染色体核型分析与BoBs技术联合检测染色体异常和染色体微缺失综合征的产前诊断新模式的建立及应用  

Prenatal diagnosis of chromosome abnormalities and nine microdeletion syndromes using both traditional karyotyping and BoBs

作　　者：唐新华[1] 杨必成[1] 朱姝[1] 苏洁[1] 章锦曼[1] 银益飞[1] 冯燕[1] 黎冬梅[1] 赵庆芬 余蕊[1] 朱宝生[1] 

机构地区：[1]昆明理工大学附属医院云南省出生缺陷与遗传病研究重点实验室,650032

出　　处：《中华妇产科杂志》2016年第5期325-330,共6页Chinese Journal of Obstetrics and Gynecology

基　　金：云南省卫生系统领军人才项目（L-201201）;云南省科技计划（2011FA030）;云南省卫生科技计划（2014NS281）

摘　　要：目的：联合细菌人工染色体微珠（BoBs）技术和传统染色体核型分析技术，建立胎儿染色体异常及常见染色体微缺失综合征产前诊断新模式，评估“核型分析＋BoBs”产前诊断新模式的临床应用价值。方法对2012年6月至2014年12月在昆明理工大学附属医院接受侵入性产前诊断的孕妇807例，同时采用染色体G显带核型分析技术和BoBs技术，对胎儿染色体异常和9种染色体微缺失综合征进行产前诊断。结果在807例胎儿中，羊水细胞染色体核型分析和BoBs技术均独立地成功检出32例胎儿染色体数目异常，包括21三体综合征18例、18三体综合征6例、13三体综合征1例、性染色体数目异常7例，BoBs检测结果与羊水细胞核型分析结果均一致。BoBs技术检出5例染色体微缺失综合征，其中DiGeorge综合征3例（2例为微重复、1例为微缺失）、Miller-Dieker综合征1例、Wolf-Hirschhorn综合征1例；基于BoBs技术检出的5例染色体微缺失综合征胎儿中，仅1例Wolf-Hirschhorn综合征通过传统核型分析技术检测出来，其余4例胎儿染色体核型分析结果未见异常。但BoBs技术漏诊了8例被传统染色体核型分析技术检测出的胎儿染色体结构异常，其中，染色体易位7例、倒位1例，7例遗传自胎儿父母、1例为新发突变。结论“核型分析＋BoBs”产前诊断新模式可以全面、快速、有效地检测染色体异常和9种染色体微缺失综合征，具有较高的临床应用价值。Objective To evaluate a new prenatal diagnosis model of chromosomal abnormalities and nine microdeletion syndromes by using both traditional karyotyping and a newly-developed rapid prenatal diagnosis technology, BACs-on-Beads （BoBs） technique. Methods From June 2012 to December 2014, 807 pregnant women with high risk after screening or with other indicators, were performed amniocentesis. Traditional karyotyping and BoBs were employed simultaneously for prenatal diagnosis. Results Thirty-two cases with chromosome aneupoidies were successfully detected both by BoBs and karyotyping, including 18 cases of trisomy 21, 6 cases of trisomy 18, 1 case of trisomy 13, and 7 cases with sex chromosome abnormality. All 8 fetuses with chromosome structural abnormalities detected by karyotyping were missed by BoBs;while BoBs contributed more in detection of five microdeletion syndrome cases, including 3 cases of DiGeorge syndromes （two with microduplication and one with microdeletion）, one case of Miller-Dieker syndrome, and one case of Wolf-Hirschhorn syndrome. Conclusion Combined use of＆amp;nbsp;traditional karyotyping and BoBs, is a rapid and effective prenatal diagnosis model that may enlarge our horizon on chromosomal diseases and should be widely used in future clinical service.

关 键 词：产前诊断 染色体畸变 染色体 人工 细菌 核型分析 染色体缺失 

分 类 号：R714.5[医药卫生—妇产科学]