Kocova M, Siegel S F, Wenger S L, Lee P A, Trucco M
Division of Immunogenetics, Children's Hospital of Pittsburgh, PA 15213-2583.
Lancet. 1993 Jul 17;342(8864):140-3. doi: 10.1016/0140-6736(93)91345-m.
Only about half of all patients with Turner's syndrome are monosomy 45,X on karyotyping and there are grounds for supposing that cryptic mosaicism for at least part of the Y chromosome may be present in some patients. If so this would be clinically important because of the risk to patients of gonadal neoplasms and virilisation. We have used a very sensitive method to detect Y chromosomal segments in eighteen patients with Turner's syndrome, none of whom had evidence of Y chromosomal material by cytogenetic analysis. In DNA from peripheral blood lymphocytes and/or fibroblasts we looked for specific nucleotide sequences from the sex-determining region of the Y chromosome (SRY gene) and repetitive sequences located at the centromeric region (DYZ3). By polymerase chain amplification (PCR) one patient had a definite positive signal and two patients had faintly positive signals for the SRY gene. Southern blot analysis of PCR material with a SRY-specific probe confirmed that these patients were positive for SRY and revealed another three. No patient was positive for DYZ3, suggesting that only a small portion of Y was present. These results suggest that "pure" 45,X monosomy is less frequent than previously supposed. Long-term follow-up of patients with Y sequences is needed to determine their risk for subsequent gonadal neoplasms and virilisation.
在进行核型分析时,特纳综合征患者中只有约一半为45,X单体型,并且有理由推测部分患者可能存在至少部分Y染色体的隐匿性嵌合体。如果是这样,由于患者存在性腺肿瘤和男性化的风险,这在临床上将具有重要意义。我们使用了一种非常敏感的方法来检测18例特纳综合征患者的Y染色体片段,这些患者通过细胞遗传学分析均未发现Y染色体物质的证据。我们在外周血淋巴细胞和/或成纤维细胞的DNA中寻找Y染色体性别决定区(SRY基因)的特定核苷酸序列以及位于着丝粒区的重复序列(DYZ3)。通过聚合酶链反应(PCR),一名患者的SRY基因有明确的阳性信号,两名患者有微弱的阳性信号。用SRY特异性探针对PCR产物进行Southern印迹分析证实这些患者的SRY基因呈阳性,并另外发现了三名阳性患者。没有患者的DYZ3呈阳性,这表明仅存在一小部分Y染色体。这些结果表明,“纯”45,X单体型比以前认为的更为少见。需要对具有Y序列的患者进行长期随访,以确定他们后续发生性腺肿瘤和男性化的风险。