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孕中期母体血浆中游离总DNA(β-珠蛋白基因)分布:子痫前期筛查的新前景。

Total cell-free DNA (beta-globin gene) distribution in maternal plasma at the second trimester: a new prospective for preeclampsia screening.

作者信息

Farina Antonio, Sekizawa Akihiko, Iwasaki Mariko, Matsuoka Ryu, Ichizuka Kiyotake, Okai Takashi

机构信息

Department of Obstetrics and Gynaecology, Showa University School of Medicine, Tokyo, Japan.

出版信息

Prenat Diagn. 2004 Sep;24(9):722-6. doi: 10.1002/pd.973.

Abstract

OBJECTIVES

Levels of cell-free foetal DNA (f-DNA) in maternal plasma are higher in those asymptomatic subjects who will eventually develop preeclampsia. f-DNA is, however, informative only for those women bearing a male foetus, by amplification of Y-specific sequences and represents a small fraction of total circulating DNA that can be dosed by using ubiquitous genes as well as beta-globin. In this study, we examined the quantitative distribution of total DNA by amplification of beta-globin gene, in asymptomatic women matched with controls to evaluate its possible role in predicting preeclampsia.

METHODS

Forty-eight low-risk women (8 asymptomatic cases matched for gestational age at the second trimester with 40 controls) were enrolled in the present study. beta-globin concentrations were converted into multiples of the median of the controls (MoM), in order to assess the possible different distribution of beta-globin MoM in cases and controls.

RESULTS

MoM values were as follows: controls, 1.00 +/- 0.59; asymptomatic cases, 1.99 +/- 1.95. After Gaussian conversion of data, at a false-positive rate (FPR) of 5%, the detection rate (DR) was 46%.

CONCLUSION

beta-globin (total DNA) levels are higher in those patients who subsequently developed preeclampsia and can potentially be used in screening for early detection of the disease. These findings represent a step forward in the study of cell-free DNA in maternal blood as a screening variable, because it overcomes the gender limitations of foetal DNA screening.

摘要

目的

在最终会发生子痫前期的无症状受试者中,母体血浆中游离胎儿DNA(f-DNA)水平较高。然而,f-DNA仅对怀有男性胎儿的女性具有信息价值,通过扩增Y特异性序列来检测,并且它只是总循环DNA中的一小部分,可通过使用普遍存在的基因以及β-珠蛋白进行定量。在本研究中,我们通过扩增β-珠蛋白基因来检测无症状女性与对照组中总DNA的定量分布,以评估其在预测子痫前期中的可能作用。

方法

本研究纳入了48名低风险女性(8例孕中期无症状病例与40名对照组按孕周匹配)。将β-珠蛋白浓度转换为对照组中位数的倍数(MoM),以评估病例组和对照组中β-珠蛋白MoM的可能不同分布。

结果

MoM值如下:对照组为1.00±0.59;无症状病例组为1.99±1.95。数据进行高斯转换后,在5%的假阳性率(FPR)下,检测率(DR)为46%。

结论

随后发生子痫前期的患者中β-珠蛋白(总DNA)水平较高,并且有可能用于该疾病的早期检测筛查。这些发现代表了将母体血液中游离DNA作为筛查变量研究的一个进步,因为它克服了胎儿DNA筛查的性别限制。

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