实用医学杂志 ›› 2022, Vol. 38 ›› Issue (2): 217-221.doi: 10.3969/j.issn.1006⁃5725.2022.02.017

• 医学检查与临床诊断 • 上一篇    下一篇

无创产前检测技术在不同血清学筛查风险值及不同年龄孕妇中检测染色体异常的价值

裴元元 胡亮 冉健 温丽娟 朱雁媚 魏凤香   

  1. 深圳市龙岗区妇幼保健院中心实验室(广东深圳 518172)


  • 出版日期:2022-01-25 发布日期:2022-01-25
  • 通讯作者: 魏凤香 E⁃mail:haowei727499@163.com
  • 基金资助:
    深圳市龙岗区出生缺陷预防重点实验室项目(编号:LGKCZSYS2018000010);深圳市龙岗区医疗卫生科技计划项目(编号:LGKCYLWS2020149,LGKCYLWS2020111)

Value of noninvasive prenatal testing in detecting chromosomal abnormalities in pregnant women of differ⁃ent serological screening risk values and different ages

PEI Yuanyuan,HU Liang,RAN Jian,WEN Lijuan,ZHU Yanmei,WEI Fengxiang.   

  1. Central Laboratory of Shenzhen Longgang Maternal and Child Health Hospital,Shenzhen 518172,China
  • Online:2022-01-25 Published:2022-01-25
  • Contact: WEI Fengxiang E⁃mail:haowei727499@163.com

摘要:

目的 探讨无创产前检测(NIPT)技术在不同血清学筛查风险值及不同年龄孕妇中检测染色体异常的价值,为实验室筛查技术的临床应用提供参考。方法 回顾性分析同时进行了早期血清学筛查与 NIPT 的单胎妊娠孕妇 11 517 例,按孕妇年龄及血清学筛查与 NIPT 结果将研究对象分组,对血清学筛查高风险及 NIPT 提示结果异常的孕妇,建议进一步产前诊断。结果 无论血清学筛查高风险率、临界风险率还是 NIPT 异常检出率,高龄组均高于低龄组,且差异有统计学意义。NIPT 检测 21 三体、18 三体的阳性预测值(84.62%,33.33%)明显高于血清学筛查(42.86%,28.57%)。以年龄分组,两种技术在不同年龄组检测 21 三体和 18 三体的阳性预测值的差异无统计学意义。但相较于血清学筛查,通过 NIPT 异常结果提示可额外确诊染色体病。结论 NIPT 可有效降低血清学筛查的漏诊,有效预防染色体病。

关键词: 无创产前检测, 血清学筛查, 阳性预测值

Abstract:

Objective To explore the value of noninvasive prenatal testing(NIPT)in detecting chromo⁃somal abnormalities in pregnant women of different serological screening risk values and different ages and to pro⁃vide reference for the clinical application of laboratory screening technology. Methods A total of 11517 singleton pregnant women who underwent early serological screening and NIPT were analyzed retrospectively. According to the age of pregnant women and the results of serological screening and NIPT,the subjects were divided into different groups. For pregnant women with high risk of serological screening and abnormal results of NIPT,further prenatal diagnosis was recommended. Results With regard to the high risk rateor the critical risk rate of serological screening or the positive rate of NIPT,the elderly group was higher than those of the younger group. The positive
predictive value(PPV)of trisomy 21 and trisomy 18 detected by NIPT(84.62%,33.33%)was significantly higher than that of serological screening(42.86% ,28.57%). The PPV of trisomy 21 and trisomy 18 in different age groups was not statistically significant. However,compared withserological screening,the abnormal results of NIPT could suggest additional chromosomal diseases. Conclusion NIPT could effectively reduce the missed diagnosis of serological screening and effectively prevent chromosomal diseases.

Key words: noninvasive prenatal testing, serological screening, positive predictive value