险计算程序LifeCycle中,是否能改善孕早期的唐氏筛查。

方法

在一项回顾性病例对照研究中,对从奥卢和库奥皮奥大学医院孕早期(9 - 12周)筛查样本中获取的唐氏综合征病例(n = 53)和对照(n = 226)的母血清ADAM12浓度进行测量并比较。计算ADAM12的中位数浓度(微克/升)、观察到的和回归后的(体重校正)中位数倍数(MoMs)。

结果

在妊娠9 + 0至10 + 6周期间,唐氏综合征患者与对照组的ADAM12水平存在显著差异,但之后无差异。将ADAM12添加到风险计算程序中使用的标志物组后,在受影响人群中出现了1例筛查为假阴性的唐氏综合征病例,而假阳性率未改变。

结论

在唐氏筛查中添加ADAM12作为参数并未导致风险值发生根本性变化。该检测在9周和10周时可能有用,尤其对于那些得到接近高风险临界值结果的女性,它可能有改善风险评估表现的潜力。ADAM12的实际影响仍有待在将ADAM12纳入风险计算程序的更大规模研究中阐明。

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