定量性宫性阴道液胎儿纤维蛋白:一种液体活检,用于内炎症
Puntabut Warintaksa1, Roberto Romero2,3,4, Waranyu Lertrat1
1Department of Obstetrics and Gynecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Acta obstetricia et gynecologica Scandinavica
|September 17, 2024
概括
一个新的定量性宫性阴道液胎儿纤维素 (fFN) 测试可以识别早产患者的胚胎内炎症. 125 ng/mL的切断值表明高灵敏度和负预测值,可能减少侵入性测试.
科学领域:
- 生殖医学 生殖医学
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 临床诊断 临床诊断 临床诊断
背景情况:
- 内炎症是自发早产的一个关键原因.
- 目前通过羊膜切割诊断的诊断是侵入性的.
- 宫性阴道液胎儿纤维蛋白 (fFN) 是一个已知的早产生物标志物.
研究的目的:
- 为了评估宫性阴道液fFN的定量,用于检测腹膜内炎症.
- 为了确定一个最佳的fFN度切断界限来识别胚胎内炎症.
主要方法:
- 78名患有早产和完整膜的患者的前性队列研究.
- 测量了宫性阴道液fFN和羊水中介质素-6 (IAI标记物) 的定量测量.
- 用于分析fFN预测性能的物流回归和诊断指数.
主要成果:
- 在26.9%的患者中检测到内炎症.
- 较高的fFN度与胚胎内炎症的风险增加相关 (p < 0.001).
- 125 ng/mL的fFN切断值显示了高的诊断准确性 (AUC 0.91),100%的灵敏度,100%的NPV和82.46%的特异性.
结论:
- 定量的宫性阴道fFN,特别是≥125 ng/mL,是胚胎内炎症的敏感和特异性标志物.
- 与传统的50 ng/mL切断值相比,这种fFN值提供了更好的预测性能.
- fFN测试可以作为一个有价值的初始查工具,以指导入侵性羊膜切割的决策.
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