Cai Meiying, Lin Min, Guo Nan, Fu Meimei, Xu Liangpu, Lin Na, Huang Hailong
Medical Genetic Diagnosis and Therapy Center, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fujian Medical University, Fuzhou, China.
Front Pediatr. 2022 Aug 10;10:910497. doi: 10.3389/fped.2022.910497. eCollection 2022.
Several studies have reported on the clinical phenotype of the 17q12 microduplication syndrome, a rare autosomal dominant genetic disorder, in children and adults, but few have reported on its prenatal diagnosis. This study analyzed the prenatal ultrasound phenotypes of the 17q12 microduplication syndrome to improve the understanding, diagnosis, and monitoring of this disease in fetuses.
A retrospective analysis of 8,200 pregnant women who had received an invasive antenatal diagnosis at tertiary referral hospitals between January 2016 and August 2021 was performed. Amniotic fluid or cord blood was sampled from the pregnant women for karyotyping and chromosome microarray analysis (CMA).
The CMA revealed microduplication in the 17q12 region of the genome in five fetuses, involving fragments of about 1.5-1.9 Mb. Five fetuses with the 17q12 microduplication syndrome had different prenatal ultrasound phenotypes, including duodenal obstruction (two fetuses); mild ventriculomegaly, dysplasia of the septum pellucidum, agenesis of the corpus callosum (one fetus); and a strong echo in the left ventricle only (one fetus). The ultrasound phenotype of one fetus was normal. Among the five fetuses with the 17q12 microduplication syndrome, the parents of three refused CNV segregation analysis, while CNV segregation analysis was performed for the remaining two fetuses to confirm whether the disorder was inherited maternally or paternally, with normal phenotypes. After genetic counseling, the parents of those two fetuses chose to terminate the pregnancy, while the parents of the three unverified fetuses continued the pregnancy, with normal follow-up after birth.
Although prenatal ultrasound phenotypes in fetuses with the 17q12 microduplication syndrome are highly variable, our study has highlighted the distinct association between duodenal obstruction and the 17q12 microduplication syndrome. Understanding the relationship between the pathogenesis of the 17q12 microduplication in prenatal ultrasound phenotypes and its long-term prognosis will contribute to better genetic counseling concerning the 17q12 microduplication syndrome, which is still a challenge.
多项研究报道了17q12微重复综合征(一种罕见的常染色体显性遗传病)在儿童和成人中的临床表型,但关于其产前诊断的报道较少。本研究分析了17q12微重复综合征的产前超声表型,以增进对胎儿期该疾病的认识、诊断和监测。
对2016年1月至2021年8月在三级转诊医院接受侵入性产前诊断的8200名孕妇进行回顾性分析。从孕妇采集羊水或脐带血进行核型分析和染色体微阵列分析(CMA)。
CMA显示5例胎儿基因组17q12区域存在微重复,涉及片段约1.5 - 1.9 Mb。5例17q12微重复综合征胎儿具有不同的产前超声表型,包括十二指肠梗阻(2例胎儿);轻度脑室扩大、透明隔发育异常、胼胝体发育不全(1例胎儿);仅左心室强回声(1例胎儿)。1例胎儿的超声表型正常。在5例17q12微重复综合征胎儿中,3例胎儿的父母拒绝进行拷贝数变异(CNV)分离分析,其余2例胎儿进行了CNV分离分析以确认疾病是母系还是父系遗传,表型正常。经过遗传咨询,这2例胎儿的父母选择终止妊娠,而3例未确诊胎儿的父母继续妊娠,出生后随访正常。
尽管17q12微重复综合征胎儿的产前超声表型高度可变,但我们的研究突出了十二指肠梗阻与17q12微重复综合征之间的明显关联。了解产前超声表型中17q12微重复的发病机制与其长期预后之间的关系,将有助于更好地对17q12微重复综合征进行遗传咨询,这仍然是一项挑战。