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Abstract：
Background Prenatal serum screening is an important modality to screen for aneuploidy in pregnancy. The addition of placental growth factor (PLGF) to screen for trisomy 21 remains controversial. Objective To determine whether the addition of PLGF to combined serum aneuploidy screening improves detection rates (DRs) for trisomy 21. Study Design We performed a systematic review of the literature until October 2019 to determine the benefits of adding PLGF to prenatal screening. We performed a goodness-of-fit test and retrieved the coefficient of determinations ( R 2 ) as a function of false positive rates (FPRs), providing mean-weighted improvements in the DRs after accounting for PLGF levels. Results We identified 51 studies, of which 8 met inclusion criteria (834 aneuploidy cases and 105,904 euploid controls). DRs were proportional to FPR across all studies, ranging from 59.0 to 95.3% without PLGF and 61.0 to 96.3% with PLGF (FPR 1-5%). Goodness-of-fit regression analysis revealed a logarithmic distribution of DRs as a function of the FPR, with R 2 = 0.109 (no PLGF) and R 2 = 0.06 (PLGF). Two-sample Kolmogorov-Smirnov\'s test reveals a p -value of 0.44. Overall, addition of PLGF improves DRs of 3.3% for 1% FPR, 1.7% for 3% FPR, and 1.4% for 5% FPR, respectively. Conclusion Addition of PLGF to prenatal screening using serum analytes mildly improves trisomy 21 DRs as a function of FPRs.
摘要：
背景产前血清筛查是筛查妊娠非整倍体的重要方式。添加胎盘生长因子（PLGF）来筛选21三体仍然存在争议。目的确定在联合血清非整倍体筛查中添加PLGF是否可以提高21三体的检出率（DRs）。研究设计我们在2019年10月之前对文献进行了系统回顾，以确定在产前筛查中添加PLGF的益处。我们进行了拟合优度检验，并检索了确定系数(R2)作为假阳性率(FPR)的函数，在考虑PLGF水平后，提供DR的均值加权改进。结果我们确定了51项研究，其中8例符合纳入标准(834例非整倍体病例和105,904例整倍体对照)。在所有研究中，DR与FPR成正比，不含PLGF的59.0％至95.3％，含PLGF的61.0％至96.3％（FPR1-5％）。拟合优度回归分析显示，DR的对数分布是FPR的函数，R2=0.109(无PLGF)，R2=0.06(PLGF)。两样本Kolmogorov-Smirnov检验显示p值为0.44。总的来说,对于1%的FPR，添加PLGF可提高3.3%的DR，1.7%为3%FPR，5%FPR为1.4%，分别。结论在使用血清分析物的产前筛查中添加PLGF可轻度改善21三体性DR作为FPR的功能。
