Prenatal Diagnostic Center, The Six Affiliated Hospital, Guangzhou Medical University or Qingyuan People's Hospital, Qingyuan, China.
J Clin Lab Anal. 2021 Nov;35(11):e23971. doi: 10.1002/jcla.23971. Epub 2021 Sep 27.
Corpus callosum abnormality (CCA) can lead to epilepsy, moderate severe neurologic or mental retardation. The prognosis of CCA is closely related to genetic etiology. However, copy number variations (CNVs) associated with fetal CCA are still limited and need to be further identified. Only a few scattered cases have been reported to diagnose CCA by whole exome sequencing (WES).
Karyotyping analysis, copy number variation sequencing (CNV-seq), chromosomal microarray analysis (CMA) and WES were parallelly performed for prenatal diagnosis of 19 CCA cases.
The total detection rate of karyotyping analysis, CMA (or CNV-seq) and WES were 15.79% (3/19), 21.05% (4/19) and 40.00% (2/5), respectively. Two cases (case 11 and case 15) were diagnosed as aneuploidy (47, XY, + 13 and 47, XX, + 21) by karyotyping analysis and CNV-seq. Karyotyping analysis revealed an unknown origin fragment (46,XY,add(13)(p11.2)) in case 3, which was further confirmed to originate from p13.3p11.2 of chromosome 17 by CNV-seq. CMA revealed arr1q43q44 (238923617-246964774) × 1(8.04 Mb) in case 8 with a negative result of chromosome karyotype. WES revealed that 2 of 5 cases with negative results of karyotyping and CNV-seq or CMA carried pathogenic genes ALDH7A1 and ARID1B.
Parallel genetic tests showed that CNV-seq and CMA are able to identify additional, clinically significant cytogenetic information of CCA compared to karyotyping; WES significantly improves the detection rate of genetic etiology of CCA. For the patients with a negative results of CNV-seq or CMA, further WES test is recommended.
胼胝体异常(CCA)可导致癫痫、中重度神经或智力障碍。CCA 的预后与遗传病因密切相关。然而,与胎儿 CCA 相关的拷贝数变异(CNVs)仍很有限,需要进一步确定。只有少数散在病例通过全外显子组测序(WES)诊断 CCA。
对 19 例 CCA 病例进行产前诊断,并行核型分析、拷贝数变异测序(CNV-seq)、染色体微阵列分析(CMA)和 WES。
核型分析、CMA(或 CNV-seq)和 WES 的总检出率分别为 15.79%(3/19)、21.05%(4/19)和 40.00%(2/5)。2 例(病例 11 和病例 15)通过核型分析和 CNV-seq 诊断为非整倍体(47,XY,+13 和 47,XX,+21)。核型分析显示病例 3 存在一个未知来源的片段(46,XY,add(13)(p11.2)),通过 CNV-seq 进一步证实该片段来源于 17 号染色体的 p13.3p11.2。CMA 显示病例 8 存在 arr1q43q44(238923617-246964774)×1(8.04 Mb),染色体核型检查结果为阴性。WES 显示 5 例核型和 CNV-seq 或 CMA 结果均为阴性的病例中,有 2 例携带致病性基因 ALDH7A1 和 ARID1B。
并行遗传学检测显示,与核型相比,CNV-seq 和 CMA 能够识别出 CCA 更多的、具有临床意义的细胞遗传学信息;WES 显著提高了 CCA 遗传病因的检出率。对于 CNV-seq 或 CMA 结果为阴性的患者,建议进一步进行 WES 检测。