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新前沿:一例关于全外显子组测序在多种胎儿异常情况中的应用

The new frontier: a case for whole exome sequencing with multiple fetal anomalies.

作者信息

Mei Jenny Y, Dayani Lila, Platt Lawrence D

机构信息

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of California, Los Angeles, CA, USA.

Laboratory Corporation of America, Monrovia, CA, USA.

出版信息

Case Rep Perinat Med. 2023 May 4;12(1):20220032. doi: 10.1515/crpm-2022-0032. eCollection 2023 Jan.

DOI:10.1515/crpm-2022-0032
PMID:40041274
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11616545/
Abstract

OBJECTIVES

Standard genetic testing can fail to identify an underlying genetic etiology in pregnancies affected by multiple fetal abnormalities. Recently, whole exome sequencing (WES) studies have shown promise in recognizing genetic diagnoses where standard genetic testing does not yield answers.

CASE PRESENTATION

A 35-year-old G1P0 healthy female found at anatomy scan to have multiple fetal anomalies, including severe bilateral ventriculomegaly, renal pyelectasis, and short long bones. Karyotype and microarray were normal. Whole exome sequencing showed the fetus was compound heterozygous for likely pathogenic variants in the ROBO1 gene.

CONCLUSIONS

In the presence of multiple fetal anomalies with normal karyotype and microarray, whole exome sequencing should be considered to not only provide answers for the affected parents, but also aid in future pregnancy planning.

摘要

目的

在受多种胎儿异常影响的妊娠中,标准基因检测可能无法识别潜在的遗传病因。最近,全外显子组测序(WES)研究已显示出在识别标准基因检测无法给出答案的遗传诊断方面的前景。

病例报告

一名35岁的初产妇健康女性,在解剖扫描时发现有多种胎儿异常,包括严重的双侧脑室扩大、肾盂积水和长骨短小。核型和微阵列检测结果正常。全外显子组测序显示胎儿在ROBO1基因中存在可能致病的变异,为复合杂合子。

结论

在存在核型和微阵列检测结果正常的多种胎儿异常的情况下,应考虑进行全外显子组测序,这不仅可为受影响的父母提供答案,还有助于未来的妊娠规划。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ffc/11616545/9528275c563c/j_crpm-2022-0032_fig_001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ffc/11616545/9528275c563c/j_crpm-2022-0032_fig_001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ffc/11616545/9528275c563c/j_crpm-2022-0032_fig_001.jpg

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本文引用的文献

1
Diagnostic yield of exome sequencing for prenatal diagnosis of fetal structural anomalies: A systematic review and meta-analysis.外显子组测序在产前诊断胎儿结构畸形中的诊断效能:系统评价和荟萃分析。
Prenat Diagn. 2022 May;42(6):662-685. doi: 10.1002/pd.6115. Epub 2022 May 7.
2
The Added Value of Whole-Exome Sequencing for Anomalous Fetuses With Detailed Prenatal Ultrasound and Postnatal Phenotype.全外显子测序在具有详细产前超声和产后表型的异常胎儿中的附加价值
Front Genet. 2021 Jul 22;12:627204. doi: 10.3389/fgene.2021.627204. eCollection 2021.
3
Evaluation of Diagnostic Yield in Fetal Whole-Exome Sequencing: A Report on 45 Consecutive Families.
胎儿全外显子测序诊断率评估:45个连续家庭的报告
Front Genet. 2019 Jun 25;10:425. doi: 10.3389/fgene.2019.00425. eCollection 2019.
4
Prenatal exome sequencing analysis in fetal structural anomalies detected by ultrasonography (PAGE): a cohort study.超声检查发现胎儿结构畸形的产前外显子组测序分析(PAGE):一项队列研究。
Lancet. 2019 Feb 23;393(10173):747-757. doi: 10.1016/S0140-6736(18)31940-8. Epub 2019 Jan 31.
5
Whole-exome sequencing in the evaluation of fetal structural anomalies: a prospective cohort study.全外显子组测序在胎儿结构畸形评估中的应用:一项前瞻性队列研究。
Lancet. 2019 Feb 23;393(10173):758-767. doi: 10.1016/S0140-6736(18)32042-7. Epub 2019 Jan 31.
6
Whole Exome Sequencing: Applications in Prenatal Genetics.全外显子组测序:在产前遗传学中的应用。
Obstet Gynecol Clin North Am. 2018 Mar;45(1):69-81. doi: 10.1016/j.ogc.2017.10.003.
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Promises, pitfalls and practicalities of prenatal whole exome sequencing.产前全外显子组测序的承诺、陷阱和实际问题。
Prenat Diagn. 2018 Jan;38(1):10-19. doi: 10.1002/pd.5102. Epub 2017 Jul 25.
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Hum Genet. 2017 Aug;136(8):921-939. doi: 10.1007/s00439-017-1821-8. Epub 2017 Jun 9.
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Next-generation DNA sequencing identifies novel gene variants and pathways involved in specific language impairment.下一代 DNA 测序鉴定出与特定语言障碍相关的新基因变异和途径。
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