Meta-Analysis

Diagnostic accuracy of the soluble Fms-like tyrosine kinase-1/placental growth factor ratio for preeclampsia with the use of a common cut-off value

Vasilios Pergialiotis1,2, Anastasia Prodromidou1, Alexandros Sotiriadis3, Nikolaos Papantoniou1,2

1Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, National and Kapodistrian University of Athens, Greece
2Third dpt of Obstetrics and Gynecology, Attikon University Hospital, National and Kapodistrian University of Athens, Greece
3Second Department of Obstetrics and Gynecology, “Hippokrateion” General Hospital, Aristotle University of Thessaloniki, Greece

Correspondence: Vasilios Pergialiotis, MD, M.Sc., Ph.D, 6, Danaidon str., Chalandri 152 32 – Greece, E – mail: pergialiotis@yahoo.com


Abstract

Background: To date, predictive markers of preeclampsia have not been established in the field of prenatal care. The Soluble fms-like tyrosine kinase-1/Platelet Growth Factor (sFlt-1/PlGF) ratio has been extensively studied in the literature and seems to be promising. However, consensus regarding its efficacy is lacking. Objective: The purpose of the present meta-analysis is to evaluate the sensitivity and specificity of sFlt-1/PlGF ratio by including studies that applied the most commonly studied cut-off (85) for the diagnosis of preeclampsia. Methods: We conducted a systematic review searching the Medline (1966-2016), Scopus (2004-2016), Clinical Trials.gov (2008-2016), and Cochrane Central Register of Controlled Trials CENTRAL (1999-2016) databases together. Results: Five studies were included that provided data concerning the sFlt-1/PIGF ratio 85 for 850 control pregnant women and 461 patients with preeclampsia. The sensitivity of sFlt-1/PlGF in detecting preeclampsia was 75.1% (95% confidence interval (CI), 70.9-78.9%) and the specificity 90.1% (95% CI, 87.8-92.0%). Additionally, the average positive likelihood ratio was 5.889 (95% CI, 2.473-14.022) and the negative likelihood ratio was 0.281 (95% CI, 0.167-0.473). The diagnostic odds ratio was 25.702 (95% CI, 7.567-87.305) and the area under the SROC curve 0.9173. Conclusions: The diagnostic cut-off 85 of sFlt-1/PlGF ratio is of mild clinical importance, mainly due to the fact that studies in the field did not limit its application on the first trimester of pregnancy. However, given its high sensitivity and specificity, at least in the case of early onset preeclampsia, it seems to be promising as a tool.

Keywords: sFlt-1, PlGF, preeclampsia, Kryptor, Elecsys

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