Law L W, Lau T K, Fung T Y, Leung T Y, Wang C C, Choy K W
Fetal Medicine Unit, Department of Obstetrics and Gynaecology, Prince of Wales Hospital, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, SAR.
BJOG. 2009 Jan;116(2):339-43. doi: 10.1111/j.1471-0528.2008.01948.x. Epub 2008 Nov 11.
We investigated the application of high-resolution microarray-based comparative genomic hybridisation (array CGH) on a fetus showing increased nuchal translucency (NT).
Case study.
Tertiary referral obstetrics unit.
Pregnant woman attended the antenatal clinic.
Conventional karyotyping and genetic test was carried out for the alpha-globin gene. High-resolution array CGH using the high-density 244K Agilent microarray was performed on fetal blood sample by cordocentesis to investigate the possibility of any genomic imbalance.
Detection of chromosomal abnormality.
Karyotyping analysis showed 46,XY. Molecular genetic diagnosis confirms the fetus has Hb-H constant spring disease but cannot explain the increased NT to 3.2 mm. Array CGH analysis discovered a 1.32-Mb microdeletion on chromosome 16p13.11. Deletion at 16p13.11 has been implicated to predispose to autism and/or mental retardation. Baby was delivered at 40 weeks of gestation, and follow up was carried out at 3 months of age without sign of mental retardation/developmental delay.
This case study demonstrated that array CGH can accurately calibrate the size and identify de novo interstitial chromosome imbalances. However, the presence of chromosome copy variants with unknown clinical significance currently limits its wider scale application in prenatal diagnosis and needs further investigations.
我们研究了基于高分辨率微阵列的比较基因组杂交技术(阵列比较基因组杂交,array CGH)在一例颈部半透明层(NT)增厚胎儿中的应用。
病例研究。
三级转诊产科单位。
一名到产前门诊就诊的孕妇。
进行常规核型分析和α-珠蛋白基因的基因检测。通过脐血穿刺采集胎儿血样,使用高密度244K安捷伦微阵列进行高分辨率阵列比较基因组杂交,以研究是否存在任何基因组失衡的可能性。
检测染色体异常。
核型分析显示为46,XY。分子遗传学诊断证实胎儿患有血红蛋白H恒春病,但无法解释NT增厚至3.2 mm的原因。阵列比较基因组杂交分析发现16号染色体p13.11区域存在一个1.32 Mb的微缺失。16p13.11区域的缺失与自闭症和/或智力迟钝的易感性有关。婴儿在妊娠40周时分娩,3个月大时进行随访,未发现智力迟钝/发育迟缓的迹象。
本病例研究表明,阵列比较基因组杂交能够准确校准大小并识别新发的间质性染色体失衡。然而,目前存在临床意义不明的染色体拷贝变异,这限制了其在产前诊断中的更广泛应用,需要进一步研究。