Angiogenic factors as diagnostic tests for preeclampsia: a performance comparison between two commercial immunoassays

• Published in: American journal of obstetrics and gynecology Vol. 205; no. 5; pp. 469.e1 - 469.e8
• Main Authors: Benton, Samantha J., BSc, Hu, Yuxiang, MD, Xie, Fang, MD, PhD, Kupfer, Kenneth, PhD, Lee, Seok-Won, PhD, Magee, Laura A., MD, MSc, von Dadelszen, Peter, MBChB, DPhil
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.11.2011; Elsevier
• Subjects: Adult; angiogenesis; Angiogenesis Inducing Agents - blood; Biological and medical sciences; biomarker; Biomarkers - blood; Case-Control Studies; diagnostic test; Diseases of mother, fetus and pregnancy; Female; Gynecology. Andrology. Obstetrics; Humans; Immunoassay; Immunologic Tests; Medical sciences; Obstetrics and Gynecology; Placenta Growth Factor; placental growth factor (PlGF); Pre-Eclampsia - blood; Pre-Eclampsia - diagnosis; preeclampsia; Pregnancy; Pregnancy Proteins - blood; Pregnancy. Fetus. Placenta; Retrospective Studies; Sensitivity and Specificity; soluble Fms-like tyrosine kinase-1 (sFlt-1); Vascular Endothelial Growth Factor Receptor-1 - blood; placental growth factor (PlGF); preeclampsia; biomarker; diagnostic test; angiogenesis; soluble Fms-like tyrosine kinase-1 (sFlt-1); Performance evaluation; Pregnancy disorders; Angiogenic factor; Gynecology; Preeclampsia; Exploration; Diagnosis; Obstetrics; Pregnancy toxemia; Comparative study
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2011.06.058

Objective Placental growth factor and soluble Fms-like tyrosine kinase-1 may be potential diagnostic markers of preeclampsia. We compared performances of 2 immunoassays, the Triage placental growth factor assay and the Elecsys soluble Fms-like tyrosine kinase-1/placental growth factor ratio in diagnosing preeclampsia. Study Design A single site, case-control study of 44 patients with preeclampsia and 84 matched normal pregnant controls. Samples were collected at the time of diagnosis. Assays were performed according to product inserts. Results Both assays had optimal performance in diagnosing early-onset preeclampsia with area under the receiver operating characteristic curves of 0.99 (Triage: 100% sensitivity, 96% specificity; Elecsys: 64% sensitivity, 100% specificity for early-onset preeclampsia). Reassignment of the Elecsys cutoff for a positive test based on receiver operating characteristic curves increased sensitivity to 92%. Conclusion Using product insert cutoffs, Triage appears to have greater sensitivity at only a small reduction in specificity compared with Elecsys in the diagnosis of early-onset preeclampsia. A different cutoff may improve Elecsys sensitivity.