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单机构中用于绒毛取样时胎儿非整倍体快速产前诊断的定量荧光聚合酶链反应

Quantitative fluorescent polymerase chain reaction for rapid prenatal diagnosis of fetal aneuploidies in chorionic villus sampling in a single institution.

作者信息

Shin You Jung, Chung Jin Hoon, Kim Do Jin, Ryu Hyun Mee, Kim Moon Young, Han Jung Yeol, Choi June Seek

机构信息

Department of Obstetrics and Gynecology, Hankook General Hospital, Jeju, Korea.

Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Seoul, Korea.

出版信息

Obstet Gynecol Sci. 2016 Nov;59(6):444-453. doi: 10.5468/ogs.2016.59.6.444. Epub 2016 Nov 15.

DOI:10.5468/ogs.2016.59.6.444
PMID:27896246
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5120063/
Abstract

OBJECTIVE

To validate quantitative fluorescent polymerase chain reaction (QF-PCR) via chorionic villus sampling (CVS) for the diagnosis of fetal aneuploidies.

METHODS

We retrospectively reviewed the medical records of consecutive pregnant women who had undergone CVS at Cheil General Hospital between December 2009 and June 2014. Only cases with reported QF-PCR before long-term culture (LTC) for conventional cytogenetic analysis were included, and the results of these two methods were compared.

RESULTS

A total of 383 pregnant women underwent QF-PCR and LTC via CVS during the study period and 403 CVS specimens were collected. The indications of CVS were as follows: abnormal first-trimester ultrasonographic findings, including increased fetal nuchal translucency (85.1%), advanced maternal age (6.8%), previous history of fetal anomalies (4.2%), and positive dual test results for trisomy 21 (3.9%). The results of QF-PCR via CVS were as follows: 76 (18.9%) cases were identified as trisomy 21 (36 cases), 18 (33 cases), or 13 (seven cases), and 4 (1.0%) cases were suspected to be mosaicism. All results of common autosomal trisomies by QF-PCR were consistent with those of LTC and there were no false-positive findings. Four cases suspected as mosaicism in QF-PCR were confirmed as non-mosaic trisomies of trisomy 21 (one case) or trisomy 18 (three cases) in LTC.

CONCLUSION

QF-PCR via CVS has the advantage of rapid prenatal screening at an earlier stage of pregnancy for common chromosomal trisomies and thus can reduce the anxiety of parents. In particular, it can be helpful for pregnant women with increased fetal nuchal translucency or abnormal first-trimester ultrasonographic findings.

摘要

目的

通过绒毛取样(CVS)验证定量荧光聚合酶链反应(QF-PCR)用于诊断胎儿非整倍体。

方法

我们回顾性分析了2009年12月至2014年6月在首尔圣母医院接受CVS的连续孕妇的病历。仅纳入在进行常规细胞遗传学分析的长期培养(LTC)之前报告了QF-PCR结果的病例,并比较这两种方法的结果。

结果

在研究期间,共有383名孕妇通过CVS接受了QF-PCR和LTC检查,并收集了403份CVS标本。CVS的指征如下:孕早期超声检查异常,包括胎儿颈部透明带增厚(85.1%)、孕妇年龄较大(6.8%)、既往有胎儿畸形史(4.2%)以及21三体综合征双重检测结果阳性(3.9%)。通过CVS进行QF-PCR的结果如下:76例(18.9%)被鉴定为21三体综合征(36例)、18三体综合征(33例)或13三体综合征(7例),4例(1.0%)疑似为嵌合体。QF-PCR检测常见常染色体三体的所有结果均与LTC结果一致,且无假阳性结果。在QF-PCR中疑似为嵌合体的4例在LTC中被确认为21三体综合征(1例)或18三体综合征(3例)的非嵌合三体。

结论

通过CVS进行QF-PCR具有在妊娠早期对常见染色体三体进行快速产前筛查的优势,从而可以减轻父母的焦虑。特别是,它对胎儿颈部透明带增厚或孕早期超声检查异常的孕妇可能有帮助。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f5b/5120063/2098351be6a7/ogs-59-444-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f5b/5120063/1bf19db33a8c/ogs-59-444-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f5b/5120063/a5f6f5396a3d/ogs-59-444-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f5b/5120063/2098351be6a7/ogs-59-444-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f5b/5120063/1bf19db33a8c/ogs-59-444-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f5b/5120063/a5f6f5396a3d/ogs-59-444-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f5b/5120063/2098351be6a7/ogs-59-444-g003.jpg

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