The appplication value of the combination detection of fetal NT and serum PAPP-A, ADAM12 in the prenatal screening of DS

ObjectiveTo explore of the clinical value of transthoracic thickness(NT)ultrasound combined with levels of plasma associated protein A(PAPP-A)and disintegrin-metalloproteinase 12(ADAM12)in the prenatal screening of Down's syndrome(DS).

MethodsThree hundred and twenty-three women with pregnancy 11 to 14 weeks were examined using B-ultrasound, and the serum levels of PAPP-A and ADAM12 at 15 to 21 weeks of gestation were measured.The results between the single detection of NT, PAPP-A and ADAM12, and combination detection of NT, PAPP-A and ADAM12 in the diagnsois of DS were compared.

ResultsFifteen, 19, 20 and 6 high-risk pregnant women were identified using the single detection of NT, PAPP-A and ADAM12, and combination detection of NT, PAPP-A and ADAM12, respectively.Two, 2 and 1 cases were missed diagnosis using the detetcion of NT, PAPP-A and ADAM12, respectively.The sensitivity, accuracy, specificity, negative predictive value and positive predictive value of the combination detection of NT, PAPP-A and ADAM12 were significantly higher than those of single of NT, serum PAPP-A and ADAM12(P < 0.05).The areas under the ROC of the single detection of NT, serum PAPP-A and ADAM12, and combination detection were 0.802, 0.729, 0.762 and 0.905, respectively.The ROC curve area of the combination detection was significantly higher than that of single detetcion of NT, serum PAPP-A and ADAM12(P < 0.05).

ConclusionsThe combination detection of NT, serum PAPP-A and ADAM12 can significantly improve the detection rate of DS, and has good clinical value.