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对 19607 例妊娠中两例威廉姆斯综合征胎儿的非侵入性产前筛查和诊断。

Noninvasive prenatal screening and diagnosis of two fetuses with Williams syndrome in a cohort of 19,607 pregnancies.

机构信息

Longgang District Maternity & Child Healthcare Hospital of Shenzhen City (Longgang Maternity and Child Institute of Shantou University Medical College), Shenzhen, China.

出版信息

Ann Med. 2024 Dec;56(1):2402071. doi: 10.1080/07853890.2024.2402071. Epub 2024 Sep 12.

Abstract

BACKGROUND

This study aimed to evaluate the efficiency of noninvasive prenatal screening (NIPS) technology in screening for microdeletions in the 7q11.23 region.

METHODS

19,607 pregnant women underwent NIPS in our hospital. Maternal peripheral cell-free foetal DNA (cffDNA) was routinely screened for aneuploidy by cffDNA enrichment and simultaneously analyzed for pathogenic copy number variants (CNVs). The Williams syndrome (WS) 7q11.23 region was targeted in this study. Chromosomal microarray analysis (CMA) was used to verify the screen-positive samples.

RESULTS

The mean concentration of cffDNA before and after enrichment increased from 9.44% to 19.32%, with a statistically significant difference. Two out of 19,607 samples tested for CNVs were found to have a heterozygous deletion at the 7q11.23 region, indicating a high risk for WS. CMA results confirmed the 1.5 megabase (Mb) deletions at the 7q11.23 region in amniotic fluid samples. One of the two WS foetuses had a small left ventricle by ultrasound screening, and the other did not have a significant cardiovascular abnormality phenotype.

CONCLUSIONS

NIPS screening for Williams syndrome can be achieved by enriching cell-free foetal DNA and improving bioinformatic analysis algorithms.

摘要

背景

本研究旨在评估非侵入性产前筛查(NIPS)技术在筛查 7q11.23 微缺失中的效率。

方法

在我院,对 19607 名孕妇进行了 NIPS。常规对母体游离胎儿 DNA(cffDNA)进行 cffDNA 富集,并同时进行致病性拷贝数变异(CNVs)分析。本研究以威廉姆斯综合征(WS)7q11.23 区域为靶点。采用染色体微阵列分析(CMA)对筛查阳性样本进行验证。

结果

富集前后 cffDNA 的平均浓度从 9.44%增加到 19.32%,差异有统计学意义。在 19607 例进行 CNVs 检测的样本中,有 2 例在 7q11.23 区域发现杂合性缺失,提示 WS 风险较高。CMA 结果证实羊水样本中存在 7q11.23 区域 1.5 兆碱基(Mb)缺失。这两个 WS 胎儿中有一个经超声筛查发现左心室较小,另一个无明显心血管异常表型。

结论

通过富集游离胎儿 DNA 和改进生物信息学分析算法,可以实现对威廉姆斯综合征的 NIPS 筛查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a8fc/11395870/4c4ace7225ec/IANN_A_2402071_F0001_C.jpg

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