Department of Gynecology and Obstetrics, Shantou Jinping Women and Children's Hospital, Shantou, Guangdong, China.
Department of Pathology, Chaonan Minsheng Hospital of Shantou, Shantou, Guangdong, China.
Int J Gynaecol Obstet. 2021 May;153(2):220-227. doi: 10.1002/ijgo.13550. Epub 2020 Dec 31.
Use of quantitative fetal fibronectin (fFN) testing to predict spontaneous preterm birth (sPTB) is gaining attention owing to its absolute measurement of fFN concentration and increased positive predictive value compared with qualitative testing.
To assess the predictive values of quantitative fFN for sPTB in different predefined thresholds using systematic review and meta-analysis.
Five major databases (PubMed, ScienceDirect, Web of Science, Embase, Cochrane library) were searched for eligible studies.
Observational studies of the diagnostic accuracy of different quantitative fFN thresholds on delivery outcomes were included.
Articles were reviewed independently by two authors and data were extracted. Sensitivity, specificity, diagnostic odds ratio, and summary receiver operating characteristic curves were extracted and calculated.
Fifteen studies were included. To detect sPTB at less than 34 weeks of gestation, pooled sensitivities for thresholds of 10, 50, 200, and 500 ng/ml were 0.78, 0.56, 0.33, and 0.11, respectively. Pooled specificities were 0.63, 0.84, 0.96, and 0.99, respectively.
Based on the results of the meta-analysis, the threshold of 10 ng/ml fFN may be a new choice for the prediction of sPTB. The improved diagnostic accuracy of quantitative testing over qualitative testing can provide additional discriminatory information for clinical practice.
由于定量胎儿纤维连接蛋白（fFN）检测能够绝对测量 fFN 浓度，并与定性检测相比提高了阳性预测值，因此其预测自发性早产（sPTB）的应用越来越受到关注。
通过系统评价和荟萃分析评估不同预设阈值下定量 fFN 对 sPTB 的预测值。
在五个主要数据库（PubMed、ScienceDirect、Web of Science、Embase、Cochrane 图书馆）中搜索符合条件的研究。
纳入使用不同定量 fFN 阈值预测分娩结局的观察性研究。
由两位作者独立对文章进行评估并提取数据。提取并计算了敏感性、特异性、诊断比值比和汇总受试者工作特征曲线。
共纳入 15 项研究。为了检测少于 34 孕周的 sPTB，阈值为 10、50、200 和 500ng/ml 的汇总敏感性分别为 0.78、0.56、0.33 和 0.11。汇总特异性分别为 0.63、0.84、0.96 和 0.99。
基于荟萃分析的结果，10ng/ml 的 fFN 阈值可能是预测 sPTB 的新选择。定量检测比定性检测具有更高的诊断准确性，可以为临床实践提供更多的鉴别信息。
