Yamada Hikari, Shimura Masaru, Takahashi Hidekuni, Nara Shonosuke, Morishima Yasuyuki, Go Soken, Miyashita Toshiyuki, Numabe Hironao, Kawashima Hisashi
Department of Pediatrics, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, Ami-machi, Inashiki-gun, Ibaraki, 300-0395, Japan.
Department of Pediatrics, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, Ami-machi, Inashiki-gun, Ibaraki, 300-0395, Japan.
Eur J Med Genet. 2020 May;63(5):103872. doi: 10.1016/j.ejmg.2020.103872. Epub 2020 Feb 3.
Microdeletions in the 9q22.3 chromosomal region can cause macrosomia with characteristic features, including prenatal-onset overgrowth, metopic craniosynostosis, hydrocephalus, developmental delay, and intellectual disability, in addition to manifestations of nevoid basal cell carcinoma syndrome (NBCCS). Haploinsufficiency of PTCH1 may be responsible for accelerated overgrowth, but the mechanism of macrosomia remains to be elucidated. We report a familial case with a 9q22.3 microdeletion, manifesting with prenatal-onset overgrowth in a mother and post-natal overgrowth in her daughter. Although both were clinically diagnosed with NBCCS, they had characteristic features of 9q22.3 microdeletion, especially the daughter. Microarray comparative genomic hybridization analysis revealed a 4.0 Mb deletion of chromosome 9q22.3 in both individuals. Among the 11 reported patients of overgrowth and/or macrosomia, a 550 Kb region encompassing PTCH1, C9orf3, FANCC, and 5 miRNAs is the most commonly deleted region. The let-7 family miRNAs, which are involved in diverse cellular processes including growth and tumor processes, were identified in the deleted regions in 10 of 11 patients. Characteristic features of 9q22.3 microdeletion might be associated with decreased expression of let-7.
9q22.3染色体区域的微缺失可导致巨大儿并伴有特征性表现,包括产前开始的过度生长、额缝早闭、脑积水、发育迟缓及智力残疾,此外还有痣样基底细胞癌综合征(NBCCS)的表现。PTCH1单倍体不足可能是加速过度生长的原因,但巨大儿的发病机制仍有待阐明。我们报告了1例9q22.3微缺失的家族性病例,母亲表现为产前开始的过度生长,女儿表现为产后过度生长。尽管两人临床均诊断为NBCCS,但她们具有9q22.3微缺失的特征性表现,尤其是女儿。微阵列比较基因组杂交分析显示两人均存在9q22.3染色体4.0 Mb的缺失。在11例报告的过度生长和/或巨大儿患者中,包含PTCH1、C9orf3、FANCC和5个微小RNA的550 Kb区域是最常缺失的区域。在11例患者中的10例的缺失区域发现了参与包括生长和肿瘤进程等多种细胞进程的let-7家族微小RNA。9q22.3微缺失的特征性表现可能与let-7表达降低有关。