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无创性产前检测在性染色体非整倍体检测中的应用:中国徐州地区的一项大规模研究。

Non-invasive prenatal testing in detecting sex chromosome aneuploidy: A large-scale study in Xuzhou area of China.

机构信息

Center for Genetic Medicine, Xuzhou Maternity and Child Health Care Hospital, Xuzhou, Jiangsu, China.

Department of Pharmacy, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.

出版信息

Clin Chim Acta. 2018 Jun;481:139-141. doi: 10.1016/j.cca.2018.03.007. Epub 2018 Mar 12.

Abstract

BACKGROUND

Cell-free fetal DNA are widely used in the prenatal genetic testing during recent years. In the present study, we tried to investigate the clinical practical feasibility of non-invasive prenatal testing (NIPT) for prenatal sex chromosome aneuploidy (SCA) analysis among pregnancies in Xuzhou area of China.

METHODS

Among a cohort of 8384 pregnancies, maternal plasma samples from our prenatal diagnosis center was subject to the analysis for SCA using NIPT detection. The cases with positive screening results by NIPT detection were validated on karyotyping analysis.

RESULTS

From 8384 clinical pregnancies, 64 cases exhibited abnormal results detected by NIPT, in which 34 cases were false positive verified by amniotic fluid puncture and chromosome karyotyping analysis. Twelve positive Turner syndrome (monosomy X) cases in NIPT was confirmed to be sex chromosome abnormal by karyotyping analysis, in which included 9 cases of monosomy X, 1 case of mosaic (45X/47XXX), and 2 cases of mosaic with 45X/45XY karyotype. Of those 9 cases with 47XXX, 5 cases were found to be true positive. Among the ten cases of Klinefelter's syndrome (47XXY) indicated by NIPT, 6 cases (60%) were true positive. Lastly, NIPT indicated 47XYY in 9 cases. Karyotyping analysis found six cases were 47XYY, and one case was mosaic (46XY/47XYY).

CONCLUSION

Our findings showed that the true positive rate for monosomy X was lower by NIPT detection, while prediction of other SCA was relatively accurate. Therefore, NIPT could be a potential method for SCA screening, while this technique needed to be further investigated.

摘要

背景

近年来,游离胎儿 DNA 广泛应用于产前遗传学检测。本研究旨在探讨非侵入性产前检测(NIPT)在徐州地区产前性染色体非整倍体(SCA)分析中的临床实用可行性。

方法

在 8384 例妊娠队列中,对我院产前诊断中心的母体外周血样本进行 SCA 的 NIPT 分析。对 NIPT 检测阳性的病例进行核型分析验证。

结果

在 8384 例临床妊娠中,64 例 NIPT 检测结果异常,其中 34 例经羊水穿刺和染色体核型分析证实为假阳性。12 例 NIPT 阳性的特纳综合征(单体 X)病例经核型分析证实为性染色体异常,其中包括 9 例单体 X、1 例嵌合体(45X/47XXX)和 2 例嵌合体伴 45X/45XY 核型。在 9 例 47XXX 中,5 例为真阳性。10 例 NIPT 提示的克氏综合征(47XXY)中,6 例(60%)为真阳性。最后,NIPT 提示 9 例 47XYY。核型分析发现 6 例为 47XYY,1 例为嵌合体(46XY/47XYY)。

结论

本研究结果表明,NIPT 检测单体 X 的真阳性率较低,而其他 SCA 的预测相对准确。因此,NIPT 可能是一种潜在的 SCA 筛查方法,但需要进一步研究。

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