Zhu L F, Zhang H M, Mai L H, Sun X F, Liu W Q
Department of Obstetrics and Gynecology, Guangdong Provincal Key Laboratory of Major Obstetric Diseases, the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China.
Central Laboratory, Shenzhen Longgang District Maternity and Child Healthcare Hospital, Shenzhen 518172, China.
Zhonghua Fu Chan Ke Za Zhi. 2022 Apr 25;57(4):271-277. doi: 10.3760/cma.j.cn112141-20210820-00455.
To detect the incidence and analyze the clinical significance of regions of homozygosity (ROH) through the single nucleotide polymorphism array (SNP array). The SNP array detection results of 5 116 pregnant women in the Third Affiliated Hospital of Guangzhou Medical University from January 2016 to December 2020 were retrospectively analyzed. The pregnant women with ROH (5 Mb as the threshold) were followed up to analyze the relationship between ROH and abnormal fetal phenotype. Whole exon sequencing was performed in 4 cases of consanguineous marriage to detect potential recessive causative genes in the ROH region. (1) A total of 39 cases of ROH were detected, with a positive rate of 0.76% (39/5 116). Among them, 25 cases (64%, 25/39) were detected only on single chromosome, and chromosome 11 had the highest detection rate, suggesting the risk of uniparental disomy; fourteen cases (36%,14/39) were detected on multiple chromosomes, most commonly on chromosomes 11, 1, 3, 4 and 8. (2) The number of cases and detection rate of ROH detected by different prenatal diagnosis indicators were as follows: 12 cases (1.78%, 12/676) in pregnant women with abnormal non-invasive prenatal testing result, 12 cases (0.37%, 12/3 284) in pregnant women with ultrasound abnormality, 4 cases (4/4) in pregnant women with consanguineous marriage, 3 cases (0.92%, 3/326) in pregnant women with previous adverse pregnancy, 2 cases (1.15%, 2/174) in pregnant women with high risk of serology in screening, 2 cases (4.00%, 2/50) in pregnant women with abnormal fetal chromosomal karyotype, 2 cases (0.79%, 2/253) in pregnant women with advanced maternal age, 1 case (0.56%, 1/178) in pregnant women with related parental genetic factors and 1 case (0.58%, 1/171) in pregnant women with the other factors. (3) The follow-up results of 39 cases of prenatal ROH showed that there were 16 cases of term birth, 15 cases of termination of pregnancy, 2 cases of preterm births, 1 case of fetal death and 5 cases lost to follow-up. Chromosomal ROH phenomenon is not rare. By analyzing the detection rate of ROH in prenatal diagnosis, combined with the results of fetal phenotype and postpartum follow-up, the clinical characteristics of ROH are discussed, so as to better understand the relationship between ROH and its phenotype.
通过单核苷酸多态性阵列(SNP阵列)检测纯合子区域(ROH)的发生率并分析其临床意义。回顾性分析2016年1月至2020年12月在广州医科大学附属第三医院就诊的5116例孕妇的SNP阵列检测结果。对存在ROH(以5 Mb为阈值)的孕妇进行随访,分析ROH与胎儿异常表型之间的关系。对4例近亲结婚病例进行全外显子测序,以检测ROH区域潜在的隐性致病基因。(1)共检测到39例ROH,阳性率为0.76%(39/5116)。其中,25例(64%,25/39)仅在单条染色体上检测到,11号染色体的检测率最高,提示单亲二体的风险;14例(36%,14/39)在多条染色体上检测到,最常见于11、1、3、4和8号染色体。(2)不同产前诊断指标检测到的ROH病例数及检测率如下:无创产前检测结果异常的孕妇中有12例(1.78%,12/676),超声异常的孕妇中有12例(0.37%,12/3284),近亲结婚的孕妇中有4例(4/4),既往有不良妊娠史的孕妇中有3例(0.92%,3/326),筛查时血清学高危的孕妇中有2例(1.15%,2/174),胎儿染色体核型异常的孕妇中有2例(4.00%,2/50),高龄孕妇中有2例(0.79%,2/253),有相关父母遗传因素的孕妇中有1例(0.56%,1/178),有其他因素的孕妇中有1例(0.58%,1/171)。(3)39例产前ROH的随访结果显示,足月分娩16例,终止妊娠15例,早产2例,胎儿死亡1例,失访5例。染色体ROH现象并不罕见。通过分析产前诊断中ROH的检测率,结合胎儿表型及产后随访结果,探讨ROH的临床特征,以更好地了解ROH与其表型之间的关系。