Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, 100026, China.
Department of Ultrasound, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, 100026, China.
Diagn Pathol. 2019 Jul 13;14(1):76. doi: 10.1186/s13000-019-0853-x.
BACKGROUND: This study aims to provide genetic diagnoses for 30 cases of fetal skeletal dysplasia, and a molecular basis for the future prenatal diagnosis of fetal skeletal dysplasia. METHODS: A total of 30 cases of fetal skeletal dysplasia detected with ultrasound between January 2014 and June 2017 were analyzed. Among these fetuses, 15 fetuses had local skeletal malformations, while 15 fetuses had short limb malformations. Samples of fetal umbilical cord blood, amniotic fluid, and/or aborted tissue were collected from all cases. Karyotyping, whole genome sequencing, and targeted next-generation sequencing of skeletal disease-related pathogenic genes were performed, as needed. Blood samples were taken from the parents for verification using Sanger sequencing. RESULTS: Among the 30 cases of fetal skeletal dysplasia, two cases were diagnosed with trisomy 18. However, none of these cases were identified with any microdeletions or microreplications associated with skeletal dysplasia. Among the 28 chromosomally normal cases with fetal skeletal dysplasia, 21 cases were detected with mutations in genes related to skeletal diseases. Furthermore, collagen gene mutations were detected in six fetuses with short limb malformations, while heterozygous disease-causing mutations in the fibroblast growth factor receptor 3 (FGFR3) gene were detected in seven fetuses. The remaining fetuses carried mutations in other various genes, including tumor protein p63 (TP63), cholestenol delta-isomerase (EBP), cholinergic receptor nicotinic gamma subunit (CHRNG), filamin B (FLNB), and SRY-box 9 (SOX9). Three compound heterozygous mutations in CHRNG, COL11A2 and SOX9 were carried by phenotypically healthy parents. CONCLUSION: Targeted next-generation sequencing can significantly improve the prenatal diagnoses of fetal skeletal dysplasia, providing parents with more precision medicine, and improved genetic counseling.
背景:本研究旨在为 30 例胎儿骨骼发育不良病例提供基因诊断,并为未来胎儿骨骼发育不良的产前诊断提供分子基础。
方法:分析 2014 年 1 月至 2017 年 6 月期间经超声检查发现的 30 例胎儿骨骼发育不良病例。其中 15 例胎儿存在局部骨骼畸形,15 例胎儿存在短肢畸形。所有病例均采集胎儿脐静脉血、羊水和/或流产组织样本,根据需要进行核型分析、全基因组测序和骨骼疾病相关致病基因的靶向下一代测序。采集父母的血样进行 Sanger 测序验证。
结果:30 例胎儿骨骼发育不良中,2 例诊断为 18 三体。然而,这些病例均未发现与骨骼发育不良相关的微缺失或微重复。28 例染色体正常的胎儿骨骼发育不良中,21 例检测到与骨骼疾病相关的基因发生突变。此外,6 例短肢畸形胎儿检测到胶原基因突变,7 例胎儿检测到成纤维细胞生长因子受体 3(FGFR3)基因突变。其余胎儿携带其他各种基因的突变,包括肿瘤蛋白 p63(TP63)、胆固醇 delta-异构酶(EBP)、胆碱能受体烟碱γ亚基(CHRNG)、细丝蛋白 B(FLNB)和性决定区 Y 框 9(SOX9)。表型正常的父母携带 CHRNG、COL11A2 和 SOX9 的三个复合杂合突变。
结论:靶向下一代测序可显著提高胎儿骨骼发育不良的产前诊断水平,为父母提供更精准的医学治疗和遗传咨询。
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