Hu Rui, Zhang Zhu, Wang Jia-Min, Li Qin-Qin, Yang Yun-Yuan, Xiao Li-Ke, Zhu Hong-Mei, Li Ling-Ping, Zhang Li-Li, Liu Shan-Ling, Wang He, Hu Ting
Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu 610041, China.
Key Laboratory of Birth Defects and Related Women and Children Diseases of the Ministry of Education (Sichuan University), Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2021 Jan;52(1):117-123. doi: 10.12182/20210160601.
To evaluate the clinical application of array-based comparative genomic hybridization (a-CGH) in the prenatal diagnosis of fetal chromosomal aberrations in gravidas with advanced maternal age (AMA).
A total of 3 677 amniotic fluid samples from pregnant women who underwent amniocentesis for prenatal diagnosis solely due to AMA were selected. Array-CGH was performed on the Agilent CGX (8X60K) platform and the data were analyzed by the Genoglyphix software.
The overall detection rate of chromosomal aberration was 2.04% (75/3677), with 53.33% (40/75) being aneuploidies, including 22 cases of trisomy-21, 5 cases of trisomy-18, 8 cases with XXY, 3 cases of XYY and 2 cases of mosaic monosomy X, 32.00% (24/75) being pathogenic copy number variations (pCNVs), including 19 cases of microdeletion and 5 cases of microduplication, with the fragment size ranging from 323 kb to 26 780 kb, and 14.67% (11/75) being likely pathogenic CNVs (lpCNVs), including 7 cases of microdeletion and 7 cases of microduplication, with the fragment size ranging from 358 kb to 16 873 kb. Besides, the detection rate of CNVs of unknown clinical significance (VUS) was 0.84% (31/3 677). The detection rate of aneuploidies increased significantly with increased maternal age ( <0.05). However, there were no significant differences in the detection rate of p/lpCNVs among different maternal age groups ( >0.05).
Our findings suggest that, compared with traditional karyotype analysis, a-CGH not only detects aneuploidies, but also detect pathogenic CNVs, including microdeletion/microduplication syndromes. The detection rate of fetal aneuploidies was closely correlated to maternal age. However, no correlation was found between the detection rate of p/lpCNVs and maternal age.
评估基于芯片的比较基因组杂交技术(a-CGH)在高龄孕妇(AMA)胎儿染色体畸变产前诊断中的临床应用。
选取3677例因高龄仅接受羊膜腔穿刺术进行产前诊断的孕妇羊水样本。在安捷伦CGX(8X60K)平台上进行芯片比较基因组杂交,并使用Genoglyphix软件分析数据。
染色体畸变的总体检出率为2.04%(75/3677),其中53.33%(40/75)为非整倍体,包括22例21-三体、5例18-三体、8例XXY、3例XYY和2例嵌合型X单体;32.00%(24/75)为致病性拷贝数变异(pCNV),包括19例微缺失和5例微重复,片段大小从323 kb到26780 kb;14.67%(11/75)为可能致病性拷贝数变异(lpCNV),包括7例微缺失和7例微重复,片段大小从358 kb到16873 kb。此外,临床意义未明的拷贝数变异(VUS)检出率为0.84%(31/3677)。非整倍体的检出率随孕妇年龄增加而显著升高(<0.05)。然而,不同孕妇年龄组中p/lpCNV的检出率无显著差异(>0.05)。
我们的研究结果表明,与传统核型分析相比,a-CGH不仅能检测非整倍体,还能检测致病性CNV,包括微缺失/微重复综合征。胎儿非整倍体的检出率与孕妇年龄密切相关。然而,未发现p/lpCNV的检出率与孕妇年龄之间存在相关性。