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经羊膜穿刺术对脑室扩张和胼胝体发育不良胎儿进行嵌合体 trisomy 8 的产前诊断。

Prenatal diagnosis of mosaic trisomy 8 by amniocentesis in a fetus with ventriculomegaly and dysgenesis of the corpus callosum.

机构信息

Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan; Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan; Department of Biotechnology, Asia University, Taichung, Taiwan; School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan; Institute of Clinical and Community Health Nursing, National Yang-Ming University, Taipei, Taiwan; Department of Obstetrics and Gynecology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.

Four Seasons Women and Children Clinics, Taipei, Taiwan.

出版信息

Taiwan J Obstet Gynecol. 2020 Jan;59(1):127-129. doi: 10.1016/j.tjog.2019.11.020.

Abstract

OBJECTIVE

We present prenatal diagnosis of mosaic trisomy 8 by amniocentesis in a fetus with central nervous system abnormalities.

CASE REPORT

A 39-year-old woman was found to have fetal bilateral ventriculomegaly and enlargement of the third ventricle on prenatal ultrasound at 32 weeks of gestation. Fetal magnetic resonance imaging examination confirmed bilateral ventriculomegaly and dysgenesis of the corpus callosum. Amniocentesis was performed subsequently. Array comparative genomic hybridization (aCGH) analysis on the DNA extracted from uncultured amniotic cells revealed trisomy 8 mosaicism with a result of arr [GRCh37] (8) × 3[0.19], (X,Y) × 1. Conventional cytogenetic analysis on cultured amniocytes showed that among 108 cells in 12 colonies of three cultures, only one cell was abnormal with trisomy 8, trisomy 9 and monosomy 13, while the rest 107 cells had a normal karyotype. Repeat amniocentesis and cord blood sampling revealed a result of arr 8p23.3q24.3 (191,530-146,280,020) × 2.3 with a log ratio of 0.2 compatible with 20-30% mosaicism for trisomy 8 on the uncultured amniocytes, and a result of arr 8p23.3q24.3 (191,530-146,280,020) × 2.1 with a log ratio of 0.08 compatible with <10% mosaicism for trisomy 8 on the cord blood lymphocytes. Polymorphic DNA marker analysis excluded uniparental disomy 8. A malformed 2440-g dead fetus was delivered at 34 weeks of gestation with facial dysmorphism.

CONCLUSION

Cytogenetic discrepancy can occur between cultured and uncultured amniocytes in mosaic trisomy 8 at amniocentesis. aCGH analysis on uncultured amniocytes is useful for confirmation of mosaic trisomy 8 at amniocentesis. Fetuses with low-level mosaicism for trisomy 8 may prenatally present ventriculomegaly and dysgenesis of the corpus callosum.

摘要

目的

我们通过羊水穿刺对一名存在中枢神经系统异常的胎儿进行了嵌合体 trisomy 8 的产前诊断。

病例报告

一名 39 岁的女性在妊娠 32 周时的产前超声检查中发现胎儿双侧脑室扩大和第三脑室扩大。胎儿磁共振成像检查证实双侧脑室扩大和胼胝体发育不良。随后进行了羊水穿刺。从未培养的羊水细胞中提取的 DNA 的阵列比较基因组杂交(aCGH)分析显示 trisomy 8 嵌合体,结果为 arr [GRCh37](8)×3[0.19],(X,Y)×1。对培养的羊水细胞进行常规细胞遗传学分析显示,在三个培养物的 12 个培养物中,只有一个细胞异常,具有 trisomy 8、trisomy 9 和单体 13,而其余 107 个细胞具有正常核型。重复羊水穿刺和脐血取样显示结果为 arr 8p23.3q24.3(191,530-146,280,020)×2.3,对数比为 0.2,与未培养的羊水细胞中 trisomy 8 的 20-30%嵌合体相符,以及结果为 arr 8p23.3q24.3(191,530-146,280,020)×2.1,对数比为 0.08,与脐血淋巴细胞中 trisomy 8 的 <10%嵌合体相符。多态性 DNA 标记分析排除了 8 号单亲二体。一名 2440 克的畸形死胎在妊娠 34 周时分娩,面部畸形。

结论

在羊水穿刺的嵌合体 trisomy 8 中,培养和未培养的羊水细胞之间可能存在细胞遗传学差异。未培养羊水细胞的 aCGH 分析有助于确认羊水穿刺的嵌合体 trisomy 8。低水平嵌合体 trisomy 8 的胎儿可能在产前出现脑室扩大和胼胝体发育不良。

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