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羊膜穿刺术时发现胎儿为嵌合型 46,XY,der(15)t(6;15)(q25.1;p12)/46,XY,该妊娠结局良好,伴有不平衡易位的非整倍体细胞系在产后减少。

Mosaic 46,XY,der(15)t(6;15)(q25.1;p12)/46,XY at amniocentesis in a pregnancy associated with a favorable fetal outcome and postnatal decrease of the aneuploid cell line with the unbalanced translocation.

机构信息

Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan; Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan; School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan; Institute of Clinical and Community Health Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Obstetrics and Gynecology, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Medical Laboratory Science and Biotechnology, College of Medical and Health Science, Asia University, Taichung, Taiwan.

Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan.

出版信息

Taiwan J Obstet Gynecol. 2023 Jan;62(1):142-147. doi: 10.1016/j.tjog.2022.01.013.

Abstract

OBJECTIVE

We present mosaic 46,XY,der(15)t(6;15)(q25.1;p12)/46,XY at amniocentesis in a pregnancy associated with a favorable fetal outcome and postnatal decrease of the aneuploid cell line with the unbalanced translocation.

CASE REPORT

A 34-year-old primigravid woman underwent amniocentesis at 17 weeks of gestation because of advanced maternal age. Amniocentesis revealed a karyotype of 46,XY,add(15)(p12)[17]/46,XY[5]. A second amniocentesis at 19 weeks of gestation revealed a karyotype of 46,XY,der(15)t(6;15)(q25.1;p12)[12]/46,XY[8], and array comparative genomic hybridization (aCGH) analysis on the DNA extracted from uncultured amniocytes revealed arr arr 6q25.1q27×2-3 with 40% mosaic level. She was referred for genetic counseling. Prenatal ultrasound and the parental karyotypes were normal. A third amniocentesis at 24 weeks of gestation revealed a karyotype of 46,XY,der(15)t(6;15)(q25.1;p12)[23]/46,XY[1], and in uncultured amniocytes, aCGH analysis revealed arr 6q25.1q27×2.5, interphase fluorescence in situ hybridization (FISH) revealed 51% mosaicism (51/100 cells) for partial trisomy 6q and quantitative fluorescence polymerase chain reaction (QF-PCR) analysis determined maternal origin of the aberrant chromosome and excluded uniparental disomy (UPD) 15 and UPD 6. A fourth amniocentesis at 27 weeks of gestation revealed a karyotype of 46,XY,der(15)t(6;15)(q25.1;p12)[21]/46,XY[5], and in uncultured amniocytes, aCGH analysis revealed arr 6q25.1q27×2.46, and interphase FISH revealed 35% mosaicism (35/100 cells) for partial trisomy 6q. At 39 weeks of gestation, a healthy 3028-g male baby was delivered without any phenotypic abnormality. The karyotypes of cord blood, umbilical cord and placenta were 46,XY,der(15)t(6;15)(q25.1;p12)[2]/46,XY,der(15)t(6;15)(q25.1;p12)[29]/46,XY[11] and 46,XY, respectively. When follow-up at age one month, the neonate was phenotypically normal, the peripheral blood had a karyotype of 46,XY (40/40 cells), and FISH analysis on 105 buccal mucosal cells detected five cells with partial trisomy 6q compared with 2% mosaicism (2/100 cells) in the normal control.

CONCLUSION

Mosaicism for an unbalanced translocation with a normal cell line without UPD at amniocentesis can be a transient and benign condition, and can be associated with a favorable fetal outcome and postnatal decrease of the aneuploid cell line.

摘要

目的

我们在羊水穿刺中发现了一个嵌合体 46,XY,der(15)t(6;15)(q25.1;p12)/46,XY 病例,该病例与有利的胎儿结局和随后的非整倍体细胞系减少相关,且伴有不平衡易位。

病例报告

一位 34 岁的初产妇因高龄接受了 17 周的羊水穿刺。羊水穿刺显示核型为 46,XY,add(15)(p12)[17]/46,XY[5]。19 周时的第二次羊水穿刺显示核型为 46,XY,der(15)t(6;15)(q25.1;p12)[12]/46,XY[8],从未培养的羊水细胞中提取的 DNA 的 array 比较基因组杂交 (aCGH) 分析显示 arr arr 6q25.1q27×2-3,存在 40%嵌合体水平。她被转介进行遗传咨询。产前超声和父母的核型均正常。24 周时的第三次羊水穿刺显示核型为 46,XY,der(15)t(6;15)(q25.1;p12)[23]/46,XY[1],在未培养的羊水细胞中,aCGH 分析显示部分 6q 三体的嵌合体率为 6q25.1q27×2.5,间期荧光原位杂交 (FISH) 显示部分 6q 三体的嵌合体率为 51%(51/100 个细胞),定量荧光聚合酶链反应 (QF-PCR) 分析确定了异常染色体的母源来源,并排除了 15 号和 6 号单亲二体 (UPD)。27 周时的第四次羊水穿刺显示核型为 46,XY,der(15)t(6;15)(q25.1;p12)[21]/46,XY[5],在未培养的羊水细胞中,aCGH 分析显示部分 6q 三体的嵌合体率为 arr 6q25.1q27×2.46,间期 FISH 显示部分 6q 三体的嵌合体率为 35%(35/100 个细胞)。39 周时,一个 3028 克重的健康男婴出生,无任何表型异常。脐带血、脐带和胎盘的核型分别为 46,XY,der(15)t(6;15)(q25.1;p12)[2]/46,XY,der(15)t(6;15)(q25.1;p12)[29]/46,XY[11]和 46,XY。在一个月的随访时,新生儿表型正常,外周血核型为 46,XY(40/40 个细胞),105 个口腔黏膜细胞的 FISH 分析显示,与正常对照的 2%嵌合体(2/100 个细胞)相比,有 5 个细胞存在部分 6q 三体。

结论

在羊水穿刺中发现的具有正常细胞系的不平衡易位的嵌合体可能是一种短暂和良性的情况,并且可能与有利的胎儿结局和随后的非整倍体细胞系减少相关。

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