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胎儿产前诊断及新发部分三体 7p(7p15.3→pter)和部分单体 13q(13q33.3→qter)的分子细胞遗传学特征与 Dandy-Walker 畸形、颅骨发育异常和小头畸形相关。

Prenatal diagnosis and molecular cytogenetic characterization of de novo partial trisomy 7p (7p15.3→pter) and partial monosomy 13q (13q33.3→qter) associated with Dandy-Walker malformation, abnormal skull development and microcephaly.

机构信息

Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan.

出版信息

Taiwan J Obstet Gynecol. 2010 Sep;49(3):320-6. doi: 10.1016/S1028-4559(10)60068-X.

Abstract

OBJECTIVE

To present the prenatal diagnosis and molecular cytogenetic characterization of de novo partial trisomy 7p (7p15.3→pter) and partial monosomy 13q (13q33.3→qter) associated with Dandy-Walker malformation (DWM), abnormal skull development, microcephaly and multiple congenital anomalies.

MATERIALS, METHODS AND RESULTS: A 42-year-old woman, gravida 6, para 1, was referred for amniocentesis at 18 weeks of gestation because of her advanced maternal age. Amniocentesis revealed an aberrant derivative chromosome 13, or der(13). The parental karyotypes were normal. Spectral karyotyping showed that the der(13) was derived from a translocation of chromosomes 7 and 13. Fluorescence in situ hybridization using subtelomeric probes revealed three signals of 7pTEL and only one signal of 13qTEL, indicating a translocation between 7p and 13q in the der(13). Array-based comparative genomic hybridization demonstrated partial trisomy 7p (7p15.3-p22.3) and partial monosomy 13q (13q33.3-q34). The karyotype was 46,XY,der(13)t(7;13)(p15.3;q33.3). Polymorphic DNA marker analysis revealed the paternal origin of the aberrant chromosome. Level II ultrasound at 24 weeks of gestation revealed microcephaly, an irregular-shaped skull, DWM, nuchal edema and transposition of the great arteries.

CONCLUSION

Spectral karyotyping, fluorescence in situ hybridization and array-based comparative genomic hybridization are useful for prenatal investigation of the nature of a de novo aberrant derivative chromosome. Partial trisomy 7p (7p15.3→pter) and partial monosomy 13q (13q33.3→qter) can be associated with DWM, microcephaly, abnormal skull development, nuchal edema and cardiovascular defects on prenatal ultrasound.

摘要

目的

介绍新发的部分三体 7p(7p15.3→pter)和部分单体 13q(13q33.3→qter)与 Dandy-Walker 畸形(DWM)、颅骨发育异常、小头畸形和多种先天性异常相关的产前诊断和分子细胞遗传学特征。

材料、方法和结果:一位 42 岁的女性,妊娠 6 次,产 1 次,因高龄被转诊进行羊膜穿刺术,妊娠 18 周。羊膜穿刺术显示异常衍生染色体 13,即 der(13)。父母的核型正常。光谱核型分析显示,der(13)是由染色体 7 和 13 的易位产生的。用端粒探针进行荧光原位杂交显示 7pTEL 有三个信号,而 13qTEL 只有一个信号,表明 der(13)在 7p 和 13q 之间发生了易位。基于阵列的比较基因组杂交显示部分三体 7p(7p15.3-p22.3)和部分单体 13q(13q33.3-q34)。核型为 46,XY,der(13)t(7;13)(p15.3;q33.3)。多态性 DNA 标记分析显示异常染色体来源于父亲。妊娠 24 周的二级超声显示小头畸形、颅骨形状不规则、DWM、颈后水肿和大动脉转位。

结论

光谱核型分析、荧光原位杂交和基于阵列的比较基因组杂交可用于产前研究新发异常衍生染色体的性质。部分三体 7p(7p15.3→pter)和部分单体 13q(13q33.3→qter)可能与 DWM、小头畸形、颅骨发育异常、颈后水肿和心血管缺陷相关,这些在产前超声上都可观察到。

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