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染色体核型分析和染色体微阵列分析在产前诊断中检测到的染色体嵌合体。

Chromosomal mosaicism detected by karyotyping and chromosomal microarray analysis in prenatal diagnosis.

机构信息

Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, China.

Department of Cardiology, Third Affiliated Hospital of Southern Medical University, Southern Medical University, Guangzhou, China.

出版信息

J Cell Mol Med. 2021 Jan;25(1):358-366. doi: 10.1111/jcmm.16080. Epub 2020 Nov 17.

Abstract

To investigate the incidence and clinical significance of chromosomal mosaicism (CM) in prenatal diagnosis by G-banding karyotyping and chromosomal microarray analysis (CMA). This is a single-centre retrospective study of invasive prenatal diagnosis for CM. From 5758 karyotyping results and 6066 CMA results, 104 foetal cases with CM were selected and analysed further. In total, 50% (52/104) of foetal cases with CM were affected by ultrasound-detectable phenotypes. Regardless of whether they were singleton or twin pregnancies, isolated structural defects in one system (51.35%, 19/37 in singletons; 86.67%, 13/15 in twins) and a single soft marker (18.92%, 7/37 in singletons; 13.33%, 2/15 in twins) were the most common ultrasound anomalies. Mosaic autosomal trisomy (19.23%, 20/104) was the most frequent type, and its rate was higher in phenotypic foetuses (28.85%, 15/52) than in non-phenotypic foetuses (9.62%, 5/52). There was no difference in mosaic fractions between phenotypic and non-phenotypic foetuses based on specimen sources or overall classification. Discordant mosaic results were observed in 16 cases (15.38%, 16/104) from different specimens or different testing methods. Genetic counselling and clinical management regarding CM in prenatal diagnosis remain challenging due to the variable phenotypes and unclear significance. Greater caution should be used in prenatal counselling, and more comprehensive assays involving serial ultrasound examinations, different specimens or testing methods verifications and follow-up should be applied.

摘要

为了研究 G 显带核型分析和染色体微阵列分析(CMA)在产前诊断中染色体嵌合体(CM)的发生率和临床意义。这是一项关于侵袭性产前诊断 CM 的单中心回顾性研究。从 5758 个核型结果和 6066 个 CMA 结果中,选择了 104 例 CM 胎儿病例进行进一步分析。共有 50%(52/104)的 CM 胎儿病例受超声可检测表型影响。无论单胎或双胎妊娠,孤立的单一系统结构缺陷(51.35%,37 例单胎中 19 例;86.67%,15 例双胎中 13 例)和单个软标记(18.92%,37 例单胎中 7 例;13.33%,15 例双胎中 2 例)是最常见的超声异常。CM 中最常见的类型是嵌合常染色体三体(19.23%,20/104),其在表型胎儿(28.85%,15/52)中的发生率高于非表型胎儿(9.62%,5/52)。根据标本来源或总体分类,表型和非表型胎儿的嵌合分数没有差异。在不同标本或不同检测方法中,有 16 例(15.38%,16/104)观察到不一致的嵌合体结果。由于表型多样且意义不明确,CM 产前诊断中的遗传咨询和临床管理仍然具有挑战性。在产前咨询中应更加谨慎,并应用更全面的检测方法,包括连续超声检查、不同标本或检测方法验证和随访。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d56/7810963/2de45632bb60/JCMM-25-358-g001.jpg

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