Department of Obstetrics and Gynecology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250021, China; The Laboratory of Medical Science and Technology Innovation Center (Institute of Translational Medicine), Shandong First Medical University (Shandong Academy of Medical Sciences) of China, Jinan, Shandong, China.
Department of Obstetrics and Gynecology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250021, China.
Placenta. 2022 Jun 24;124:48-54. doi: 10.1016/j.placenta.2022.05.009. Epub 2022 May 14.
Our study aimed to distinguish patients with placenta accreta (crete, increta, and percreta) from those with placenta previa using maternal plasma levels of soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PLGF) and the sFlt-1/PLGF ratio.
We obtained maternal plasma from 185 women in late pregnancy and sorted them into three groups: 72 women with normal placental imaging results (control group), 50 women with placenta previa alone (PP group), and 63 women with placenta previa and placenta accreta (PAS group). The concentrations of sFlt-1 and PLGF in the maternal plasma were measured using ELISA kits and the sFlt-1/PLGF ratio was calculated.
The median (min-max) sFlt-1 levels and the sFlt-1/PLGF ratio in the PAS group (12.8 ng/ml, 3.8-34.2 ng/ml) (133, 14-361) were lower than in the PP group (28.7 ng/ml, 13.1-60.3 ng/ml) (621, 156-2013) (p < 0.0001 and P < 0.0001, respectively). The median (min-max) PLGF levels in the PAS group (108 pg/ml, 38-679 pg/ml) was higher than that in the PP group (43 pg/ml, 12-111 pg/ml) (p < 0.0001 and p < 0.0001, respectively). The area under the ROC of the sFlt-1 levels, PLGF levels, and sFlt-1/PLGF ratio were 0.91, 0.90, and 0.99, respectively; the cut-off values were 18.9 ng/ml, 75.9 pg/ml, and 229.5, respectively. The concentration of sFlt-1 and sFlt-1/PLGF ratio were associated with the volume of blood loss (-.288*, -.301*).
The concentrations of sFlt-1 and PLGF and ratio of plasma sFlt-1/PLGF may distinguish patients with placenta accreta from those with placenta previa.
我们的研究旨在通过检测母体血浆中可溶性 fms 样酪氨酸激酶-1（sFlt-1）和胎盘生长因子（PLGF）的水平以及 sFlt-1/PLGF 比值，来区分胎盘植入（creta、increta 和 percreta）患者和单纯胎盘前置（PP）患者。
我们从 185 名晚期妊娠的孕妇中采集了母体血浆，并将其分为三组：72 名胎盘影像学正常的孕妇（对照组），50 名单纯胎盘前置的孕妇（PP 组），63 名胎盘前置合并胎盘植入的孕妇（PAS 组）。采用 ELISA 试剂盒检测母体血浆中 sFlt-1 和 PLGF 的浓度，并计算 sFlt-1/PLGF 比值。
PAS 组（12.8ng/ml，3.8-34.2ng/ml）的中位数（最小-最大）sFlt-1 水平和 sFlt-1/PLGF 比值（133，14-361）均低于 PP 组（28.7ng/ml，13.1-60.3ng/ml）（621，156-2013）（均 P<0.0001）。PAS 组（108pg/ml，38-679pg/ml）的中位数（最小-最大）PLGF 水平高于 PP 组（43pg/ml，12-111pg/ml）（均 P<0.0001）。sFlt-1 水平、PLGF 水平和 sFlt-1/PLGF 比值的 ROC 曲线下面积分别为 0.91、0.90 和 0.99，截断值分别为 18.9ng/ml、75.9pg/ml 和 229.5。sFlt-1 浓度和 sFlt-1/PLGF 比值与出血量呈负相关（-.288*，-.301*）。
sFlt-1、PLGF 浓度及其比值可能有助于区分胎盘植入患者和单纯胎盘前置患者。
