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首页> 中文期刊> 《生殖医学杂志》 >新生21号染色体部分重复致胎儿唐氏综合征的产前诊断一例并文献复习

新生21号染色体部分重复致胎儿唐氏综合征的产前诊断一例并文献复习

         
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Objective:To report a case of de novo partial duplication of chromosome 21 associated with Down syndrome and review the literatures.Clinical data:A 29-year-old gravida 1,para 0 woman came to our clinic at 15 gestational weeks.The ultrasound showed the nuchal fold of 0.6 cm thickness.The maternal serum screening showed that the risk of fetal Down syndrome was 1/110.The amniocentesis was performed at 18 weeks of gestation.The interphase fluorescence in situ hybridization (FISH) showed three signals of the probe DSCR2:21q22.The karyotyping of the amniotic fluid cell was 46,XX,21p+.Results:The karyotyping of the blood lymphocytes from the parents was normal.The metaphase FISH analysis revealed that the segment of the 21p+ was 21q22 in origin.The array-based comparative genomic hybridization(aCGH)analysis demonstrated a 11.74 Mb duplication of 21q22.12-q22.3,a 1.31 Mb duplication of 21q21.3,a 1.33 Mb duplication of 21q21.1 and a 1.68 Mb deletion of 21q21.1-21q21.2.The parents opted to terminate the pregnancy.A malformed female fetus with some characterization of Down syndrome was delivered.Conclusions:FISH and aCGH analyses are useful in prenatal diagnosis of de novo alterations of small fragments of the chromosome.%目的 报道罕见的新生21号染色体部分重复致胎儿唐氏综合征的产前诊断一例,并对相关文献进行复习.临床资料 患者29岁,G1P0,孕15周超声发现胎儿颈后皱褶厚0.6 cm,孕16周母血清学筛查提示胎儿罹患唐氏综合征的风险为1/110,孕18周行羊膜腔穿刺术.采用DSCR2:21q22探针的羊水间期细胞荧光原位杂交(fluorescence in situ hybridization,FISH)分析发现在细胞核中出现3个杂交信号,但羊水细胞染色体核型分析结果为46,XX,21p+. 结果 孕妇夫妇外周血染色体核型分析未见异常,进一步行羊水中期分裂相FISH分析发现在一条21号染色体的短臂上出现了一个杂交信号.提取羊水细胞DNA行基于微阵列的比较基因组杂交(array-based comparative genomic hybridization,aCGH)分析发现胎儿的21号染色体出现部分重复和部分缺失,包括21q22.12-21q22.3区域11.74 Mb的重复、21q21.1区域1.33 Mb的重复、21q21.3区域1.31Mb的重复、21q21.1-21q21.2区域1.68Mb的缺失.孕妇及其家属选择终止妊娠.于孕26周行利凡诺引产,分娩一死女婴,尸检观察女婴外观符合唐氏综合征的临床特征. 结论 FISH和aCGH技术是产前诊断新生染色体小片段改变的有效方法.

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