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染色体微阵列分析结合核型分析是检测高危指标孕妇的有力工具。

Chromosome microarray analysis combined with karyotype analysis is a powerful tool for the detection in pregnant women with high-risk indicators.

机构信息

Obstetrics and Gynecology Department, The Second Affiliated Hospital of Chongqing Medical University, No. 74 Linjiang Road, Yuzhong District, Chongqing, 400010, China.

出版信息

BMC Pregnancy Childbirth. 2023 Nov 11;23(1):784. doi: 10.1186/s12884-023-06052-z.

Abstract

BACKGROUND

Karyotype analysis and fluorescence in situ hybridization (FISH) are commonly used for prenatal diagnosis, however they have many disadvantages. Chromosome microarray analysis (CMA) has the potential to overcome these disadvantages. This study aimed to evaluate the clinical value of CMA in the diagnosis of fetal chromosomal anomalies in southwest of China.

METHODS

A total of 3336 samples of amniotic fluid or umbilical cord blood from pregnant women with high-risk indicators at our center in southwest of China from June 2018 to January 2023 were included in the retrospective analysis. 3222 cases tested by CMA and karyotyping, 114 cases only tested by CMA.

RESULTS

3336 samples divided into 2911 cases with single and 425 cases with multiple high-risk indicators. The aneuploidy and pathogenic/likely pathogenic copy number variations (CNVs) of 2911 cases with single high-risk indicator were 4.43% (129/2911) and 2.44% (71/2911) respectively; the aneuploidy and pathogenic/likely pathogenic CNVs of 425 cases with multiple high-risk indicators were 6.82% (29/425) and 2.12% (9/425) respectively. The rate of aneuploidy increased significantly with pregnancy age or NT value. The detection rate of aneuploidy on cases with AMA combined NT ≥ 2.5 mm was significantly higher than that in cases only with AMA (p < 0.001); the detection rate of aneuploidy and pathogenic/likely pathogenic CNVs in cases with AMA combined NIPT high-risk were higher than that in cases only with AMA (p < 0.001, p < 0.05).

CONCLUSIONS

The combined application of CMA and karyotyping were recommended in prenatal diagnosis for providing a scientific and accurate genetic diagnosis and improving the quality of prenatal genetic counseling.

摘要

背景

核型分析和荧光原位杂交(FISH)常用于产前诊断,但存在许多缺点。染色体微阵列分析(CMA)有可能克服这些缺点。本研究旨在评估 CMA 在我国西南地区产前诊断胎儿染色体异常中的临床价值。

方法

对 2018 年 6 月至 2023 年 1 月在我院就诊的有高危因素的 3336 例孕妇羊水或脐血样本进行回顾性分析。其中 3222 例同时进行 CMA 和核型分析,114 例仅进行 CMA 检测。

结果

3336 例样本分为 2911 例单指标高危和 425 例多指标高危。2911 例单指标高危样本的非整倍体和致病性/疑似致病性拷贝数变异(CNVs)分别为 4.43%(129/2911)和 2.44%(71/2911);425 例多指标高危样本的非整倍体和致病性/疑似致病性 CNVs 分别为 6.82%(29/425)和 2.12%(9/425)。非整倍体率随孕妇年龄或 NT 值的增加而显著升高。AMA 联合 NT≥2.5mm 组的非整倍体检出率明显高于 AMA 组(p<0.001);AMA 联合 NIPT 高危组的非整倍体和致病性/疑似致病性 CNVs 检出率明显高于 AMA 组(p<0.001,p<0.05)。

结论

建议在产前诊断中联合应用 CMA 和核型分析,为提供科学准确的遗传诊断,提高产前遗传咨询质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/790c/10638706/e94f4dc4ce73/12884_2023_6052_Fig1_HTML.jpg

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