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母体血清甲种胎儿蛋白变体（AFP-L2 和 AFP-L3）在预测胎儿开放性神经管缺陷和腹壁缺陷中的诊断准确性。

The diagnostic accuracy of maternal serum alpha-fetoprotein variants (AFP-L2 and AFP-L3) in predicting fetal open neural tube defects and abdominal wall defects.

机构信息

Department of Prenatal Diagnosis and Screening Center, Hangzhou Women's Hospital (Hangzhou Maternity and Child Health Care Hospital), Hangzhou, Zhejiang 310008, China.

Nanjing Medical University, Nanjing, Jiangsu 210000, China.

出版信息

Clin Chim Acta. 2020 Aug;507:125-131. doi: 10.1016/j.cca.2020.03.044. Epub 2020 Apr 3.

DOI:10.1016/j.cca.2020.03.044

PMID:32251652

Abstract

INTRODUCTION

To evaluate a risk model of the maternal serum α-fetoprotein variants L2 and L3 (AFP-L2 and AFP-L3) for predicting fetal open neural tube defects (ONTD) and abdominal wall defects (AWD).

METHODS

Subjects were divided into the ONTD group (21), the AWD group (16) and the control group (38). Comparative analysis was performed using a risk model, receiver operating characteristic (ROC) curves and area under the curve (AUC) were used for screening performance of AFP-L2 and AFP-L3.

RESULTS

AFP-L2 and AFP-L3 concentrations in the ONTD group and the AWD group were both significantly higher than those in the control group (P < 0.001). The AUC for screening ONTD or AWD using AFP-L2 was 0.830 [95% confidence interval (CI):0.734-0.926, P < 0.001], while using AFP-L3 was 0.886 (95% CI: 0.809-0.963, P < 0.001). ROC curves indicated that the optimal threshold values for ONTD or AWD by AFP-L2 and AFP-L3 were 1.467 multiple of the median (MoM) and 1.944 MoM. The corresponding sensitivity, specificity and Youden index for AFP-L2 and AFP-L3 were 0.703, 0.947, 0.650 and 0.730, 0.974, 0.703, respectively.

CONCLUSION

AFP-L2 and AFP-L3 are favorable biomarkers for screening ONTD and AWD fetuses, and the risk model using AFP-L2 and AFP-L3 is of superior sensitivity and specificity.

摘要

简介

评估母体血清 α-胎蛋白变异体 L2 和 L3（AFP-L2 和 AFP-L3）预测胎儿开放性神经管缺陷（ONTD）和腹壁缺陷（AWD）的风险模型。

方法

将研究对象分为 ONTD 组（21 例）、AWD 组（16 例）和对照组（38 例）。采用风险模型进行对比分析，绘制受试者工作特征（ROC）曲线并计算曲线下面积（AUC），以评估 AFP-L2 和 AFP-L3 的筛查效能。

结果

ONTD 组和 AWD 组的 AFP-L2 和 AFP-L3 浓度均明显高于对照组（P<0.001）。使用 AFP-L2 筛查 ONTD 或 AWD 的 AUC 为 0.830[95%置信区间（CI）：0.734-0.926，P<0.001]，使用 AFP-L3 的 AUC 为 0.886（95%CI：0.809-0.963，P<0.001）。ROC 曲线表明，AFP-L2 和 AFP-L3 预测 ONTD 或 AWD 的最佳截断值分别为中位数倍数（MoM）的 1.467 和 1.944。AFP-L2 和 AFP-L3 的相应灵敏度、特异度和约登指数分别为 0.703、0.947、0.650 和 0.730、0.974、0.703。