Department of Obstetric and Gynecology, Karadeniz Technical University, School of Medicine, Trabzon, Turkey.
J Perinat Med. 2010 Jul;38(4):367-71. doi: 10.1515/jpm.2010.062.
To determine the possible underlying cause of a false-positive first or second trimester biochemical Down syndrome screening test result by means of second trimester amniotic fluid cytokine level analysis.
A total of 74 consecutive patients undergoing amniocentesis for karyotype analysis at 16-20 weeks' gestation were included in this prospective age-matched case-control study. The study group (n=38) had abnormal first or second trimester screening test results and normal karyotype results, while controls (n=36) included those admitted for genetic amniocentesis for other reasons who had normal first or second trimester screening test and normal karyotype results. Four markers [interleukin (IL)-6, IL-8, tumor necrosis factor (TNF)-alpha, and ischemia-modified albumin (IMA)] were studied in amniotic fluid.
The mean age of the women in the study and control groups was 34.0+/-5.6 and 33.6+/-7.2 years, respectively. The women in the study and control groups had similar clinical and laboratory characteristics. The mean amniotic fluid IL-6 (414.84+/-83.96 vs. 343.02+/-110.59, p=0.002) and IL-8 (377.61+/-243.31 vs. 261.90+/-201.29, p=0.029), TNF-alpha (24.91+/-5.78 vs. 21.60+/-5.55, p=0.014), and IMA (1.19+/- 0.10 vs. 1.05+/-0.12, p<0.001) values were significantly increased in the study group when compared to controls.
The higher amniotic fluid cytokine and ischemia-modified albumin levels in patients with false-positive first or second trimester biochemical Down syndrome screening test may result from subclinical fetal membrane inflammation and/or ischemia.
通过分析中期羊水中细胞因子水平，确定导致唐氏综合征筛查试验中假阳性初筛或二筛结果的潜在原因。
本前瞻性病例对照研究共纳入 74 例 16-20 周因核型分析行羊膜穿刺术的连续患者。研究组（n=38）初筛或二筛结果异常且核型正常，而对照组（n=36）因其他原因行遗传羊膜穿刺术且初筛和核型正常。研究中检测了羊水 4 种标志物[白细胞介素（IL）-6、IL-8、肿瘤坏死因子（TNF）-α和缺血修饰白蛋白（IMA）]。
研究组和对照组患者的平均年龄分别为 34.0±5.6 岁和 33.6±7.2 岁。两组患者的临床和实验室特征相似。研究组羊水 IL-6（414.84±83.96 与 343.02±110.59，p=0.002）和 IL-8（377.61±243.31 与 261.90±201.29，p=0.029）、TNF-α（24.91±5.78 与 21.60±5.55，p=0.014）和 IMA（1.19±0.10 与 1.05±0.12，p<0.001）水平明显高于对照组。
唐氏综合征筛查试验初筛或二筛假阳性患者的羊水细胞因子和 IMA 水平升高，可能与亚临床的胎膜炎症和/或缺血有关。
