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多重连接依赖探针扩增联合桑格测序在21-羟化酶缺乏症中的诊断价值

[Diagnostic value of multiplex ligation dependent probe amplification combined with Sanger sequencing in 21-hydroxylase deficiency].

作者信息

Gao Y J, Yu B Q, Lu L, Tong A L, Chen S, Mao J F, Wang X, Wu X Y, Nie M

机构信息

Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Key Laboratory of Endocrinology, National Health Commission, Beijing 100730, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2019 Feb 12;99(6):432-437. doi: 10.3760/cma.j.issn.0376-2491.2019.06.010.

Abstract

To study the procedure of gene mutation detection in 21-hydroxylase deficiency (21-OHD) patients. The detail clinical and biochemical data of 51 patients with 21-OHD [18 males and 33 females, with an average age of (16.4±9.9) years] were collected between December 2016 and December 2017 at Department of Endocrinology, Peking Union Medical College Hospital. Multiplex ligation dependent probe amplification (MLPA) and Sanger sequencing of the gene were used to clarify the cause of 21-OHD. The genotype-phenotype correlation was also analyzed. The incidences of large deletion, 8 bp deletion, I2G, I172N and F306+T were 19.6% (20/102), 1.0% (1/102), 30.4% (31/102), 25.5% (26/102) and 1.0%(1/102), respectively, and the detection rate of gene mutation in 51 21-OHD patients was 77.5% (79/102) by MLPA test. Except large and 8 bp deletion, all above mutations contained in MLPA and other 8 mutations, including P31L, Q319X, R361L, R357W, V282L, R484Q, G425S and R342W were detected, and the detection rate was 79.4% (81/102) by Sanger sequencing of . MLPA combined with direct sequencing identified mutations in all patients. Genotype correlated well with clinical phenotype in 21-OHD patients. When MLPA or gene sequencing were used alone to diagnose the cause of 21-OHD, gene mutations in all patients could not be detected. The combination of the two methods can complement each other and fully clarify the underlying causes of 21-OHD.

摘要

研究21-羟化酶缺乏症(21-OHD)患者基因突变检测的方法。2016年12月至2017年12月期间,在北京协和医院内分泌科收集了51例21-OHD患者[18例男性和33例女性,平均年龄为(16.4±9.9)岁]的详细临床和生化数据。采用多重连接依赖探针扩增(MLPA)和该基因的桑格测序来明确21-OHD的病因,并分析基因型与表型的相关性。大片段缺失、8bp缺失、I2G、I172N和F306+T的发生率分别为19.6%(20/102)、1.0%(1/102)、30.4%(31/102)、25.5%(26/102)和1.0%(1/102),通过MLPA检测,51例21-OHD患者中基因突变的检出率为77.5%(79/102)。除大片段和8bp缺失外,MLPA检测还发现了上述所有突变以及其他8种突变,包括P31L、Q319X、R361L、R357W、V282L、R484Q、G425S和R342W,通过该基因的桑格测序,检出率为79.4%(81/102)。MLPA联合直接测序可检测出所有患者的突变。21-OHD患者的基因型与临床表型相关性良好。单独使用MLPA或基因测序诊断21-OHD病因时,无法检测出所有患者的基因突变。两种方法联合使用可相互补充,充分明确21-OHD的潜在病因。

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