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在一项结局良好的妊娠中,通过羊膜穿刺术对单一滋养细胞株系的 11 三体和 12 三体三体性进行镶嵌性产前诊断。

Prenatal diagnosis of mosaicism for double trisomies of trisomy 11 and trisomy 12 in a single colony at amniocentesis in a pregnancy with a favorable outcome.

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.

Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan.

出版信息

Taiwan J Obstet Gynecol. 2020 May;59(3):443-445. doi: 10.1016/j.tjog.2020.03.020.

Abstract

OBJECTIVE

We present prenatal diagnosis of mosaicism for double trisomies of trisomy 11 and trisomy 12 in a single colony at amniocentesis with a favorable outcome.

CASE REPORT

A 23-year-old woman underwent amniocentesis at 24 weeks of gestation because of congenital bowel dilation in the fetus. Amniocentesis revealed a karyotype of 48,XX,+11,+12[1]/46,XX[24]. In 25 colonies of cultured amniocytes, all five cells in one colony had the karyotype of 48,XX,+11,+12, while the rest 24 colonies had the karyotype of 46,XX. The parental karyotypes were normal. Repeat amniocentesis was performed at 26 weeks of gestation. Interphase fluorescence in situ hybridization (FISH), array comparative genomic hybridization (aCGH) and quantitative fluorescent polymerase chain reaction (QF-PCR) were applied on the uncultured amniocytes, and conventional cytogenetic analysis was applied on cultured amniocytes. Interphase FISH analysis showed no trisomy 11 signal and no trisomy 12 signal in 102 uncultured amniocytes. QF-PCR analysis excluded uniparental disomy (UPD) 11 and UPD 12. aCGH analysis showed no genomic imbalance. The cultured amniocytes at repeat amniocentesis had the karyotype of 46,XX in 13/13 colonies. At term, a healthy 3445-g female baby was delivered with no phenotypic abnormality except imperforate anus and a perianal fistula. The cord blood had a karyotype of 46,XX in 40/40 lymphocytes. Postnatal interphase FISH analysis of buccal cells and urinary cells revealed trisomies 11 and 12 signals in 11/111 (9.9%) buccal cells compared with 3% in normal control, and in 3/103 (2.9%) urinary cells compared with 0.98% in normal control.

CONCLUSION

Mosaicism for double trisomies of trisomy 11 and trisomy 12 in a single colony at amniocentesis without UPD 11 and UPD 12 can be associated with a favorable outcome.

摘要

目的

我们介绍了一例在羊膜穿刺术中单一细胞系中存在 11 三体和 12 三体双重嵌合体的产前诊断病例,且结局良好。

病例报告

一位 23 岁的女性因胎儿先天性肠扩张而在 24 周时接受羊膜穿刺术。羊膜穿刺术显示核型为 48,XX,+11,+12[1]/46,XX[24]。在培养的羊水细胞的 25 个细胞系中,一个细胞系的 5 个细胞核型为 48,XX,+11,+12,其余 24 个细胞系的核型为 46,XX。父母的核型正常。在妊娠 26 周时再次进行羊膜穿刺术。对未培养的羊水细胞进行间期荧光原位杂交(FISH)、比较基因组杂交微阵列(aCGH)和定量荧光聚合酶链反应(QF-PCR),并对培养的羊水细胞进行常规细胞遗传学分析。间期 FISH 分析显示 102 个未培养的羊水细胞中无 11 三体信号和 12 三体信号。QF-PCR 分析排除了 11 号和 12 号单亲二体(UPD)。aCGH 分析显示无基因组失衡。重复羊膜穿刺术获得的羊水细胞 13/13 个细胞系的核型为 46,XX。足月时,娩出一名 3445g 的健康女婴,除肛门闭锁和肛周瘘管外,无其他表型异常。脐带血 40/40 个淋巴细胞的核型为 46,XX。产后口腔细胞和尿液细胞的间期 FISH 分析显示,11/111(9.9%)口腔细胞中有 11 三体和 12 三体信号,而正常对照组为 3%;103 个尿液细胞中有 3/3(2.9%)尿液细胞中有 11 三体和 12 三体信号,而正常对照组为 0.98%。

结论

在羊膜穿刺术中单一细胞系中存在 11 三体和 12 三体双重嵌合体,且无 UPD11 和 UPD12,可与良好的结局相关。

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