Xie X, Zhao Q, Fu Y, Zhang W, Meng Y, Lu Y
Seventh Medical Center of Chinese PLA General Hospital, Department of Obstetrics and Gynecology, Beijing 100007, China.
First Medical Center of Chinese PLA General Hospital, Beijing 100853, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2022 Jul 20;42(7):1057-1061. doi: 10.12122/j.issn.1673-4254.2022.07.14.
Trisomy 11 mosaicism is clinically rare, for which making diagnostic and treatment decisions can be challenging. In this study, we used noninvasive prenatal testing, chromosome karyotype analysis, chromosome microarray analysis, copy number variation sequencing and fluorescence in situ hybridization for detecting trisomy 11 mosaicism in two cases and provided them with genetic counseling. In one of the cases, the fetus with confined placental mosaicism trisomy 11 presented with severe growth restriction and a placental mosaic level of 44%, and pregnancy was terminated at 25+3 weeks of gestation. In the other case with true low-level fetal mosaicism of trisomy 11, the pregnancy continued after exclusion of the possibility of uniparental disomy and structural abnormalities and careful prenatal counseling. The newborn was followed up for more than one year, and no abnormality was found. Noninvasive prenatal testing is capable of detecting chromosomal mosaicism but may cause missed diagnosis of true fetal mosaicism. For cases with positive noninvasive prenatal testing but a normal karyotype of the fetus, care should be taken in prenatal counseling and pregnancy management.
11号染色体嵌合体在临床上较为罕见,对此类情况做出诊断和治疗决策可能具有挑战性。在本研究中,我们使用无创产前检测、染色体核型分析、染色体微阵列分析、拷贝数变异测序和荧光原位杂交技术对两例11号染色体嵌合体进行检测,并为其提供遗传咨询服务。其中一例为局限于胎盘的11号染色体三体嵌合体胎儿,表现为严重生长受限,胎盘嵌合水平为44%,于妊娠25+3周时终止妊娠。另一例为真正的低水平胎儿11号染色体三体嵌合体,在排除单亲二体和结构异常可能性并经过仔细的产前咨询后继续妊娠。新生儿随访一年多,未发现异常。无创产前检测能够检测染色体嵌合体,但可能导致对真正胎儿嵌合体的漏诊。对于无创产前检测结果阳性但胎儿核型正常的病例,产前咨询和妊娠管理时应谨慎。