Xu Ying, Li Yu, Song Tingting, Guo Fenfen, Zheng Jiao, Xu Hui, Yan Feng, Cheng Lu, Li Chunyan, Chen Biliang, Zhang Jianfang
Department of Obstetrics and Gynecology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
The State Key Laboratory of Cancer Biology, Department of Biopharmaceutics, School of Pharmacy, The Fourth Military Medical University, Xi'an, China.
J Clin Lab Anal. 2018 Sep;32(7):e22445. doi: 10.1002/jcla.22445. Epub 2018 Mar 31.
To offer 4-year clinical prenatal diagnosis experience of Duchenne muscular dystrophy (DMD).
Denaturing high-performance liquid chromatography (DHPLC) and Sanger sequencing were used for molecular diagnosis of 237 DMD families.
In the study, deletions, duplications, complex rearrangement and small mutations accounted for 47.3%, 8.4%, 1.7% and 42.6% of 237 families, respectively. Sixty-six different deletion patterns were identified in 112 families. Fourteen different duplication patterns were identified in 20 families and 4 complex rearrangements were identified. About 87.1% different small mutation patterns were identified, including 37.6% different nonsense mutation patterns, 24.8% different frameshift mutation patterns, 7.9% different missense mutation patterns, and 16.8% different splice site mutation patterns. There was no significant difference in the age of onset and mutation patterns (P > .05). The follow-up examinations revealed that the pregnancies of 14 cases were interrupted. Two cases were preterm births, 151 cases were delivered at term, 63 cases continued to pregnancy, and 7 cases were lost to follow-up.
DHPLC and Sanger sequencing technique are efficient, sensitive, and specific in screening for DMD gene mutations. And pre-pregnancy DMD gene examination is an important step to assess mutation type of family with suspected DMD and guides exactly prenatal diagnosis in high-risk families.
提供杜氏肌营养不良症(DMD)4年的临床产前诊断经验。
采用变性高效液相色谱(DHPLC)和桑格测序法对237个DMD家庭进行分子诊断。
本研究中,缺失、重复、复杂重排和小突变分别占237个家庭的47.3%、8.4%、1.7%和42.6%。在112个家庭中鉴定出66种不同的缺失模式。在20个家庭中鉴定出14种不同的重复模式,并鉴定出4种复杂重排。鉴定出约87.1%不同的小突变模式,包括37.6%不同的无义突变模式、24.8%不同的移码突变模式、7.9%不同的错义突变模式和16.8%不同的剪接位点突变模式。发病年龄与突变模式之间无显著差异(P>0.05)。随访检查显示,14例妊娠终止。2例早产,151例足月分娩,63例继续妊娠,7例失访。
DHPLC和桑格测序技术在筛查DMD基因突变方面高效、灵敏且特异。孕前DMD基因检测是评估疑似DMD家庭突变类型及准确指导高危家庭产前诊断的重要步骤。