Wu Qinghua, Wang Cong, Shi Huirong, Kong Xiangdong, Ren Shumin, Jiang Miao
Center of Genetics and Prenatal Diagnosis, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Sex Dev. 2017;11(2):64-69. doi: 10.1159/000455260. Epub 2017 Feb 18.
45,X/46,XY mosaicism is a rare chromosomal abnormality and probably underdiagnosed. Although clinical and genetic analyses have been performed in some disorders of sexual development, there have been few studies focusing on the phenotype and genetic details of 45,X/46,XY mosaicism, especially in the Chinese population. The aim of this study was to describe the experience of our service in relation to 16 cases with 45,X/46,XY mosaicism. The age at the first evaluation of the patients ranged from 43 days to 30 years. Eight patients were reared as female and 8 as male. The main reasons for examination were primary amenorrhea, sterility, or ambiguous genitalia. Short stature was more common in female than in male patients. Two patients accepted gonadectomy due to tumor risk and none presented gonadal malignancy. The SRY gene was amplified positively in all of the patients. AZF gene microdeletions were present in 6 of 8 male patients, and all adult male patients had no sperm. No correlation has been found between clinical manifestations and the proportion of mosaic cells in peripheral blood. Our observations may permit a better management of people with 45,X/46,XY mosaicism.
45,X/46,XY嵌合体是一种罕见的染色体异常,可能存在诊断不足的情况。尽管已经对一些性发育障碍进行了临床和基因分析,但针对45,X/46,XY嵌合体的表型和基因细节的研究很少,尤其是在中国人群中。本研究的目的是描述我们对16例45,X/46,XY嵌合体患者的诊疗经验。患者首次评估时的年龄范围为43天至30岁。8例患者按女性抚养,8例按男性抚养。检查的主要原因是原发性闭经、不育或生殖器模糊。身材矮小在女性患者中比男性患者更常见。2例患者因肿瘤风险接受了性腺切除术,均未出现性腺恶性肿瘤。所有患者的SRY基因均呈阳性扩增。8例男性患者中有6例存在AZF基因微缺失,所有成年男性患者均无精子。未发现临床表现与外周血中嵌合细胞比例之间存在相关性。我们的观察结果可能有助于更好地管理45,X/46,XY嵌合体患者。