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基于单中心回顾性研究的22q11.2微缺失综合征的产前诊断及临床表型异质性

Prenatal Diagnosis and Clinical Phenotypic Heterogeneity of 22q11.2 Microdeletion Syndrome Based on a Single Center Retrospective Study.

作者信息

Chen Jia-Yan, Cai Mei-Jiao, Ge Yun-Sheng

机构信息

Department of Central Laboratory, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China.

出版信息

J Clin Lab Anal. 2025 Jun;39(11):e70045. doi: 10.1002/jcla.70045. Epub 2025 May 5.

DOI:10.1002/jcla.70045
PMID:40325521
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12144570/
Abstract

OBJECTIVE

To retrospectively investigate the incidence of prenatal diagnosis of 22q11.2 microdeletion syndrome (22q11.2DS) in a single center and summarize its clinical manifestations to expand the phenotypic database.

METHODS

Pregnant women who underwent prenatal diagnosis at The Women and Children's Hospital, School of Medicine, Xiamen University, from January 2018 to February 2024 were retrospectively analyzed. Prenatal diagnosis was performed using routine G-banding karyotype analysis and chromosomal microarray analysis (CMA) or copy number variation sequencing (CNV-seq). Fetuses diagnosed with 22q11.2DS were further analyzed using detailed ultrasound diagnostic records to summarize the clinical manifestations of 22q11.2DS.

RESULTS

A total of 24,319 pregnant women underwent prenatal diagnosis, and 24 cases were diagnosed with 22q11.2DS, with an incidence of 0.99‰ (24/24319), including 16 cases of congenital heart disease, 4 cases of renal pelvis separation, 3 cases of cleft lip and palate, 2 cases of double strephenopodia, 2 cases of nasal bone dysplasia, and 1 case each of unclear thymus, spina bifida with meningomyelocele, abnormal fetal growth retardation, and NT thickening.

CONCLUSION

Congenital heart disease was the most common phenotype in 22q11.2DS, and other malformations also occurred in a certain proportion. In addition, some rare clinical phenotypes, such as spina bifida with myelomeningocele and nasal bone hypoplasia, were also found in this cohort, which should be taken seriously to improve the detection rate of fetal 22q11.2DS.

摘要

目的

回顾性调查单中心22q11.2微缺失综合征(22q11.2DS)的产前诊断发生率,并总结其临床表现以扩充表型数据库。

方法

回顾性分析2018年1月至2024年2月在厦门大学医学院附属妇女儿童医院接受产前诊断的孕妇。采用常规G显带核型分析和染色体微阵列分析(CMA)或拷贝数变异测序(CNV-seq)进行产前诊断。对诊断为22q11.2DS的胎儿进一步分析详细的超声诊断记录,以总结22q11.2DS的临床表现。

结果

共有24319例孕妇接受产前诊断,24例被诊断为22q11.2DS,发生率为0.99‰(24/24319),其中先天性心脏病16例,肾盂分离4例,唇腭裂3例,双侧马蹄内翻足2例,鼻骨发育不良2例,胸腺不清、脊柱裂伴脊髓脊膜膨出、胎儿生长发育异常、NT增厚各1例。

结论

先天性心脏病是22q11.2DS最常见的表型,其他畸形也有一定比例发生。此外,本队列中还发现了一些罕见的临床表型,如脊柱裂伴脊髓脊膜膨出和鼻骨发育不全,应予以重视以提高胎儿22q11.2DS的检出率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc4e/12144570/f3e61511ca2a/JCLA-39-e70045-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc4e/12144570/1f0a042de80f/JCLA-39-e70045-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc4e/12144570/069316a74193/JCLA-39-e70045-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc4e/12144570/f314b09dca3e/JCLA-39-e70045-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc4e/12144570/f3e61511ca2a/JCLA-39-e70045-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc4e/12144570/1f0a042de80f/JCLA-39-e70045-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc4e/12144570/069316a74193/JCLA-39-e70045-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc4e/12144570/f314b09dca3e/JCLA-39-e70045-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc4e/12144570/f3e61511ca2a/JCLA-39-e70045-g003.jpg

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本文引用的文献

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Am J Obstet Gynecol. 2024 Mar;230(3):368.e1-368.e12. doi: 10.1016/j.ajog.2023.09.005. Epub 2023 Sep 16.
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Updated clinical practice recommendations for managing children with 22q11.2 deletion syndrome.22q11.2 缺失综合征患儿管理的临床实践更新推荐
Genet Med. 2023 Mar;25(3):100338. doi: 10.1016/j.gim.2022.11.006. Epub 2023 Feb 2.
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Prenatal Screening and Diagnostic Considerations for 22q11.2 Microdeletions.
22q11.2 微缺失的产前筛查和诊断注意事项。
Genes (Basel). 2023 Jan 6;14(1):160. doi: 10.3390/genes14010160.
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Frequency of chromosome 22q11.2 deletion among newborns with non-syndromic congenital heart defects from western Mexico.墨西哥西部非综合征性先天性心脏病新生儿中22q11.2染色体缺失的频率。
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22q11.2 Deletion Syndrome: Impact of Genetics in the Treatment of Conotruncal Heart Defects.22q11.2缺失综合征:遗传学在圆锥动脉干心脏缺陷治疗中的影响
Children (Basel). 2022 May 25;9(6):772. doi: 10.3390/children9060772.
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Neurological manifestation of 22q11.2 deletion syndrome.22q11.2 缺失综合征的神经表现。
Neurol Sci. 2022 Mar;43(3):1695-1700. doi: 10.1007/s10072-021-05825-8. Epub 2022 Jan 18.
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[Clinical aspects of 22q11.2 microdeletion syndrome].[22q11.2微缺失综合征的临床特征]
Orv Hetil. 2022 Jan 2;163(1):21-30. doi: 10.1556/650.2022.32299.
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Clinical Manifestations of 22q11.2 Deletion Syndrome.22q11.2 缺失综合征的临床表现。
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