Abstract：
BACKGROUND: The aim of the study was to identify predictive values of the soluble fms-like tyrosine kinase/placental growth factor (sFlt-1/PlGF) ratio and interleukin (IL)-6, assessed with a clinically available method in a large-volume biochemistry laboratory, in maternal blood, amniotic fluid, and umbilical cord blood for the presence of the placental lesions consistent with maternal vascular malperfusion (MVM) and acute histological chorioamnionitis (HCA), respectively.
METHODS: This retrospective study included 92 women with preterm labor with intact membranes (PTL) delivered within 7 days of admission with gestational ages between 22+0 and 34+6 weeks. The sFlt-1/PlGF ratio and IL-6 were assessed in stored samples of maternal serum, amniotic fluid, and umbilical cord serum using Elecsys® sFlt-1, PlGF, and IL-6 immunoassays.
RESULTS: Women with MVM had a higher sFlt-1/PlGF ratio in the maternal serum, compared to those without MVM (19.9 vs. 4.6; p < 0.0001), but not in the amniotic fluid or umbilical cord blood. A cut-off value of 8 for the sFlt-1/PlGF ratio in maternal serum was identified as optimal for predicting MVM in patients with PTL. Women with HCA had higher concentrations of IL-6 in maternal serum, compared to those without HCA (11.1 pg/mL vs. 8.4 pg/mL; p = 0.03), amniotic fluid (9,216 pg/mL vs. 1,423 pg/mL; p < 0.0001), and umbilical cord blood (20.7 pg/mL vs. 10.7 pg/mL, p = 0.002). Amniotic-fluid IL-6 showed the highest predictive value. A cut-off value of IL-6 concentration in the amniotic fluid of 5,000 pg/mL was found to be optimal for predicting HCA in PTL.
CONCLUSIONS: Maternal serum sFlt-1/PlGF and amniotic fluid IL-6 concentrations can be used for liquid biopsy to predict placental lesions in women with PTL who deliver within 7 days.
METHODS: This retrospective study included 92 women with preterm labor with intact membranes (PTL) delivered within 7 days of admission with gestational ages between 22+0 and 34+6 weeks. The sFlt-1/PlGF ratio and IL-6 were assessed in stored samples of maternal serum, amniotic fluid, and umbilical cord serum using Elecsys® sFlt-1, PlGF, and IL-6 immunoassays.
RESULTS: Women with MVM had a higher sFlt-1/PlGF ratio in the maternal serum, compared to those without MVM (19.9 vs. 4.6; p < 0.0001), but not in the amniotic fluid or umbilical cord blood. A cut-off value of 8 for the sFlt-1/PlGF ratio in maternal serum was identified as optimal for predicting MVM in patients with PTL. Women with HCA had higher concentrations of IL-6 in maternal serum, compared to those without HCA (11.1 pg/mL vs. 8.4 pg/mL; p = 0.03), amniotic fluid (9,216 pg/mL vs. 1,423 pg/mL; p < 0.0001), and umbilical cord blood (20.7 pg/mL vs. 10.7 pg/mL, p = 0.002). Amniotic-fluid IL-6 showed the highest predictive value. A cut-off value of IL-6 concentration in the amniotic fluid of 5,000 pg/mL was found to be optimal for predicting HCA in PTL.
CONCLUSIONS: Maternal serum sFlt-1/PlGF and amniotic fluid IL-6 concentrations can be used for liquid biopsy to predict placental lesions in women with PTL who deliver within 7 days.
摘要：
背景：为了确定可溶性fms样酪氨酸激酶/胎盘生长因子（sFlt-1/PlGF）比率和白介素（IL）-6的预测值，在大容量生物化学实验室中使用临床可用的方法进行评估，在母体血液中，羊水,和脐带血是否存在与母体血管灌注不良（MVM）和急性组织学绒毛膜羊膜炎（HCA）一致的胎盘病变，分别。研究方法这项回顾性研究包括92名早产妇女，在入院后7天内分娩了完整的膜（PTL），胎龄在220至346周之间。在储存的母体血清样品中评估sFlt-1/PlGF比率和IL-6，羊水,和脐带血清使用ElecsyssFlt-1，PlGF，和IL-6免疫测定。
结果：患有MVM的女性在母体血清中具有较高的sFlt-1/PlGF比率，与没有MVM的人相比（19.9vs.4.6；p＆lt;0.0001），但不在羊水或脐带血中。母体血清中sFlt-1/PlGF比率的截断值8被鉴定为预测PTL患者中的MVM的最佳。患有HCA的妇女在母体血清中有较高浓度的IL-6,与不含HCA的那些相比（11.1pg/mLvs.8.4pg/mL；p=0.03），羊水（9,216pg/mL与1,423pg/mL；p<0.0001)，和脐带血（20.7pg/mL与10.7pg/mL,p=0.002)。羊水IL-6的预测价值最高。发现羊水中IL-6浓度的截断值为5,000μg/mL对于预测PTL中的HCA是最佳的。
结论：孕妇血清sFlt-1/PlGF和羊水IL-6浓度可用于液体活检，以预测在7天内分娩的PTL妇女的胎盘病变。
结果：患有MVM的女性在母体血清中具有较高的sFlt-1/PlGF比率，与没有MVM的人相比（19.9vs.4.6；p＆lt;0.0001），但不在羊水或脐带血中。母体血清中sFlt-1/PlGF比率的截断值8被鉴定为预测PTL患者中的MVM的最佳。患有HCA的妇女在母体血清中有较高浓度的IL-6,与不含HCA的那些相比（11.1pg/mLvs.8.4pg/mL；p=0.03），羊水（9,216pg/mL与1,423pg/mL；p<0.0001)，和脐带血（20.7pg/mL与10.7pg/mL,p=0.002)。羊水IL-6的预测价值最高。发现羊水中IL-6浓度的截断值为5,000μg/mL对于预测PTL中的HCA是最佳的。
结论：孕妇血清sFlt-1/PlGF和羊水IL-6浓度可用于液体活检，以预测在7天内分娩的PTL妇女的胎盘病变。
