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大规模平行测序在中国人前瞻性人群中进行的胎儿非整倍体无创性产前检测。

Noninvasive prenatal testing of fetal aneuploidies by massively parallel sequencing in a prospective Chinese population.

机构信息

Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.

出版信息

Prenat Diagn. 2013 Jul;33(7):700-6. doi: 10.1002/pd.4160. Epub 2013 Jun 17.

Abstract

OBJECTIVE

The recently developed noninvasive prenatal test (NIPT) presents a new era of prenatal screening. Previously reported studies were primarily conducted on high-risk and advanced maternal age (AMA) pregnancies. We sought to evaluate the performance of NIPT for detection of fetal aneuploidies in a Chinese cohort of women younger than 35 years old in a prospective clinical setting.

METHODS

Maternal plasma samples were sequenced to identify the aneuploidies. The results were compared against the serum screening results and validated by karyotyping through invasive procedures and birth follow-up.

RESULTS

A total of 1916 prospectively collected maternal plasma samples were sequenced, among which 73 samples (3.8%) failed the sequencing quality control. Birth follow-up missed 111 samples (5.8%). The remaining 1741 samples were analyzed. Sequencing reported 15 aneuploidy samples, including all the T21, T18, and T13 cases. Sequencing performed moderately in identifying sex chromosome aneuploidies, detecting two out of four samples, with a specificity of 99.88% (95% CI 99.53% to 99.98%).

CONCLUSIONS

Noninvasive prenatal detection of common fetal aneuploidies is a more sensitive and specific method than triple maternal serum screening. It has a remarkable low false positive rate and is applicable to women younger than 35 years old.

摘要

目的

最近开发的无创产前检测(NIPT)开创了产前筛查的新纪元。以前的研究主要集中在高危和高龄(AMA)妊娠上。我们旨在评估 NIPT 在一个前瞻性临床环境中,对 35 岁以下中国女性胎儿非整倍体的检测性能。

方法

对母体血浆样本进行测序,以识别非整倍体。将结果与血清筛查结果进行比较,并通过有创程序的核型分析和出生后随访进行验证。

结果

共前瞻性收集了 1916 份母体血浆样本进行测序,其中 73 份(3.8%)样本测序质量控制失败。出生后随访丢失了 111 份(5.8%)样本。分析了其余的 1741 份样本。测序报告了 15 例非整倍体样本,包括所有的 T21、T18 和 T13 病例。测序在识别性染色体非整倍体方面表现中等,检测出了四例中的两例,特异性为 99.88%(95%CI 99.53%至 99.98%)。

结论

与三联母体血清筛查相比,常见胎儿非整倍体的无创产前检测具有更高的敏感性和特异性。它具有显著的低假阳性率,适用于 35 岁以下的女性。

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