Prenatal trisomy 21 screening using the Lens culinaris agglutinin-reactive alpha-fetoprotein ratio.
For the purpose of improving the clinical efficacy of alpha-fetoprotein (AFP)-L3% in prenatal screening for trisomy 21, we calculated the multiple of the median (MoM) of AFP-L3% (L3 MoM) and the ratio of L3 MoM to AFP MoM (L3 MoM/AFP MoM) in maternal serum. Maternal serum samples from 1822 women (maternal age 37.3 +/- 3.8 years, and weeks of gestation 16.0 +/- 1.0; mean +/- SD) with unaffected pregnancies and 28 women (37.6 +/- 4.6 years, 16.6 +/- 3.1) pregnant with of trisomy 21 fetuses were obtained. The AFP concentration and AFP-L3% in maternal serum were measured using a liquid-phase binding assay. The areas under the receiver operating characteristic curves (AUCs) of AFP MoM, AFP-L3%, L3 MoM, and L3 MoM/AFP MoM were 0.750, 0.868, 0.949 and 0.946, respectively. The AUCs of L3 MoM and L3 MoM/AFP MoM were significantly higher than AFP-L3% (P < 0.05) and AFP MoM (P < 0.0005). However, no statistical difference was observed between the AUCs of L3 MoM and L3 MoM/AFP MoM. In conclusion, the L3 MoM should be an effective replacement for AFP-L3% in prenatal trisomy 21 screening.
Yamamoto
Ritsu
R
Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Kita-Ku, Sapporo, Japan.
Minobe
Shinichiro
S
Ebina
Yasuhiko
Y
Watari
Hidemichi
H
Kudo
Masataka
M
Henmi
Fumiyo
F
Satomura
Shinji
S
Fujimoto
Seiichiro
S
Minakami
Hisanori
H
Sakuragi
Noriaki
N
D000328:Adult; D000373:Agglutinins; D004314:Down Syndrome / Q000175:diagnosis* / Q000378:metabolism; D005260:Female; D006801:Humans; D007202:Indicators and Reagents; D007621:Karyotyping; D027806:Lens Plant; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods*; D000509:alpha-Fetoproteins / Q000032:analysis*
D000373:Agglutinins; D007202:Indicators and Reagents; D000509:alpha-Fetoproteins