单指标中位数倍数值阈值和风险灰区对血清学产前筛查效能的影响

Effect of single marker multiple of median cutoff and risk grey- zone on serological prenatal screening efficiency

目的研究单指标中位数倍数(multiple of median,Mo M)值阈值和风险灰区对血清学产前筛查效能的影响。方法对石家庄市妇幼保健院2012年1月至2013年4月105 899例孕妇孕中期唐氏综合征筛查结果进行甲胎蛋白(alphafetoprotein,AFP)、人绒毛膜促性腺激素(human chorionic gonadotropin,HCG)和游离雌三醇(unconjugated estriol,u E3)的Mo M值百分位数分析,21-三体风险灰区分析。结果最适合本实验室的单指标Mo M值阈值是HCG Mo M 2.70和u E3Mo M 0.50,风险灰区设置的效率偏低。结论实验室在考虑设置单Mo M值阈值和灰区时,应在经验的基础上,再回顾历史数据,设置合理的阈值和灰区。

Objective To explore the effect of single marker multiple of median（ MoM） cutoff and risk grey-zone on screening efficiency.Methods A total of 105 899 serum screening sample results of second trimester pregnant women in Shijiazhuang Maternal and Child Health Hospital from Jan 2012 to Apr 2014 were selected, MoM of alphafetoprotein （ AFP） , human chorionic gonadotropin （ HCG） and unconjugated estriol （ uE3 ） were analyzed for percentile distribution and risk grey -zone distribution for trisomy of chromosome.Results A suitable single marker MoM cutoff for hCG and uE3 were 2.70 and 0.50.Due to the low efficiency, downs risk grey-zone was not preferable.Conclusion When laboratory applies single marker MoM cutoff and risk grey-zone, it should not only base on experience, but also review previous data to set a reasonable cutoff.