Correlation Risk Modelling of Maternal Serum Alpha-Fetoprotein Variants(AFP-L2 and AFP-L3) in the Detection of Fetal Open Neural Tube Defects and Abdominal Wall Defects
作者单位：Department of Prenatal diagnosis and screening centerHangzhou Women's Hospital (Hangzhou Maternity and Child Health Care Hospital) Department of Cell Biology and Medical GeneticsSchool of MedicineZhejiang University Department of Cell Biology and Medical GeneticsSchool of MedicineZhejiang University866Yuhangtang Road
会议名称：《2019浙江省妇产科医师大会及妇产科学学术年会》
会议日期：2019年
学科分类：1002[医学-临床医学] 100211[医学-妇产科学] 10[医学]
关 键 词：pregnant women mid-pregnancy prenatal screening fetoprotein variant AFP-L2/AFP-L3 open neural tube abnormalities case-controlled study
摘 要：Objective:To evaluate correlation risk model screening efficiency of the maternal serum alphafetoprotein variants L2 and L3(AFP-L2 and AFP-L3) in the detection of fetal open neural tube defects(ONTD) and abdominal wall defects(AWD).Methods:We divided Subjects into the ONTD group(21 cases),the AWD group(16 cases) and the control group(38 cases) depending on the presence or absence of fetal ONTD or *** levels of AFP-L2 and AFP-L3 using the multiple of the median(MoM) were detected by Enzyme linked immunosorbent assay(ELISA).Comparative analysis was performed on AFP-L2 and AFP-L3 levels using a model created by multiple indicators to determine the efficiency of ONTD or AWD *** operating characteristic(ROC) curves were used to determine the optimal cut-off value,area under the curve(AUC) and to evaluate the screening performance of AFP-L2 and ***:AFP-L2 levels in the ONTD group and the AWD group were 1.77(0.76-2.89) MoM and 1.79(0.77-4.41) MoM,*** were both significantly higher than those in the control group [1.01(0.15-1.53) MoM,P0.001)].AFP-L3 levels in the ONTD group and the AWD group were 2.85(0.74-5.85) MoM and 3.57(0.86-6.81) MoM,*** were also both significantly higher than those in the control group [1.16(0.13-1.92) MoM,P0.001)].The AUC for screening ONTD or AWD using AFP-L2 was 0.830 [95% confidence interval(CI):0.734-0.926,P0.001],while using AFP-L3 was 0.886 [95% confidence interval(CI):0.809-0.963,P0.001].ROC curves indicated that the optimal threshold values for ONTD or AWD by AFP-L2 and AFP-L3 were 1.467 MoM and 1.944 MOM,*** corresponding sensitivity,specificity and Youden index for AFP-L2 and AFP-L3 were 0.703,0.947,0.650 and 0.730,0.974,0.703,*** correlation risk model established using AFP-L2 and AFP-L3 showed better screening efficiency than the original AFP MOM as a single-value ***:Mid-pregnancy maternal serum levels of AFP-L2 and AFP-L3 are good bi