[1]伍 欣,覃 婷,龙喜贵,等.101 例胎儿性染色体非整倍体异常核型分布特征及妊娠结局分析[J].现代检验医学杂志,2024,39(04):40-44+62.[doi:10.3969/j.issn.1671-7414.2024.04.008]
 WU Xin,QIN Ting,LONG Xigui,et al.Abnormal Karyotypes Distribution Characteristics and Pregnancy Outcomes of Fetal Sex Chromosome Aneuploidy in 101 Cases[J].Journal of Modern Laboratory Medicine,2024,39(04):40-44+62.[doi:10.3969/j.issn.1671-7414.2024.04.008]
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101 例胎儿性染色体非整倍体异常核型分布特征及妊娠结局分析()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第39卷
期数:
2024年04期
页码:
40-44+62
栏目:
论著
出版日期:
2024-07-15

文章信息/Info

Title:
Abnormal Karyotypes Distribution Characteristics and Pregnancy Outcomes of Fetal Sex Chromosome Aneuploidy in 101 Cases
文章编号:
1671-7414(2024)04-040-06
作者:
伍 欣覃 婷龙喜贵张红燕苏林虹张秀群
(广西壮族自治区人民医院医学遗传与产前诊断中心,南宁 530001)
Author(s):
WU Xin QIN Ting LONG Xigui ZHANG Hongyan SU Linhong ZHANG Xiuqun
(Medical Genetics and Prenatal Diagnosis Center, Guangxi Zhuang Autonomous Region People’s Hospital, Nanning 530001,China)
关键词:
性染色体非整倍体异常核型妊娠结局拷贝数变异测序
分类号:
R446.7
DOI:
10.3969/j.issn.1671-7414.2024.04.008
文献标志码:
A
摘要:
目的 分析101 例胎儿性染色体非整倍体(sex chromosome aneuploidy,SCA)异常核型分布特征及妊娠结局。方法 回顾性收集2016 年1 月~ 2021 年12 月7 821 例于广西壮族自治区人民医院成功进行产前核型诊断孕妇的临床资料,均行细胞培养染色体核型分析与拷贝数变异测序(copy number variation sequencing,CNV-seq)检测,对检出的101 例SCA 异常胎儿病历进行分析。结果 SCA 共检出101 例,检出率为1.29%。其中克氏综合征占比33.66%,超雌综合征占比17.82%,超雄综合征占比12.87%,特纳综合征占比10.89%,其他非整倍体异常(包括:48,XXXY 1 例,69,XXY[80%]/68,XXY,-22[20%] 1 例)占比1.98%,嵌合体占比22.77%。101 例SCA 产前指征结果为:年龄≥ 35周岁占比53.47%(54/101),血清生化指标筛查高/ 临界风险占比4.95%(5/101),胎儿超声检测异常占比17.82%(18/101),无创产前基因检测(non-invasive prenatal testing,NIPT)异常占比51.49%(52/101),不良孕产史占比12.87%(13/101),其他原因(孕妇脑瘫1 例、双方珠蛋白生成障碍性贫血4 例)5 例行产前诊断,占比4.95%(5/101),部分病例并发多项产前诊断指征。23 例诊断为性染色体嵌合体的胎儿,其中有22 例通过核型与CNV-seq 双向验证,11 例孕妇选择终止妊娠,其余选择继续妊娠。结论 产前核型诊断联合血清学检测、孕期超声等不同产前筛查手段,有利于提高SCA 检出率。而CNV-seq 可对性染色体嵌合体孕妇的遗传咨询提供更多临床依据。
Abstract:
Objective To analyze the distribution characteristics of abnormal karyotypes of fetal sex chromosome aneuploidy (SCA) and pregnancy outcomes in 101 fetal cases. Methods A retrospective study was conducted among 7 821 pregnant women who underwent successfully prenatal karyotyping diagnosis at Guangxi Zhuang Autonomous Region People’s Hospital from January 2016 to December 2021. All women received amniotic fluid cell culture karyotype analysis and copy number variation sequencing (CNV-seq) detection and 101 cases of SCA detected were analyzed. Results A total of 101 cases were detected by SCA, with a detection rate of 1.29%. Among them, Klinefelter syndrome accounted for 33.66%, superestrogenism syndrome accounted for 17.82%, superandrogenic syndrome accounted for 12.87%, turner syndrome accounted for 10.89%, other aneuploidy abnormalities [including 48, XXXY: 1 case; 69, XXY (80%)/68, XXY, -22 (20%): 1 case] accounted for 1.98%, and chimerism accounted for 22.77%. The prenatal indications for 101 cases of SCA were as follows: age ≥ 35 years, high/ critical risk of serum biochemical screening, fetal ultrasound abnormalities, abnormalities in non-invasive prenatal testing (NIPT), history of adverse pregnancy and childbirth and other reasons (1 case of cerebral palsy in pregnant women and 4 cases of bilateral thalassemia) accounted for 53.47%(54/101), 4.95%(5/101), 17.82%(18/101), 51.49%(52/101),12.87%(13/101), 4.95%(5/101), respectively. Partial cases had multiple prenatal diagnostic indications. Meanwhile, 23 fetuses diagnosed with sex chromosome chimerism, of which 22 cases were validated by karyotype and CNV seq, 11 pregnant women chose to terminate their pregnancy, with the rest chose to continue pregnancy. Conclusion The combination of prenatal karyotype diagnosis, serological testing, prenatal ultrasound and other prenatal screening methods can help improve the detection rate of SCA, while CNV-seq can provide more clinical evidence for genetic counseling of pregnant women with sex chromosome chimerism.

参考文献/References:

[1] 周元圆, 翟秀璋, 卢庆, 等. 无创产前筛查技术在胎儿性染色体非整倍体中的临床应用[J]. 中国计划生育和妇产科, 2023, 15(2): 96-98, 107. ZHOU Yuanyuan, ZHAI Xiuzhang, LU Qing, et al. Clinical application of non-invasive prenatal testing technology in fetal sex chromosomes aneuploidy [J]. Chinese Journal of Family Planning & Gynecotokology, 2023, 15(2): 96-98, 107.
[2] 苏世博, 李俊果, 杨珣, 等. 无创产前基因检测对胎儿性染色体非整倍体的检测性能分析[J]. 中国妇幼保健, 2022, 37(22): 4119-4122. SU Shibo, LI Junguo, YANG Xun, et al. Analysis on the performance of non-invasive prenatal testing for fetal sex chromosome aneuploidies [J]. Maternal and Child Health Care of China, 2022, 37(22): 4119-4122.
[3] 王飞, 庄丹燕, 潘小莉, 等. 联合探针锚定聚合测序法检测胎儿染色体非整倍体效果评价[J]. 中国卫生检验杂志, 2023, 33(4): 455-458. WANG Fei, ZHUANG Danyan, PAN Xiaoli, et al. Evaluation on the effect of combined probe anchored polymerization sequencing in detecting fetal chromosomal aneuploidy [J]. Chinese Journal of Health Laboratory Technology, 2023, 33(4): 455-458.
[4] 高明雅, 柴玉琼, 王亚男. 核型分析联合CNV-seq技术在羊水染色体嵌合体检测中的应用[J]. 检验医学与临床, 2022, 19(15): 2082-2085, 2090. GAO Mingya, CHAI Yuqiong, WANG Ya’nan. Application of karyotype analysis combined with CNVseq techndogy in detection of chimera in amniotic fluid chromosome [J]. Laboratory Medicine and Clinic, 2022, 19(15): 2082-2085, 2090.
[5] 王玲, 王珺, 高玲霞, 等. 无创DNA 检测对高龄孕妇胎儿染色体非整倍体疾病及染色体拷贝数变异筛查中的临床价值[J]. 中国实验诊断学, 2023, 27(6):666-669. WANG Ling, WANG Jun, GAO Lingxia, et al. Clinical value of non-invasive prenatal testing for fetal chromosomal aneuploidy disease and chromosome copy number variation in elderly pregnant women [J]. Chinese Journal of Laboratory Diagnosis, 2023, 27(6): 666-669.
[6] 崔凤姬, 江玉华, 焦泽华, 等. 基因组拷贝数变异测序联合核型分析在产前诊断中的临床应用[J]. 北京医学, 2023, 45(4): 289-293. CUI Fengji, JIANG Yuhua, JIAO Zehua, et al. Clinical application of copy number variation sequencing combined with karyotype analysis in prenatal diagnosis [J]. Beijing Medical Journal, 2023, 45(4): 289-293.
[7] 黎冬梅, 陈红, 镡颖, 等. 先天性泌尿系统畸形胎儿的染色体核型及拷贝数变异产前诊断结果分析[J].实用妇产科杂志, 2023, 39(4): 297-301. LI Dongmei, CHEN Hong, CHAN Ying, et al. Analysis of the results of prenatal diagnosis of chromosomal karyotype and copy number variations in fetuses with abnormal urinary system [J]. Journal of Practical Obstetrics and Gynecology, 2023, 39(4): 297-301.
[8] 朱燕飞, 王萍, 吴燕, 等. 22 种隐性遗传病相关基因变异在产前人群中的分布情况[J]. 中国妇幼保健,2023, 38(5): 908-911. ZHU Yanfei, WANG Ping, WU Yan, et al. Distribution of 22 recessive genetic disease-related gene mutations in prenatal population [J]. Maternal and Child Health Care of China, 2023, 38(5): 908-911.
[9] 王路明, 杨莉, 宋勤浩, 等. BoBs 技术用于胎儿性染色体异常产前诊断的临床效能评价[J]. 中国卫生检验杂志, 2021, 31(18): 2237-2241. WANG Luming, YANG Li, SONG Qinhao, et al. Evaluation of the clinical efllcacy of BoBs technique in prenatal diagnosis of fetal sex chromosome abnormalities [J]. Chinese Journal of Health Laboratory Technology, 2021, 31(18): 2237-2241.
[10] 屈素真, 时盼来, 张田园, 等. CNV-seq 与染色体核型分析在平衡易位携带者产前诊断中的应用[J]. 中华医学遗传学杂志, 2022, 39(4): 366-369. QU Suzhen, SHI Panlai, ZHANG Tianyuan, et al. Application of CNV-seq and chromosomal karyotyping in the prenatal diagnosis for carriers of balanced translocations [J]. Chinese Journal of Medical Genetics, 2022, 39(4): 366-369.
[11] 马一婧, 詹福寿, 万艳, 等. 31 例克氏综合征患者核型、睾丸体积及生殖激素水平分析[J]. 宁夏医科大学学报, 2021, 43(3): 291-294. MA Yijing, ZHAN Fushou, WAN Yan, et al. Karyotype, testicular volume and reproductive hormone level in 31 patients with Klinefelter’s syndrome [J]. Journal of Ningxia Medical University, 2021, 43(3): 291-294.
[12] 谢理玲, 张雨琴, 杨玉, 等. 47, XXY Klinefelter 综合征以青春早发育快进展发病的临床特征及文献复习[J]. 重庆医科大学学报, 2022, 47(3): 282-284. XIE Liling, ZHANG Yuqin, YANG Yu, et al. Clinical features and literature review of early youth and rapid development of 47,XXY Klinefelter’s syndrome [J]. Journal of Chongqing Medical University, 2022, 47(3):282-284.
[13] 李晨曦, 党玉洁, 秦莹莹. 特纳综合征患者生育力相关问题的研究进展[J]. 中华妇产科杂志, 2021,56(1): 73-76. LI Chenxi, DANG Yujie, QIN Yingying. Research progress on fertility related issues in patients with Turner syndrome[J]. Chinese Journal of Obstetrics and Gynecology, 2021, 56(1): 73-76.
[14] 杨利, 冯亚琴, 杨玉, 等. 伴有生长迟缓的47,XXX综合征3 例报道[J]. 上海交通大学学报( 医学版),2021, 41(11): 1425-1428. YANG Li, FENG Yaqin, YANG Yu, et al. Report of 3 cases of 47,XXX syndrome with growth retardation [J]. Journal of Shanghai Jiaotong University(Medical Science), 2021, 41(11): 1425-1428.
[15] PERSSON S, ELENIS E, TURKMEN S, et al. Higher risk of type 2 diabetes in women with hyperandrogenic polycystic ovary syndrome[J]. Fertility and Sterility, 2021, 116(3): 862-871.
[16] GEERTS M, STEYAERT J, FRYNS J P. The XYY syndrome: a follow-up study on 38 boys[J]. Genetic Counseling (Geneva, Switzerland), 2003, 14(3): 267-279.
[17] 邱惠国, 潘华, 洪国粦, 等. 无创产前筛查技术在胎儿性染色体非整倍体筛查中的应用[J]. 中国妇幼保健, 2022, 37(18): 3452-3456. QIU Huiguo, PAN Hua, HONG Guolin, et al. Application of non-invasive prenatal screening technology in screening for fetal sex chromosome aneuploidy[J]. Maternal & Child Health Care of China, 2022, 37(18): 3452-3456.
[18] 彭建美, 李瑞, 于娇, 等. 颈项透明层厚度超声联合无创DNA 对孕妇胎儿染色体非整倍体异常诊断效能的影响[J]. 现代生物医学进展, 2021, 21(11):2129-2132. PENG Jianmei, LI Rui, YU Jiao, et al. Effect of ultrasound on thickness of neck transparent layer combined with noninvasive DNA on diagnosis of abnormal chromosomal aneuploidy [J]. Progress in Modern Biomedicine, 2021, 21(11): 2129-2132.
[19] 胡睿, 张竹, 王嘉敏, 等. 比较基因组杂交微阵列技术在高龄孕妇产前诊断胎儿染色体异常中的应用[J]. 四川大学学报( 医学版), 2021, 52(1): 117-123. HU Rui, ZHANG Zhu, WANG Jiamin, et al. Application of array-based comparative genomic hybridization in the prenatal diagnosis of fetal chromosomal aberration in gravidas with advanced age [J]. Journal of Sichuan University(Medical Sciences), 2021, 52(1): 117-123.
[20] 赵小秋, 崔婉婷. 205 例羊水细胞嵌合体的产前诊断结果分析[J]. 中国生育健康杂志, 2022, 33(1): 18-22,26. ZHAO Xiaoqiu, CUI Wanting. Analysis of prenatal diagnosis outcomes of 205 cases with mosaicism in amniotic fluid cells [J]. Chinese Journal of Reproductive Health, 2022, 33(1): 18-22, 26.

备注/Memo

备注/Memo:
基金项目:广西自然科学基金项目(2021GXNSFAA075027)。
作者简介:伍欣(1985-),女,硕士,主治医师,研究方向:产前诊断,E-mail:qingt53@163.com。
通讯作者:张秀群(1977-),女,本科,主任医师,研究方向:医学遗传与产前诊断,E-mail:suerise@163.com。
更新日期/Last Update: 2024-07-15