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Amniotic fluid gamma-glutamyl transferase for prediction of biliary atresia in cases of non-visualisation of the fetal gallbladder: a retrospective study using a validated analytical platform and local reference range.
Cheung, T Y T; Wong, N K L; Sahota, D S; Subramaniam, S R; Lau, S L; Zhu, X; Lui, W T; Chan, E K W; Kwok, Y K Y; Choy, K W; Leung, T Y; Chan, M H M; Wong, F C K; Ting, Y H.
Afiliación
  • Cheung TYT; Department of Chemical Pathology, The Chinese University of Hong Kong, Hong Kong SAR, China.
  • Wong NKL; Department of Chemical Pathology, Princess Margaret Hospital, Hong Kong SAR, China.
  • Sahota DS; Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong SAR, China.
  • Subramaniam SR; Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong SAR, China.
  • Lau SL; Department of Chemical Pathology, The Chinese University of Hong Kong, Hong Kong SAR, China.
  • Zhu X; Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong SAR, China.
  • Lui WT; Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong SAR, China.
  • Chan EKW; Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong SAR, China.
  • Kwok YKY; Division of Paediatric Surgery and Paediatric Urology, Department of Surgery, Prince of Wales Hospital, Hong Kong SAR, China.
  • Choy KW; Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong SAR, China.
  • Leung TY; Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong SAR, China.
  • Chan MHM; Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong SAR, China.
  • Wong FCK; Department of Chemical Pathology, Prince of Wales Hospital, Hong Kong SAR, China.
  • Ting YH; Department of Chemical Pathology, Prince of Wales Hospital, Hong Kong SAR, China.
Hong Kong Med J ; 30(3): 218-226, 2024 Jun.
Article en En | MEDLINE | ID: mdl-38835098
ABSTRACT

INTRODUCTION:

The level of amniotic fluid gamma-glutamyl transferase (AFGGT) may help identify biliary atresia (BA) in cases of non-visualisation of the fetal gallbladder (NVFGB). This study aimed to validate a serum/plasma matrix-based gamma-glutamyl transferase (GGT) assay for amniotic fluid (AF) samples, establish a local gestational age-specific AFGGT reference range, and evaluate the efficacy of AFGGT for predicting fetal BA in pregnancies with NVFGB using the constructed reference range.

METHODS:

The analytical performance of a serum/plasma matrix-based GGT assay on AF samples was evaluated using a Cobas c502 analyser. Amniotic fluid gamma-glutamyl transferase levels in confirmed euploid singleton pregnancies (16+0 to 22+6 weeks of gestation) were determined using the same analyser to establish a local gestational age-specific reference range (the 2.5th to 97.5th percentiles). This local reference range was used to determine the positive predictive value (PPV) and negative predictive value (NPV) of AFGGT level <2.5th percentile for identifying fetal BA in euploid pregnancies with NVFGB.

RESULTS:

The serum/plasma matrix-based GGT assay was able to reliably and accurately determine GGT levels in AF samples. Using the constructed local gestational age-specific AFGGT reference range, the NPV and PPV of AFGGT level <2.5th percentile for predicting fetal BA in pregnancies with NVFGB were 100% and 25% (95% confidence interval=0, 53), respectively.

CONCLUSION:

In pregnancies with NVFGB, AFGGT level ≥2.5th percentile likely excludes fetal BA. Although AFGGT level <2.5th percentile is not diagnostic of fetal BA, fetuses with AFGGT below this level should be referred for early postnatal investigation.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Atresia Biliar / Edad Gestacional / Vesícula Biliar / Gamma-Glutamiltransferasa / Líquido Amniótico Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: Hong Kong Med J Asunto de la revista: MEDICINA Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: China
Texto completo
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Atresia Biliar / Edad Gestacional / Vesícula Biliar / Gamma-Glutamiltransferasa / Líquido Amniótico Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: Hong Kong Med J Asunto de la revista: MEDICINA Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: China