Department of Medicine, Mackay Medical College, New Taipei City, Taiwan.
Taiwan J Obstet Gynecol. 2012 Sep;51(3):435-9. doi: 10.1016/j.tjog.2012.07.022.
The purpose of this case report is to present prenatal diagnosis and molecular cytogenetic characterization of pure partial monosomy 3p (3p25.3 → pter) by array comparative genomic hybridization (aCGH) and quantitative fluorescent polymerase chain reaction (QF-PCR) on uncultured amniocytes.
A 35-year-old, gravida 2, para 0, woman underwent amniocentesis at 19 weeks of gestation because of advanced maternal age. Her husband was 37 years of age. She had experienced one intrauterine fetal death. Amniocentesis during this pregnancy revealed a distal deletion of chromosome 3p. The parental karyotypes were normal. Prenatal ultrasonography findings were unremarkable. At 22 weeks of gestation, she underwent repeated amniocentesis, and aCGH investigation using CytoChip Oligo Array on uncultured amniocytes revealed a 9.29-Mb deletion of 3p26.3p25.3 [arr 3p26.3p25.3 (64,096-9,357,258 bp) ×1] encompassing the genes of CHL1, CNTN4, CRBN, LRRN1, ITPR1, and SRGAP3, but not involving the markers D3S1263 and D3S3594. Polymorphic DNA marker analysis on uncultured amniocytes showed a paternal origin of the deletion. Cytogenetic analysis of cultured amniocytes revealed a karyotype of 46,XX,del(3)(p25.3). At 24 weeks of gestation, prenatal ultrasonography findings of the brain, heart, and other internal organs were unremarkable. The pregnancy was subsequently terminated, and an 886-g female fetus was delivered with brachycephaly, hypertelorism, a short and thick nose, micrognathia and low-set ears.
In this case, aCGH has characterized a 3p deleted region with haploinsufficiency of the neurodevelopmental genes associated with cognitive deficit and mental retardation but without involvement of the congenital heart disease susceptibility locus, and QF-PCR has determined a paternal origin of the deletion. aCGH and QF-PCR help to delineate the genomic imbalance in prenatally detected de novo chromosome aberration, and the information acquired is useful for genetic counseling.
本病例报告旨在通过未培养的羊水细胞的阵列比较基因组杂交(aCGH)和定量荧光聚合酶链反应(QF-PCR),对纯部分单体性 3p (3p25.3→pter)进行产前诊断和分子细胞遗传学特征分析。
一位 35 岁、孕 2 产 0、经产妇,因高龄接受了 19 周的羊膜穿刺术。她的丈夫 37 岁。她曾经历过一次宫内胎儿死亡。此次妊娠的羊膜穿刺术显示染色体 3p 远端缺失。父母的核型正常。产前超声检查未见异常。在 22 周时,她再次进行了羊膜穿刺术,并对未培养的羊水细胞进行了 CytoChip Oligo Array 的 aCGH 研究,发现 3p26.3p25.3 处存在 9.29Mb 的缺失[arr 3p26.3p25.3(64,096-9,357,258bp)×1],包括 CHL1、CNTN4、CRBN、LRRN1、ITPR1 和 SRGAP3 基因,但不包括标记 D3S1263 和 D3S3594。对未培养的羊水细胞的多态性 DNA 标记分析显示,缺失来源于父亲。培养羊水细胞的细胞遗传学分析显示核型为 46,XX,del(3)(p25.3)。在 24 周时,胎儿脑、心脏和其他内部器官的产前超声检查未见异常。随后终止妊娠,娩出一名 886g 女婴,表现为短头畸形、斜视、短而厚的鼻子、小下颌和低位耳朵。
在本病例中,aCGH 对 3p 缺失区域进行了特征分析,该区域神经发育基因单倍不足,与认知缺陷和智力迟钝有关,但不涉及先天性心脏病易感性基因座,QF-PCR 确定了缺失的父源起源。aCGH 和 QF-PCR 有助于描绘产前检测到的新发染色体异常中的基因组失衡,所获得的信息对遗传咨询有用。