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16p11.2 微缺失的分子细胞遗传学特征与多种产前表型:4 例病例报告及文献复习。

Molecular cytogenetic characterization of 16p11.2 microdeletions with diverse prenatal phenotypes: Four cases report and literature review.

机构信息

Center for Reproductive Medicine and Center for Prenatal Diagnosis, First Hospital, Jilin University, Changchun, 130021, China; Jilin Engineering Research Center for Reproductive Medicine and Genetics, Jilin University, Changchun, 130021, China.

Center for Reproductive Medicine and Center for Prenatal Diagnosis, First Hospital, Jilin University, Changchun, 130021, China; Jilin Engineering Research Center for Reproductive Medicine and Genetics, Jilin University, Changchun, 130021, China.

出版信息

Taiwan J Obstet Gynecol. 2022 May;61(3):544-550. doi: 10.1016/j.tjog.2022.03.027.

Abstract

OBJECTIVE

Chromosome 16p11.2 deletions have been recognized as a genetic disorder with well-described postnatal phenotypes. However, the prenatal manifestations are atypical for lacking of enough evidence.

CASE REPORT

Four pregnant women underwent amniocentesis for cytogenetic analysis and chromosomal microarray analysis (CMA) because of various indications for prenatal diagnosis: prenatal ultrasound abnormalities (cases 1, 2 and 4) and the childbearing history of cerebral palsy child (case 3). No overlapping phenotypes were observed in cases 1, 2 and 4, which might indicate phenotypic diversities in prenatal phenotypes for 16p11.2 microdeletion. All four fetuses showed normal karyotypic results while CMA identified 0.303-0.916 Mb microdeletions of 16p11.2, encompassing BP2-BP3 and BP4-BP5 regions separately. According to the parental CMA verification, case 1 carried a maternal inherited duplication in the region of Xp22.33 and a de novo deletion in the region of Xp21.1. All parents opted for the termination of pregnancies based upon genetic counselling.

CONCLUSION

Our findings enriched the intrauterine phenotypic features of 16p11.2 microdeletions, which would be beneficial for genetic counselling in clinic. In addition, preimplantation genetic testing was recognized as a first-tier approach for such carriers if they intended to conceive again.

摘要

目的

16p11.2 号染色体缺失已被确认为一种具有明确的产后表型的遗传疾病。然而,由于缺乏足够的证据,产前表现是非典型的。

病例报告

由于产前诊断的各种指征,四名孕妇接受了羊膜穿刺术进行细胞遗传学分析和染色体微阵列分析(CMA):产前超声异常(病例 1、2 和 4)和脑瘫患儿的生育史(病例 3)。病例 1、2 和 4 中未观察到重叠的表型,这可能表明 16p11.2 微缺失的产前表型存在表型多样性。所有 4 例胎儿的核型结果均正常,而 CMA 则发现 16p11.2 存在 0.303-0.916 Mb 的微缺失,分别涵盖 BP2-BP3 和 BP4-BP5 区域。根据父母的 CMA 验证,病例 1 在 Xp22.33 区域携带母体遗传的重复,在 Xp21.1 区域携带新生的缺失。所有父母均在遗传咨询后选择终止妊娠。

结论

我们的发现丰富了 16p11.2 微缺失的宫内表型特征,这将有助于临床遗传咨询。此外,如果这些携带者打算再次怀孕,那么植入前基因检测被认为是首选方法。

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