He Jun, Wang Shunyao, Zhang Jingjing, Zhou Shihao, Kuang Yang, Ding Jia, Yang Mengyue, Lin Jiawei, Ding Siyi, Liu Shaolan, Peng Huanhuan, Wang Nan, Liu Jiyang
Changsha Maternal and Child Health Care Hospital, Changsha, Hunan 410007, China.
Zhonghua Yi Xue Yi Chuan Xue Za Zhi. 2022 Aug 10;39(8):803-808. doi: 10.3760/cma.j.cn511374-20211030-00864.
To compare the clinical application and health economic values of non-invasive prenatal testing (NIPT) and second trimester serum screening (STSS).
A retrospective analysis was carried out on 54 026 singleton pregnant women undergoing NIPT and STSS from March 1, 2018 to December 31, 2019 in Changsha Maternal and Child Health Care Hospital. For pregnant women with high-risk results of NIPT, prenatal diagnosis and follow-up of pregnancy outcomes were conducted. The data was grouped to 4 screening models, and their cost-benefit was analyzed.
The sensitivity, specificity and positive predictive value of NIPT were all higher than STSS. Screening models 1 to 4 have prevented the birth of 71, 29, 52 and 54 patients with Down syndrome, respectively. The safety index of screening models 1 to 4 were 0.0036, 0.3944, 02215 and 0.1281, respectively. When the price of NIPT was decreased to 600 RMB, the cost-benefit of the screening models 1 to 4 was 0.46, 0.65, 0.44 and 0.40 million RMB, respectively.
NIPT has a better detection performance than STSS. When the price of NIPT is 600 RMB, screening model 1 has the best screening effect and the highest accuracy, safety index and health economical value.
比较无创产前检测（NIPT）与孕中期血清学筛查（STSS）的临床应用及卫生经济学价值。
对2018年3月1日至2019年12月31日在长沙市妇幼保健院接受NIPT和STSS的54026名单胎孕妇进行回顾性分析。对NIPT高危结果的孕妇进行产前诊断及妊娠结局随访。将数据分组为4种筛查模式，并分析其成本效益。
NIPT的灵敏度、特异度和阳性预测值均高于STSS。筛查模式1至4分别预防了71、29、52和54例唐氏综合征患儿出生。筛查模式1至4的安全指数分别为0.0036、0.3944、0.2215和0.1281。当NIPT价格降至600元时，筛查模式1至4的成本效益分别为46万、65万、44万和40万元。
NIPT的检测性能优于STSS。当NIPT价格为600元时，筛查模式1具有最佳的筛查效果、最高的准确性、安全指数和卫生经济学价值。
