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[对一名具有45,X/46,X,idic(Y)(q11.2)嵌合体的胎儿进行的基因分析]

[Genetic analysis of a fetus with with 45,X/46,X,idic(Y)(q11.2) mosaicism].

作者信息

Pan Feiyan, Zhang Weiqing, Zhang Weiguo

机构信息

Central Laboratory, Taizhou Hospital, Linhai, Zhejiang 317000, China.

出版信息

Zhonghua Yi Xue Yi Chuan Xue Za Zhi. 2024 Aug 10;41(8):897-902. doi: 10.3760/cma.j.cn511374-20230807-00042.

Abstract

OBJECTIVE

To explore the genetic characteristics of a fetus with sex chromosome abnormality indicated by non-invasive prenatal testing (NIPT) at 25 gestational weeks.

METHODS

A pregnant woman who was admitted to the Taizhou Hospital for abnormal NIPT result on January 6, 2023 was selected as the study subject. Relevant clinical data was collected. The fetus was subjected to chromosomal karyotyping analysis, copy number variation sequencing (CNV-seq), fluorescence in situ hybridization (FISH), and multiplex PCR assays.

RESULTS

NIPT had suggested monosomy of X chromosome. The fetus was found to have a chromosomal karyotype of 45,X[59]/46,X,del(Y)(q11.2)[17] at 30 weeks of gestational age. CNV-seq suggested the presence a 7.98 Mb deletion at Yq11.222q12 and a mosaicism 16.92 Mb deletion. FISH suggested that the fetus harbored two SRY genes and a mosaicism sex chromosomal abnormality, and multiplex PCR revealed that its AZF b+c region was completely deleted. C-banded karyotyping showed darkly stained dense mitotic granules at both ends of the Y chromosome. The fetus was ultimately determined as a 45,X/46,X,idic(Y)(q11.2) mosaicism. Following elected abortion, testing of the fetal tissue confirmed the presence of 45,X/46,XY mosaicism, and CNV-seq result of the placental tissue was compatible with that of NIPT. CNV-seq analysis of the couple revealed no obvious abnormality.

CONCLUSION

With combined NIPT, karyotyping, CNV-seq, FISH and multiplex PCR assays, the fetus was diagnosed as a 45,X/46,X,idic(Y)(q11.2) mosaicism with deletion of the AZF b+c region. Above finding has enabled prenatal diagnosis for the fetus.

摘要

目的

探讨孕25周时经无创产前检测(NIPT)提示性染色体异常胎儿的遗传特征。

方法

选取2023年1月6日因NIPT结果异常入住台州医院的一名孕妇作为研究对象。收集相关临床资料。对胎儿进行染色体核型分析、拷贝数变异测序(CNV-seq)、荧光原位杂交(FISH)和多重聚合酶链反应(PCR)检测。

结果

NIPT提示X染色体单体型。孕30周时,胎儿染色体核型为45,X[59]/46,X,del(Y)(q11.2)[17]。CNV-seq提示Yq11.222q12存在7.98 Mb缺失及16.92 Mb嵌合缺失。FISH提示胎儿存在两个SRY基因及嵌合性性染色体异常,多重PCR显示其AZF b+c区域完全缺失。C带核型分析显示Y染色体两端有深染的致密有丝分裂颗粒。胎儿最终被确定为45,X/46,X,idic(Y)(q11.2)嵌合体。选择流产后,对胎儿组织检测证实存在45,X/46,XY嵌合体,胎盘组织的CNV-seq结果与NIPT结果相符。对夫妇双方的CNV-seq分析未发现明显异常。

结论

联合应用NIPT、核型分析、CNV-seq、FISH和多重PCR检测,诊断该胎儿为45,X/46,X,idic(Y)(q11.2)嵌合体,伴AZF b+c区域缺失。上述结果实现了对该胎儿的产前诊断。

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