Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah.
Intermountain Healthcare, Salt Lake City, Utah.
Am J Perinatol. 2019 Jan;36(1):22-26. doi: 10.1055/s-0038-1636501. Epub 2018 Feb 28.
We aimed to evaluate the relationship between hyperglycosylated human chorionic gonadotropin (hCG-H) and placenta accreta spectrum (PAS) in the second and third trimesters of pregnancy.
This was a case-control study of PAS and controls. hCG-H was measured in the second and third trimesters of pregnancy in women with pathologically confirmed cases of PAS and in gestational age-matched controls without PAS. We compared serum hCG-H levels in cases and controls, calculated summary statistics for diagnostic accuracy, and used receiver operating characteristic (ROC) curves to define an optimal cut-point for diagnosis of PAS using hCG-H.
Thirty case samples and 30 control samples were evaluated for hCG-H. Mean hCG-H was lower in the case compared with control group (7.8 ± 5.9 μg/L vs. 11.8 ± 8.8 μg/L, = 0.03). At an optimal cut-point for hCG-H of ≤7.6 μg/L, the sensitivity, specificity, positive likelihood ratios, negative likelihood ratios, and area under the ROC curve were 66.7%, 69.7%, 2.20%, 0.48%, and 0.68%, respectively.
Hyperglycosylated hCG levels in the second and third trimesters of pregnancy were lower in patients with PAS than in controls, but hCG-H showed only modest capability as a diagnostic test for PAS.
我们旨在评估妊娠中晚期高糖基化人绒毛膜促性腺激素（hCG-H）与胎盘部位滋养细胞肿瘤谱（PAS）之间的关系。
这是一项 PAS 病例对照研究和对照组。在经病理证实的 PAS 患者和妊娠年龄匹配的无 PAS 对照组的妊娠第二和第三孕期测量 hCG-H。我们比较了病例和对照组的血清 hCG-H 水平，计算了诊断准确性的综合统计数据，并使用受试者工作特征（ROC）曲线来定义 hCG-H 诊断 PAS 的最佳截断值。
评估了 30 例病例样本和 30 例对照样本的 hCG-H。与对照组相比，病例组的 hCG-H 平均值较低（7.8±5.9μg/L 比 11.8±8.8μg/L，=0.03）。在 hCG-H 的最佳截断值≤7.6μg/L 时，敏感性、特异性、阳性似然比、阴性似然比和 ROC 曲线下面积分别为 66.7%、69.7%、2.20%、0.48%和 0.68%。
妊娠中晚期 PAS 患者的高糖基化 hCG 水平低于对照组，但 hCG-H 作为 PAS 的诊断试验能力仅为中等。
