摘要
Abstract
Objective To detect serum levels of sialic acid-binding immunoglobulin-like lectin 6(Siglec-6),galectin-13(Gal-13),and neuroaxon guidance factor-1(also called Netrin-1)of pregnant women in mid pregnancy,and to analyze their correlations with risk of pernicious placenta previa(PPP)combined with placenta accreta spectrum(PAS).Methods A total of 176 pregnant women who were diagnosed as PPP and underwent cesarean section in our hospital from January 2020 to December 2023 were selected as study subjects.According to intraoperative findings and postoperative pathological examination results,these 176 PPP patients were divided into PPP combined with PAS group(71 cases)and simple PPP group(105 cases).Enzyme linked immunosorbent assay(ELISA)was applied to detect serum levels of Siglec-6,Gal-13 and Netrin-1.Spearman correlation was applied to analyze correlations between serum Siglec-6,Gal-13,Netrin-1 levels and PPP combined with PAS.Multiple Logistic regression analysis(stepforward method)was applied to obtain odds ratio(OR)and 95%confidence interval(95%CI)of factors affecting PPP combined with PAS.Receiver operating characteristic(ROC)curve was plotted to obtain the areas under the curve(AUCs)of serum Siglec-6,Gal-13,Netrin-1,and combination of the three indexes for diagnosing PPP with PAS,and Z-test was used to compare the data.Results The serum level of Siglec-6 of the pregnant women in the PPP combined with PAS group was significantly higher than that in the simple PPP group,while the serum levels of Gal-13 and Netrin-1 were significantly lower than those in the simple PPP group(t=6.266,5.611 and 4.567 respectively,all P<0.05).The parity,and proportions of pregnant women with cesarean section history and frequency of curettage≥2 in the PPP combined with PAS group were significantly higher than those in the simple PPP group,the differences were statistically significant(χ2=5.151,10.836 and 15.515 respectively,all P<0.05).Spearman correlation analysis showed that serum Siglec-6 was positively correlated with PPP combined with PAS(r=0.613,P<0.001),while serum Gal-13 and Netrin-1 levels were negatively correlated with PPP combined with PAS(r=-0.518 and-0.474 respectively,both P<0.001).Multiple Logistic regression analysis shown that history of cesarean section≥2 times,frequency of curettage=1 time,frequency of curettage≥2 times,and high serum level of Siglec-6 were risk factors for PPP combined with PAS(OR=1.843,2.650,6.247 and 4.306 respectively,all P<0.05),while high serum levels of Gal-13 and Netrin-1 were protective factors for PPP combined with PAS(OR=0.207 and 0.274 respectively,both P<0.05).The AUC of the combination of serum Siglec-6,Gal-13 and Netrin-1 for diagnosing PPP combined with PAS was 0.941(95%CI:0.908-0.974),suggesting that the combined diagnostic value of the three was higher than that of individual diagnostic efficacy of single Siglec-6(Z=2.539,P=0.011),single Gal-13(Z=3.753,P<0.001),and single Netrin-1(Z=4.163,P<0.001).Conclusion The serum level of Siglec-6 of the pregnant women with PPP combined with PAS significantly elevates,while the serum Gal-13 and Netrin-1 levels significantly decrease,and changes in the serum levels of the three indexes have some diagnostic reference value for PPP combined with PAS.关键词
凶险性前置胎盘/胎盘植入/唾液酸结合免疫球蛋白样凝集素6/半乳糖凝集素13/轴突生长诱向因子1Key words
pernicious placenta previa/placenta accreta spectrum/sialic acid-binding immunoglobulin-like lectin 6/galectin-13/neuroaxon guidance factor-1分类
医药卫生
