染色体微阵列分析对于无创产前检测提示异常的孕妇的诊断价值

• 作 者: 卜秀芬 曾黎 李红玉 周世豪 胡兰萍 贺骏
• 出 处: 中华医学遗传学杂志
• 发表日期: 2021年6期
• 关键词: 染色体微阵列分析 无创产前检测 核型分析 产前诊断

目的:探讨染色体微阵列分析(chromosomal microarray analysis，CMA)对于无创产前检测(non-invasive prenatal testing，NIPT)提示高风险胎儿的诊断价值。方法:为628例NIPT提示高风险的孕妇提供羊膜腔穿刺，采集羊水/脐血样本，进行染色体G显带核型分析或全基因组CMA检测。随访妊娠结局以及新生儿出生后的情况。结果:NIPT对于21三体、18三体、13三体、性染色体非整倍体、其他罕见三体和拷贝数变异(copy number variations，CNVs)的阳性预测值分别为86.4%(127/147)、41.7%(30/72)、12.9%(4/31)、43.7%(101/231)、16.5%(14/85)和52.2%(35/67)。在218例核型未见异常的样本中，全基因组CMA额外检出约12例(5.5%)的致病性CNVs和5例(2.3%)的杂合度丢失。结论:CMA联合染色体核型分析可作为NIPT阳性孕妇首选的产前诊断方案。“,”Objective:To explore the value of chromosomal microarray analysis (CMA) for the diagnosis of fetuses with high risk signaled by non-invasive prenatal testing (NIPT).Methods:From June 2017 to August 2019, 628 pregnant women with high risk signaled by NIPT underwent invasive prenatal diagnosis. Amniotic fluid or cord blood samples were subjected to chromosomal karyotyping analysis or CMA. Pregnancy outcome and postnatal conditions of the fetuses were followed up.Results:The positive predictive value for trisomy 21, trisomy 18, trisomy 13, sex chromosome aneuploidy, other rare trisomies and copy number variants (CNVs) among the 628 women were 86.4% (127/147), 41.7%(30/72), 12.9%(4/31), 43.7%(101/231), 16.5%(14/85) and 52.2%(35/67), respectively. In 218 samples with normal karyotype, 5.5% (12/218) of additional pathogenic CNVs and 2.3% (5/218) of loss of heterozygosity were detected by CMA.Conclusion:CMA combined with karyotyping analysis can be used as first-tier test for prenatal diagnosis for women with high-risk signaled by NIPT.