Abstract:Objective: To investigate the diagnostic value of ultrasonography combined with serology for trisomy 21 syndrome. Methods: 1500 pregnant women for Production inspection from January 2017 to March 2021 in our hospital were selected as the research object, and were detected with ultrasound and serological. Those who were diagnosed with trisomy 21 syndrome were suggested to have amniotic fluid chromosome screening, and to be followed-up if not had amniotic fluid chromosome screening. The detection rates of trisomy 21 syndrome with ultrasonography and serology, alone or combined, were compared, the consistency of the three tests with the gold standard was analyzed by Kappa test, and the diagnostic value of the three tests for trisomy 21 syndrome was evaluated by ROC curve. Results: A total of 218 cases of trisomy 21-syndrome were diagnosed by amniotic fluid chromosome and follow-up results of 1500 pregnant women, among which 165 cases were detected as high risk and 53 cases as low risk by ultrasound. Serological tests showed high risk in 183 cases and low risk in 35 cases. Joint examination revealed 204 cases with high risk and 14 cases with low risk. Compared with the gold standard test results (Kappa=0.501, 0.647, 0.895, P< 0.05). ROC analysis showed that the AUC of ultrasonic serology and combined diagnosis of trisomy 21 syndrome were 0.809, 0.874 and 0.958, respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 75.69%, 86.19%, 48.24%, 95.42%, 84.67%, respectively. Serological diagnosis was 83.95%, 90.87%, 61.0%, 97.08%, 89.87%, respectively; the combined diagnosis was 93.58%, 97.97%, 88.70%, 98.90%, and 97.33%, respectively, both of which were of certain value. Conclusion: Both prenatal ultrasound and serology have higher value in prenatal screening for trisomy 21 syndrome, but the combined diagnosis value of the two is better.
王力, 桂定清, 张讯, 张力. 超声与血清学及两者联合对21-三体综合征的诊断价值[J]. 河北医学, 2021, 27(11): 1856-1860.
WANG Li, GUI Dingqing, et al. Diagnostic Value of Ultrasonography, Serology and Their Combination in Trisomy 21 Syndrome. HeBei Med, 2021, 27(11): 1856-1860.
[1] Gkanatsiou E,Sahlin C,Portelius E,Johannesson M,et al.Characterization of monomeric and soluble aggregated Aβ in down's syndrome and Alzheimer's disease brains.[J].Alzheimer's and Dementia,2020,16(2):88~93. [2] Fernanda,Fresneda,Villibor,et al.Cutaneous leishmaniasis in an indigenous infant with down's syndrome:A case report[J].Asian Pacific Journal of Tropical Medicine,2019,12(12):48~50. [3] 陈丽军,孟倩.孕中期胎儿超声软指标与血清学筛查在产前诊断21-三体综合征中的临床价值[J].中国优生与遗传杂志,2019,27(9):1063~1065. [4] 王文,白雪,熊静.超声软指标NT与NF检测对胎儿21-三体综合征产前诊断的价值[J].海南医学,2019,30(14):1833~1836. [5] Choi E S, Jung Y, Lee S,et al.VP03.08:Down's syndrome screening in triplet pregnancy:a large single centre cohort study[J].Ultrasound in Obstetrics and Gynecology,2020,56(S1):66~67. [6] 胡成子,杨若云,李敏文.超声NT指标与母体血清学筛查在胎儿21-三体综合征产前诊断中的价值[J].中国优生与遗传杂志,2019,27(9):34~42. [7] 李晓菲、岳嵩、王晶晶、等.基于孕11~13~(+6)周不同颈项透明层厚度增加标准建立模型筛查高风险人群21-三体综合征[J].中国医学影像技术,2020,36(11):76~79. [8] Fonseca L M,Padilla C,Jones E,et al.Amnestic and non-amnestic symptoms of dementia:an international study of alzheimer's disease in people with down's syndrome[J].International Journal of Geriatric Psychiatry,2020,35(6):650~661. [9] 刘琼娜,高悦.妊娠早期超声联合血清Fβ-hCG与uE3及AFP诊断21-三体综合征的临床价值[J].解放军预防医学杂志,2019,37(11):102~103. [10] 赵金侠,郑元元.颈项透明层厚度超声联合血清AFP、freeβ-HCG筛查孕早期21-三体综合征胎儿效能的价值[J].生物医学工程与临床,2018,22(3):267~271. [11] 张军辉,骆迎春,黄晓靓,等.超声联合血清标志物检测对筛查21-三体综合征的临床意义[J].中国医师杂志,2018,20(8):1164~1166,1170.