Center of Reproductive Medicine and Center of Prenatal Diagnosis, the First Hospital, Jilin University, Changchun, Jilin, China.
Medicine (Baltimore). 2021 Feb 12;100(6):e24740. doi: 10.1097/MD.0000000000024740.
Non-invasive prenatal testing (NIPT) is an incomparable prenatal screening technology, but we should undergo amniocentesis to confirm fetal chromosome when pregnancies receive a positive result via NIPT. We aimed to investigate the detection rate and positive predictive value of NIPT results in pregnancies from Northeast China, and to determine the reasons for false positive and false negative NIPT results.This study evaluates 17,428 singleton pregnancies had undergone NIPT detection. 202 samples were NIPT positive with the detection rate was 1.16% (202/17,428). Among all the positive samples, 160 samples (79.21%) were referred for an amniocentesis procedure to investigate the fetal chromosome. The positive predictive value of T21, T18, and T13 was found to be 75% with a 0.07% false positive rate. Positive predictive value from high to low was as follows: trisomy 21 (84.38%), followed by trisomy 18 (61.54%), autosomal abnormalities (52.94%), sex chromosomal abnormalities (38.46%), and trisomy 13 (33.33%). The positive predictive values for sex chromosome abnormalities turned out to be mosaic sex chromosome aneuploidies (83.33%), followed by XYY (57.14%), XXY (37.50%), XXX (36.36%), and Monosomy X (28.95%). Out of the 160 samples had amniocentesis, the true positive cases in trisomy 21 had a higher percentage of Z-scores compared with the false positive cases in trisomy 21 (P < .05). And the true positive cases in trisomy 18 had a significantly higher percentage of Z-scores compared with the false positive cases in trisomy 18 (P < .01).These findings indicate that the positive predictive value of T21, T18, and T13 was found to be 75% with a 0.07% false positive rate. It is worth noting that the positive predictive value of NIPT for autosomes and sex chromosomes. Moreover, if women receive a positive result via NIPT, they should pay attention to the results with undergoing further prenatal diagnosis.
非侵入性产前检测(NIPT)是一种无与伦比的产前筛查技术,但当妊娠通过 NIPT 检测呈阳性时,我们应该进行羊膜穿刺术以确认胎儿染色体。我们旨在研究东北地区妊娠 NIPT 结果的检测率和阳性预测值,并确定假阳性和假阴性 NIPT 结果的原因。
本研究评估了 17428 例单胎妊娠进行了 NIPT 检测。202 例样本 NIPT 阳性,检测率为 1.16%(202/17428)。在所有阳性样本中,160 例(79.21%)被转诊进行羊膜穿刺术以检查胎儿染色体。T21、T18 和 T13 的阳性预测值为 75%,假阳性率为 0.07%。阳性预测值从高到低依次为:三体 21(84.38%),其次是三体 18(61.54%),常染色体异常(52.94%),性染色体异常(38.46%),三体 13(33.33%)。性染色体异常的阳性预测值结果为嵌合体性染色体非整倍体(83.33%),其次是 XYY(57.14%)、XXY(37.50%)、XXX(36.36%)和单体 X(28.95%)。在 160 例进行羊膜穿刺术的样本中,三体 21 的真阳性病例与三体 21 的假阳性病例相比,Z 评分的百分比更高(P<.05)。而三体 18 的真阳性病例与三体 18 的假阳性病例相比,Z 评分的百分比显著更高(P<.01)。
这些发现表明,T21、T18 和 T13 的阳性预测值为 75%,假阳性率为 0.07%。值得注意的是,NIPT 对常染色体和性染色体的阳性预测值。此外,如果女性通过 NIPT 检测呈阳性,她们应该注意进一步进行产前诊断的结果。