[Neonatal screening for cystic fibrosis in the Liège region : first evaluation after 4 years].

Revue medicale de Liege Pub Date : 2024-10-01
Matthieu Thimmesch, François Boemer, Géraldine Luis, Cécile Libioulle, Vinciane Dideberg, Hedwige Boboli
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Abstract

Since January 2020, neonatal screening for cystic fibrosis (CF-NBS) has been implemented in the Wallonia-Brussels Federation. It's based on the immunoreactive trypsin (IRT1) assay between day 2 and day 4, associated with a 12 CFTR pathogenic variants analysis and with an IRT control on day 21. The aim of this study is to evaluate the performance of our CF-NBS in Liège according to the quality criteria defined by the European Cystic Fibrosis Society's working group on neonatal screening. After four years, 58.762 newborns have been screened. Nineteen children with cystic fibrosis were diagnosed : 14 by NBS, 3 following a meconium ileus, 1 by family history and 1 false negative diagnosed on clinical basis. Furthermore, 39 healthy carriers and 2 uncertain diagnosis (CFSPID) were identified. The sensitivity of CF NBS is 93,3 % (target ≥ 95 %), the positive predictive value (PPV) 17,7 % (target ≥ 30 %). Increasing the TIR1 threshold by 0,1 in 0,1 from P99 to P99,5, would be associated with a lower sensitivity and a non-significant improvement of PPV. A national assessment of CF NBS needs to be carried out.

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[列日地区新生儿囊性纤维化筛查:4 年后的首次评估]。
自 2020 年 1 月起,瓦隆-布鲁塞尔联邦开始实施新生儿囊性纤维化筛查(CF-NBS)。该筛查基于第 2 天和第 4 天之间的免疫反应性胰蛋白酶(IRT1)检测、12 个 CFTR 致病变体分析以及第 21 天的 IRT 对照。这项研究的目的是根据欧洲囊性纤维化协会新生儿筛查工作组制定的质量标准,评估列日CF-NBS的性能。四年后,共有 58 762 名新生儿接受了筛查。19名新生儿被确诊患有囊性纤维化:14名通过新生儿筛查,3名在胎粪呛入后确诊,1名通过家族病史确诊,1名通过临床确诊为假阴性。此外,还发现了 39 名健康携带者和 2 名诊断不确定者(CFSPID)。CF NBS 的灵敏度为 93.3%(目标值≥ 95%),阳性预测值 (PPV) 为 17.7%(目标值≥ 30%)。将 TIR1 临界值从 P99 提高到 P99,5,每提高 0.1,灵敏度就会降低,PPV 也不会显著提高。需要对 CF NBS 进行全国性评估。
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