Wei Youhua, Wang Rui, Xi Meixia, Wei Li, Zhu Wenjuan, Liu Yan
Medical Genetics and Prenatal Screening Department, Maternity and Child Health Care Hospital of Zaozhuang, Zaozhuang, Shandong 277100, China.
Zhonghua Yi Xue Yi Chuan Xue Za Zhi. 2023 Aug 10;40(8):933-938. doi: 10.3760/cma.j.cn511374-20220815-00545.
To assess the value of non-invasive prenatal testing (NIPT) for trisomy 21 (T21), trisomy 18 (T18), trisomy 13 (T13), sex chromosome aneuploidies, chromosomal microdeletions and microduplications using cell-free fetal DNA from peripheral blood samples of pregnant women.
A total of 15 237 pregnant women who had undergone NIPT testing at the Maternity and Child Health Care Hospital of Zaozhuang from February 2015 to December 2021 were enrolled in this study. For those with a high risk by NIPT, amniotic fluid samples were collected for G-banding chromosomal karyotyping analysis and chromosomal microarray analysis to verify the consistency of NIPT with results of prenatal diagnosis. All of the women were followed up by telephone for pregnancy outcomes.
Among the 15 237 pregnant women, 266 (1.75%) were detected with a high risk for fetal chromosomal abnormality were detected. Among these, 79 (29.7%) were at a high risk for T21, 26 (9.77%) were at a high risk for T18, 9 (3.38%) were at a high risk for T13, 74 (27.82%) were at a high risk for sex chromosome aneuploidies, 12 (4.51%) were at a high risk for other autosomal aneuploidies, and 66 (24.81%) were at a high risk for chromosomal microdeletions or microduplications. 217 women had accepted invasive prenatal diagnosis and respectively 50, 13, 1, 25, 1 and 18 were confirmed with T21, T18, T13, sex chromosome aneuploidies, autosomal aneuploidies and microdeletions/microduplications, and the positive predictive values were 75.76%, 68.42%, 11.11%, 40.32%, 10% and 35.29%, respectively. For 13 042 women (85.59%), the outcome of pregnancy were successfully followed up. During the follow-up, one false negative case of T21 was discovered. No false positive cases for T13 and T18 were found.
NIPT has a sound performance for screening T13, T18 and T21, and is also valuable for screening other autosomal aneuploidies, sex chromosome aneuploidies and chromosomal microdeletions/microduplications.
利用孕妇外周血样本中的游离胎儿DNA评估无创产前检测(NIPT)对21三体(T21)、18三体(T18)、13三体(T13)、性染色体非整倍体、染色体微缺失和微重复的检测价值。
选取2015年2月至2021年12月在枣庄市妇幼保健院接受NIPT检测的15237例孕妇纳入本研究。对NIPT检测为高风险的孕妇,采集羊水样本进行G显带染色体核型分析和染色体微阵列分析,以验证NIPT结果与产前诊断结果的一致性。所有孕妇均通过电话随访妊娠结局。
15237例孕妇中,检测出266例(1.75%)胎儿染色体异常高风险。其中,79例(29.7%)为T21高风险,26例(9.77%)为T18高风险,9例(3.38%)为T13高风险,74例(27.82%)为性染色体非整倍体高风险,12例(4.51%)为其他常染色体非整倍体高风险,66例(24.81%)为染色体微缺失或微重复高风险。217例孕妇接受了侵入性产前诊断,分别确诊50例T21、13例T18、1例T13、25例性染色体非整倍体、1例常染色体非整倍体和18例微缺失/微重复,阳性预测值分别为75.76%、68.42%、11.11%、40.32%、10%和35.29%。13042例孕妇(85.59%)妊娠结局随访成功。随访期间,发现1例T21假阴性病例。未发现T13和T18假阳性病例。
NIPT对T13、T18和T21的筛查性能良好,对其他常染色体非整倍体、性染色体非整倍体及染色体微缺失/微重复的筛查也具有重要价值。