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[法国使用游离循环胎儿DNA(cffDNA)进行无创产前检测以检测胎儿21三体、18三体和13三体的性能及指征]

[Performance and indications of noninvasive prenatal testing using cell free circulating fetal DNA (cffDNA) for the detection of fetal trisomy 21, 18 and 13 in France].

作者信息

Benachi A, Letourneau A, Kleinfinger P, Senat M-V, Gautier E, Favre R, Bidat L, Houfflin-Debarge V, Querol V, Bouyer J, Costa J-M

机构信息

Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Antoine-Béclère, 157, rue de la Porte-de-Trivaux, 92140 Clamart, France; Université Paris Sud, 91405 Orsay, France.

Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Antoine-Béclère, 157, rue de la Porte-de-Trivaux, 92140 Clamart, France; Université Paris Sud, 91405 Orsay, France.

出版信息

J Gynecol Obstet Biol Reprod (Paris). 2016 Jun;45(6):633-40. doi: 10.1016/j.jgyn.2015.08.003. Epub 2015 Oct 27.

DOI:10.1016/j.jgyn.2015.08.003
PMID:26518155
Abstract

OBJECTIVES

To evaluate de performances of noninvasive prenatal testing using cell free circulating fetal DNA (cffDNA) for the detection of fetal trisomy 21, 18 and 13 in a French population.

MATERIALS AND METHODS

cffDNA analysis was performed by massive parallel sequencing during a multicenter, non interventional, prospective study and the results were compared with a standard fetal karyotype.

RESULTS

Results were available for 886 patients who have been classified as high- or moderate-risk depending on the presence of fetal abnormalities on ultrasound examination. For the high-risk group (n=376), the sensitivity and specificity of the test were 100% and 99.9% for trisomy 21, 88% and 99.9% for trisomy 18 and 100% and 99.9% for trisomy 13. The rate of other pathogenic chromosomal abnormalities with a negative NIPT was 7.9%. In the low-risk group (n=510), the sensitivity was 100% and the specificity 99.8% for trisomy 21, and only 0.4% of pathogenic chromosomal abnormalities were revealed by fetal karyotyping but not detected by cffDNA analysis.

CONCLUSION

Noninvasive prenatal testing using cffDNA for high risk patients without fetal anomalies at ultrasound could be recommended in France after counseling on the possible risk of undiagnosed anomalies.

摘要

目的

评估在法国人群中使用游离循环胎儿DNA(cffDNA)进行无创产前检测以检测胎儿21三体、18三体和13三体的性能。

材料与方法

在一项多中心、非干预性、前瞻性研究中,通过大规模平行测序进行cffDNA分析,并将结果与标准胎儿核型进行比较。

结果

886例患者的结果可用,这些患者根据超声检查中胎儿异常的存在被分类为高风险或中度风险。对于高风险组(n = 376),该检测对21三体的敏感性和特异性分别为100%和99.9%,对18三体为88%和99.9%,对13三体为100%和99.9%。无创产前检测结果为阴性但存在其他致病性染色体异常的比例为7.9%。在低风险组(n = 510)中,对21三体检测的敏感性为100%,特异性为99.8%,胎儿核型分析发现但cffDNA分析未检测到的致病性染色体异常仅占0.4%。

结论

在法国,对于超声检查无胎儿异常的高风险患者,在就未诊断异常的可能风险进行咨询后,可推荐使用cffDNA进行无创产前检测。

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