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胎儿-胎盘单位中的染色体镶嵌现象。

Chromosomal mosaicism in the fetoplacental unit.

作者信息

Grati Francesca Romana, Malvestiti Francesca, Branca Lara, Agrati Cristina, Maggi Federico, Simoni Giuseppe

机构信息

TOMA Advanced Biomedical Assays S.p.A., Via Francesco Ferrer 25/27, 21052, Busto Arsizio, Varese, Italy.

出版信息

Best Pract Res Clin Obstet Gynaecol. 2017 Jul;42:39-52. doi: 10.1016/j.bpobgyn.2017.02.004. Epub 2017 Feb 17.

Abstract

Cytogenetic prenatal diagnosis on chorionic villi (CV) can be complicated by the detection of "chromosomal mosaicism." This is one of the main issues of first-trimester cytogenetic prenatal diagnosis as it can involve different types of chromosomal abnormalities, and the prediction of the fetal involvement is challenging because the detected abnormal mosaic cell line is not necessarily extended to fetal tissues. In addition, because the cell-free fetal DNA that is targeted by the new technologies for fetal aneuploidy risk assessment is mainly derived from the CV cells, the same challenges related to chromosomal mosaicism can be transferred into this new clinical field. This review illustrates the phenomenon of fetoplacental mosaicism, the management of prenatal diagnosis cases complicated by the detection of such a biological phenomenon, and the implications of its presence for the management of high-risk cfDNA testing results for fetal aneuploidies.

摘要

绒毛膜绒毛(CV)的细胞遗传学产前诊断可能因检测到“染色体嵌合体”而变得复杂。这是孕早期细胞遗传学产前诊断的主要问题之一,因为它可能涉及不同类型的染色体异常,而且由于检测到的异常嵌合细胞系不一定会扩展到胎儿组织,预测胎儿是否受累具有挑战性。此外,由于用于胎儿非整倍体风险评估的新技术所针对的游离胎儿DNA主要来源于CV细胞,与染色体嵌合体相关的相同挑战也可能转移到这个新的临床领域。本综述阐述了胎儿-胎盘嵌合体现象、因检测到这种生物学现象而使产前诊断病例复杂化的处理方法,以及其存在对胎儿非整倍体高风险cfDNA检测结果处理的影响。

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