Journal of radiological science and technology (대한방사선기술학회지:방사선기술과학)

Korean Society of Radiological Science (대한방사선과학회)
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Guideliness of the Parameters Using Integrated Test in Down Syndrome Risk Prediction

다운증후군위험도 예측에서 통합선별검사를 이용한 파라미터의 유의성

  • Lee, Jin-Won (Graduate School of Catholic University of Pusan) ;
  • Go, Sung-Jin (Dept. Radiological Science, College of Health Sciences, Catholic University of Pusan) ;
  • Kang, Se-Sik (Dept. Radiological Science, College of Health Sciences, Catholic University of Pusan) ;
  • Kim, Chang-Soo (Dept. Radiological Science, College of Health Sciences, Catholic University of Pusan)
  • 이진원 (부산가톨릭대학교 방사선학과 대학원) ;
  • 고성진 (부산가톨릭대학교 보건과학대학 방사선학과) ;
  • 강세식 (부산가톨릭대학교 보건과학대학 방사선학과) ;
  • 김창수 (부산가톨릭대학교 보건과학대학 방사선학과)
  • Received : 2016.09.28
  • Accepted : 2016.11.27
  • Published : 2016.12.31
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Abstract

This study was an evaluation of the significance of each parameter through aimed at pregnant women subjected to screening test(integrated test) in predicting risk of Down syndrome. We retrospectively analysed the correlation of risk of Down's syndrome with Nuchal Translucency(NT) images measured by ultrasound, Pregnancy Associated Plasma Protein A(PAPP-A), alpha-fetoprotein(AFP), unconjugated estriol(uE3), human chorionic gonadotrophin(hCG) and Inhibin A by maternal serum. As a result, a significant correlation with NT, uE3, hCG, Inhibin A is revealed with Down's syndrome risk(P<.001). In ROC analysis, AUC of Inhibin A is analysed as the biggest predictor of Down's syndrome(0.859). And the criterion for cut-off was inhibin A 1.4 MoM(sensitivity 81.8%, specificity 75.9%). In conclusion, Inhibin A was the most useful in parameters to predict Down's syndrome in the integrated test. If we make up for the weakness based on the cut-off value of parameters they will be able to be used as an independent indicator in the risk of Down's syndrome screening.

본 연구는 다운증후군 위험도의 예측을 위해 통합선별검사를 실시한 산모를 대상으로, 각 표지자의 유의성에 대한 평가를 하였다. 초음파로 측정한 NT 영상, 산모혈청 PAPP-A, AFP, uE3, hCG, 인히빈 A의 상관성을 후향적으로 분석하였다. 그 결과 NT, uE3, hCG, 인히빈 A와 유의한 상관관계를 보였다(p<.001). ROC분석에서 인히빈 A의 AUC가 0.851로 다운증후군의 가장 큰 예측인자로 분석되었으며. cut-off value 1.33 MoM(민감도 87.5%, 특이도 71.5%)으로 결정되었다. 결론적으로 통합선별검사에서 인히빈 A가 다운증후군을 예측하는 가장 유용한 인자로 나타났다. 이에 각 표지자(parameter)들의 cut-off value를 바탕으로 통합선별검사의 단점을 보완한다면 다운증후군 선별의 독립적인 지표로 사용될 수 있을 것으로 사료된다.

Keywords

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