Laboratory for Reproductive Immunology, Hospital & Institute of Obstetrics and Gynecology, Shanghai Medical College, Fudan University.
Office of Clinical Epidemiology, Obstetrics and Gynecology Hospital of Fudan University.
Biosci Trends. 2018 Jul 17;12(3):317-324. doi: 10.5582/bst.2018.01044. Epub 2018 Jun 28.
Noninvasive prenatal testing (NIPT) is increasingly recognized and utilized in the antenatal care field. In the current study, we aimed to evaluate the clinical application and compare test outcomes of two generations of currently used NIPT techniques for detecting fetal chromosome abnormalities in a high-risk prenatal population. A total of 7,252 pregnant women were included from twenty-one hospitals from January 2015 to September 2017. A maternal blood sample of each participant was collected for fetal DNA sequencing. Group I received a first generation NIPT sequencing technique to detect chromosome aneuploidies, and Group II received a second generation NIPT sequencing technique to detect subchromosome abnormalities. An abnormal NIPT result was reported in 0.90% (44/4,868) of the women in Group I and 2.68% (64/2,384) in Group II. In Group I, seventeen (17/37, 45.95%) women with suspected fetal aneuploidy received amniocentesis, which confirmed 100% (10/10) of positive trisomy 21 samples, 100% (1/1) of trisomy 18, 100% (1/1) of sex chromosome abnormality, 0% (0/2) of trisomy 16, 0% (0/2) of trisomy 13, and 0% (0/1) of trisomy 20 and 13. In Group II, aneuploidy accounted for 46.88% (30/64) of the abnormal results. Five underwent amniocentesis and three had an abnormal result, including two cases of trisomy 21 and one case of chromosome 5p deletion syndrome. Whereas one case of 46,XN,del(16q11.2-q22.3) and another case of 46,XN,dup(Xp22.31) were considered as normal. NIPT is a quick and reliable screening method for detecting fetal chromosome aneuploidies and subchromosome deletions/duplications. Challenges remain for the comprehensive clinical application of NIPT.
非侵入性产前检测(NIPT)在产前保健领域越来越受到认可和应用。在本研究中,我们旨在评估两种当前使用的 NIPT 技术在高危产前人群中检测胎儿染色体异常的临床应用,并比较它们的检测结果。共有 7252 名孕妇来自 2015 年 1 月至 2017 年 9 月的 21 家医院。每位参与者采集了一份母体外周血样进行胎儿 DNA 测序。第 I 组接受第一代 NIPT 测序技术检测染色体非整倍体,第 II 组接受第二代 NIPT 测序技术检测亚染色体异常。第 I 组中,4868 名女性中有 0.90%(44/4868)报告异常 NIPT 结果,第 II 组中,2384 名女性中有 2.68%(64/2384)报告异常 NIPT 结果。第 I 组中,17 名(17/37,45.95%)疑似胎儿非整倍体的女性接受了羊膜穿刺术,其中 100%(10/10)的唐氏综合征 21 阳性样本、100%(1/1)的 18 三体、100%(1/1)的性染色体异常、0%(0/2)的 16 三体、0%(0/2)的 13 三体和 0%(0/1)的 20 三体和 13 三体均得到确认。第 II 组中,异常结果的非整倍体占 46.88%(30/64)。其中 5 名接受了羊膜穿刺术,3 名结果异常,包括 2 例唐氏综合征 21 例和 1 例 5p 染色体缺失综合征。而 1 例 46,XN,del(16q11.2-q22.3)和另 1 例 46,XN,dup(Xp22.31)被认为正常。NIPT 是一种快速可靠的筛查方法,可用于检测胎儿染色体非整倍体和亚染色体缺失/重复。NIPT 的全面临床应用仍面临挑战。