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通过对微缺失综合征和亚端粒不平衡进行 MLPA 补充产前中期核型分析,提高诊断率。

Diagnostic yield by supplementing prenatal metaphase karyotyping with MLPA for microdeletion syndromes and subtelomere imbalances.

机构信息

Department of Clinical Genetics, University Hospital of Copenhagen, Rigshospitalet, Denmark.

出版信息

Prenat Diagn. 2010 Oct;30(10):995-9. doi: 10.1002/pd.2604.

Abstract

OBJECTIVE

The aim of the study was to retrospectively assess the relevance of using multiplex ligation-dependent probe amplification (MLPA) for detection of selected microdeletion syndromes (22q11, Prader-Willi/Angelman, Miller-Dieker, Smith-Magenis, 1p-, Williams), the reciprocal microduplication syndromes and imbalance at the subtelomere regions of chromosomes in a routine prenatal setting.

METHOD

A total of 530 prenatal samples were analysed by commercial MLPA kits (SALSA P064, P036 and P069) in addition to rapid aneuploidy testing and G-band karyotyping.

RESULTS

Among the prenatal samples with a normal metaphase karyotype, nine submicroscopic imbalances were detected: seven 22q11 deletions (Velocardiofacial/DiGeorge syndrome), one 15q11 deletion (Prader-Willi syndrome) and one terminal deletion of the short arm of chromosome 4 (Wolf-Hirschhorn syndrome). All imbalances were found in amniocentesis (AC) taken due to fetal structural malformation and/or other ultrasound scan (US) detected abnormality. The diagnostic yield was 4.1% in the subgroup with structural malformation and 1.6% in the subgroup with other US abnormality.

CONCLUSION

The data set substantiates that additional MLPA analyses for selected microdeletions and subtelomere imbalances are valuable in routine prenatal diagnostics, when a malformation(s) and/or other abnormalities are detected by US. In contrast, the additional MLPA analyses gave no diagnostic yield in case of increased nuchal translucency (NT).

摘要

目的

本研究旨在回顾性评估使用多重连接依赖性探针扩增(MLPA)检测选定微缺失综合征(22q11、Prader-Willi/Angelman、Miller-Dieker、Smith-Magenis、1p-、Williams)、反向微重复综合征以及染色体亚端粒区不平衡的相关性,这在常规产前检查中具有重要意义。

方法

对 530 例产前样本进行了商业性 MLPA 试剂盒(SALSA P064、P036 和 P069)分析,同时还进行了快速非整倍体检测和 G 带核型分析。

结果

在具有正常中期核型的产前样本中,检测到了九个亚微观不平衡:七个 22q11 缺失(心脏面部畸形/ DiGeorge 综合征)、一个 15q11 缺失(Prader-Willi 综合征)和一个染色体 4 短臂末端缺失(Wolf-Hirschhorn 综合征)。所有不平衡均发生在因胎儿结构畸形和/或其他超声扫描(US)检测到异常而进行的羊膜穿刺术(AC)中。在结构畸形亚组中,诊断率为 4.1%,在其他 US 异常亚组中,诊断率为 1.6%。

结论

该数据集证实,当 US 检测到畸形和/或其他异常时,对选定的微缺失和亚端粒不平衡进行额外的 MLPA 分析在常规产前诊断中具有重要价值。相比之下,在增加的颈项透明层(NT)情况下,额外的 MLPA 分析没有提供诊断收益。

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