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在患有生育问题的成年女性中检测到的源自14号/22号染色体的小额外标记染色体的分子特征:三例病例报告及文献综述

Molecular characterization of small supernumerary marker chromosomes derived from chromosome 14/22 detected in adult women with fertility problems: Three case reports and literature review.

作者信息

Sun Meiling, Zhang Han, Xi Qi, Li Leilei, Hu Xiaonan, Zhang Hongguo, Liu Ruizhi

机构信息

Center for Reproductive Medicine and Center for Prenatal Diagnosis, First Hospital.

Jilin Engineering Research Center for Reproductive Medicine and Genetics, Jilin University, Changchun, Jilin, P.R. China.

出版信息

Medicine (Baltimore). 2020 Oct 2;99(40):e22532. doi: 10.1097/MD.0000000000022532.

Abstract

RATIONALE

Small supernumerary marker chromosomes (sSMC) are structurally abnormal chromosomes, which can be detected in patients with developmental retardation, infertile problems, and prenatal fetus. We report 3 adult female with fertility problems carrying sSMC(14/22) and aim to explore the correlation between sSMC(14/22) and fertility problems in women.

PATIENT CONCERNS

Three Chinese female patients were referred for infertility consultation in our hospital.

DIAGNOSES

The karyotype of these 3 patients were 47, XX, +mar. The chromosome microarray analysis (CMA) detected various chromosomal duplications and deletions in the 3 cases: a 0.49Mb gain of 5q32 for case 1; a 0.54Mb gain of 14q32.33 and a 1.83Mb gain of 16p11.2 for case 2; a 0.37Mb loss of 13q21.2q21.31 and a 0.12Mb gain of Xp11.2 for case 3. Fluorescence in situ hybridization (FISH) using the specific probes for chromosomes 13/21, 14/22, and 15 was applied to identify the origination of these sSMC, which were all finally identified as sSMC(14/22).

INTERVENTIONS

Case 1 underwent the artificial reproductive technology to get her offspring and finally delivered a healthy male infant at 39 weeks. Case 2 did not plan to choose in vitro fertilization (IVF) to get offspring. Case 3 refused to do assisted reproductive technology.

OUTCOMES

The genotype-phenotype correlation of sSMC(14/22) remain unclear. However, the existence of sSMC(14/22) might negatively affect the fertility ability in sSMC female carriers.

LESSONS

The combined application of traditional banding technique and molecular cytogenetic techniques can better identify more details of sSMC. For sSMC carriers with fertility problems, they could get their offsprings through assisted reproductive technologies after comprehensive fertility assessment.

摘要

原理

小额外标记染色体(sSMC)是结构异常的染色体,可在发育迟缓、不孕问题患者及产前胎儿中检测到。我们报告了3例携带sSMC(14/22)的成年女性生育问题患者,旨在探讨sSMC(14/22)与女性生育问题之间的相关性。

患者情况

3名中国女性患者因不孕问题前来我院咨询。

诊断

这3例患者的核型均为47, XX, +mar。染色体微阵列分析(CMA)在3例中检测到各种染色体重复和缺失:病例1为5q32区域0.49Mb增益;病例2为14q32.33区域0.54Mb增益和16p11.2区域1.83Mb增益;病例3为13q21.2q21.31区域0.37Mb缺失和Xp11.2区域0.12Mb增益。使用针对13/21、14/22和15号染色体的特异性探针进行荧光原位杂交(FISH)以确定这些sSMC的起源,最终均鉴定为sSMC(14/22)。

干预措施

病例1接受了辅助生殖技术以获得后代,最终在39周时产下一名健康男婴。病例2未计划选择体外受精(IVF)来获得后代。病例3拒绝进行辅助生殖技术。

结果

sSMC(14/22)的基因型-表型相关性仍不清楚。然而,sSMC(14/22)的存在可能会对sSMC女性携带者的生育能力产生负面影响。

经验教训

传统显带技术和分子细胞遗传学技术的联合应用可以更好地识别sSMC的更多细节。对于有生育问题的sSMC携带者,在进行全面的生育评估后,他们可以通过辅助生殖技术获得后代。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0185/7535553/22ac6c8c36ad/medi-99-e22532-g002.jpg

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