title: The utility of circulating LHCGR as a predictor of Down's syndrome in early pregnancy.
abstract: BACKGROUND
  Previous studies showed that soluble LHCGR/hCG-sLHCGR concentrations in serum or plasma combined with PAPP-A and free βhCG significantly increased the sensitivity of Down's syndrome screen at early pregnancy without altering the false positive rate. The goal of the present study was to further examine the role of sLHCGR forms as combinatorial markers and to investigate whether sLHCGR could serve as an independent biomarker for Down's syndrome in first trimester pregnancy screens.
  
  
  METHODS
  The PAPP-A, free βhCG, and hCG-sLHCGR concentrations together with nuchal translucency (NT) were measured in 40 Down's and 300 control pregnancies. The sLHCGR concentration was analysed in 40 Down's and 206 control pregnancies.
  
  
  RESULTS
  The hCG-LHCGR in combination with PAPP-A and free βhCG increased the detection rate (DR) by 35% without altering the false positive rate (FPR). The sLHCGR: hCG-sLHCGR ratio alone detected 80% of Down's pregnancies in first trimester screening, with a false positive rate of 0.5%.
  
  
  CONCLUSIONS
  While measurement of sLHCGR forms in combination with PAPP-A and free βhCG significantly increases the detection rate of Down's syndrome at first trimester, the ratio of sLHCGR: hCG-sLHCGR acts as an independent marker with a detection rate that is significantly higher than the existing biochemical markers individually for prenatal first trimester screening of Down's syndrome.
authors.forename: Anne E
authors.initials: AE
authors.lastname: Chambers
authors.forename: Walter E
authors.initials: WE
authors.lastname: Mills
authors.forename: Imma
authors.initials: I
authors.lastname: Mercadé
authors.forename: Francesca
authors.initials: F
authors.lastname: Crovetto
authors.forename: Fatima
authors.initials: F
authors.lastname: Crispi
authors.forename: Laia Rodriguez-Revenga
authors.initials: LR
authors.lastname: Bodi
authors.forename: Michael
authors.initials: M
authors.lastname: Pugia
authors.forename: Aurea
authors.initials: A
authors.lastname: Mira
authors.forename: Luis
authors.initials: L
authors.lastname: Lasalvia
authors.affiliation: Origin Biomarkers, Biocity Scotland, Bo'Ness Road, Newhouse, Lanarkshire ML1 5UH, UK. dr_sbanerjee@hotmail.com.
authors.forename: Subhasis
authors.initials: S
authors.lastname: Banerjee
authors.forename: Elena
authors.initials: E
authors.lastname: Casals
authors.forename: Eduard
authors.initials: E
authors.lastname: Gratacos
mesh_terms: D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D004314:Down Syndrome / Q000175:diagnosis*; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D048208:Nuchal Translucency Measurement; D011237:Predictive Value of Tests; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood; D011266:Pregnancy-Associated Plasma Protein-A / Q000378:metabolism; D011296:Prenatal Diagnosis / Q000379:methods*; D012372:ROC Curve; D011974:Receptors, LH / Q000097:blood*; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D018997:Chorionic Gonadotropin, beta Subunit, Human; D011974:Receptors, LH; D011266:Pregnancy-Associated Plasma Protein-A