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[孤立性胼胝体异常胎儿的产前基因诊断]

[Prenatal genetic diagnosis of the fetuses with isolated corpus callosum abnormality].

作者信息

She Q, Zhen L, Fu F, Lei T Y, Li L S, Li R, Wang D, Zhang Y L, Jing X Y, Yi C X, Zhong H Z, Tan W H, Li F G, Liao C

机构信息

Prenatal Diagnostic Center,the Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People's Hospital, Qingyuan 511518, China.

Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou 510623, China.

出版信息

Zhonghua Fu Chan Ke Za Zhi. 2022 Sep 25;57(9):671-677. doi: 10.3760/cma.j.cn112141-20220428-00281.

Abstract

To explore the application value of chromosome karyotype analysis, chromosomal microarray analysis (CMA) and whole exome sequencing (WES) in prenatal diagnosis of isolated corpus callosum abnormality (CCA) fetus. Fetuses diagnosed with isolated CCA by ultrasound and MRI and receiving invasive prenatal diagnosis in Guangzhou Women and Children's Medical Center and Qingyuan People's Hospital from January 2010 to April 2021 were selected. Karyotype analysis and/or CMA [or copy number variation sequencing (CNV-seq)] were performed on all fetal samples, and WES was performed on fetal samples and their parents whose karyotype analysis and/or CMA (or CNV-seq) results were not abnormal. Among 65 fetuses with isolated CCA, 38 cases underwent karyotype analysis, and 3 cases were detected with abnormal karyotypes, with a detection rate of 8% (3/38). A total of 49 fetuses with isolated CCA underwent CMA (or CNV-seq) detection, and 6 cases of pathogenic CNV were detected, the detection rate was 12% (6/49). Among them, the karyotype analysis results were abnormal, and the detection rate of further CMA detection was 1/1. The karyotype results were normal, and the detection rate of further CMA (or CNV-seq) detection was 14% (3/21). The detection rate of CMA as the first-line detection technique was 7% (2/27). A total of 25 fetuses with isolated CCA with negative results of karyotyping and/or CMA were tested by WES, and 9 cases (36%, 9/25) were detected with pathogenic genes. The gradient genetic diagnosis of chromosomal karyotyping, CMA and WES resulted in a definite genetic diagnosis of 26% (17/65) of isolated CCA fetuses. Prenatal genetic diagnosis of isolated CCA fetuses is of great clinical significance. The detection rate of CMA is higher than that of traditional karyotyping. CMA detection could be used as a first-line detection technique for fetuses with isolated CCA. WES could increase the pathogenicity detection rate of fetuses with isolated CCA when karyotype analysis and/or CMA test results are negative.

摘要

探讨染色体核型分析、染色体微阵列分析(CMA)及全外显子测序(WES)在孤立性胼胝体发育异常(CCA)胎儿产前诊断中的应用价值。选取2010年1月至2021年4月期间在广州市妇女儿童医疗中心及清远市人民医院经超声及磁共振成像诊断为孤立性CCA并接受侵入性产前诊断的胎儿。对所有胎儿样本进行核型分析和/或CMA[或拷贝数变异测序(CNV-seq)],对核型分析和/或CMA(或CNV-seq)结果无异常的胎儿样本及其父母进行WES检测。在65例孤立性CCA胎儿中,38例行核型分析,3例核型异常,检出率为8%(3/38)。共49例孤立性CCA胎儿行CMA(或CNV-seq)检测,检出6例致病性CNV,检出率为12%(6/49)。其中,核型分析结果异常,进一步CMA检测的检出率为1/1。核型结果正常,进一步CMA(或CNV-seq)检测的检出率为14%(3/21)。CMA作为一线检测技术的检出率为7%(2/27)。共25例核型分析和/或CMA结果为阴性的孤立性CCA胎儿行WES检测,9例(36%,9/25)检出致病基因。染色体核型分析、CMA及WES的梯度基因诊断使26%(17/65)的孤立性CCA胎儿得到明确的基因诊断。孤立性CCA胎儿的产前基因诊断具有重要临床意义。CMA的检出率高于传统核型分析。CMA检测可作为孤立性CCA胎儿的一线检测技术。当核型分析和/或CMA检测结果为阴性时,WES可提高孤立性CCA胎儿的致病基因检出率。

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