Zhang Tianyue, Wang Shaowei
Department of Gynaecology and Obstetrics, National Center of Gerontology, Beijing Hospital, Beijing, China.
Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
Front Med (Lausanne). 2022 May 30;9:860186. doi: 10.3389/fmed.2022.860186. eCollection 2022.
Placenta accreta spectrum (PAS) refers to the abnormal invasion of trophoblastic tissues. Because of its increasing morbidity and possibility of catastrophic outcomes, PAS requires an antenatal diagnosis and making full preparations in advance to realize safe delivery. Current clinical screening modalities for PAS are not always conclusive. Recently, it has been reported that bio-markers detected in maternal serum have the potential for predicting PAS during pregnancy. Some of these biomarkers, such as β-hcg, AFP, PAPP-A, and cffDNA, can be clinically detected. It is convenient for us to test and compare with standard threshold. However, how can we distinguishing PAS from other pregnancy complications through these biomarkers remains complicated. Some biomarkers are specific, such as microRNA and placenta-specific mRNA. They are stability and reliability. These biomarkers are currently research hotspots. This study aims to summarize the characteristics of the newly reported biomarkers and to point out their potential application and current limitations to provide a basis for future research. Finally, the combination of imageological examination and biomarkers will be an attractive future theme to study in diagnosing this challenging condition.
胎盘植入谱系障碍(PAS)是指滋养层组织的异常侵入。由于其发病率不断上升以及出现灾难性后果的可能性,PAS需要进行产前诊断并提前做好充分准备以实现安全分娩。目前用于PAS的临床筛查方法并不总是具有决定性意义。最近,有报道称在母体血清中检测到的生物标志物有可能在孕期预测PAS。其中一些生物标志物,如β-人绒毛膜促性腺激素(β-hcg)、甲胎蛋白(AFP)、妊娠相关血浆蛋白-A(PAPP-A)和胎儿游离DNA(cffDNA),可以在临床上进行检测。这便于我们进行检测并与标准阈值进行比较。然而,如何通过这些生物标志物将PAS与其他妊娠并发症区分开来仍然很复杂。一些生物标志物具有特异性,如微小RNA(microRNA)和胎盘特异性信使核糖核酸(mRNA)。它们具有稳定性和可靠性。这些生物标志物是目前的研究热点。本研究旨在总结新报道的生物标志物的特征,并指出它们的潜在应用和当前局限性,为未来的研究提供依据。最后,影像学检查和生物标志物的联合将是未来研究诊断这一具有挑战性疾病的一个有吸引力的主题。