荧光原位杂交技术产前诊断唐氏综合征

目的应用荧光原位杂交(fluorescence in situ hybridization,FISH)技术,简便、快速、准确产前诊断唐氏综合征.方法采用染色体特殊位点的特异性探针(LSI21)对30例羊水细胞和6例绒毛细胞标本进行未培养间期细胞荧光原位杂交.结果检测出21三体儿1例, 21三体和二倍体的嵌合体1例.检测结果与染色体核型分析及随访相符.结论 FISH技术应用于未培养间期细胞产前诊断唐氏综合征,可使诊断时间提早到孕50～70d,并且具有简便、快速、准确、灵敏度高、特异性强的独特优势.     

用荧光原位杂交技术对100例羊水标本的产前诊断

目的探讨荧光原位杂交（fluorescence in situ hybridization,FISH）技术在快速产前诊断胎儿染色体数目异常中的价值。方法对100例孕18-23w、有产前诊断指征者,在B超引导下经腹抽取羊水后,应用18号、X、Y染色体着丝粒探针以及13q14和21q22特异性探针,对未培养的羊水间期细胞进行荧光原位杂交（FISH）,然后用荧光显微镜进行观察,并用荧光成像系统进行摄像和后期处理。结果 100例产前诊断者中,羊水间期细胞染色体数目正常者99例,染色体数目异常者1例（47,XX,＋21）,此例经引产后取脐血,经核型分析证实。结论 FISH可以快速、准确的诊断胎儿染色体数目异常。     

新疆地区荧光原位杂交产前诊断非整倍体的应用价值

目的探讨荧光原位杂交（FISH）技术产前诊断常见染色体非整倍体的应用价值。方法采用21、18、13、和Y染色体特异性DNA探针对96例孕18～23周孕妇的未培养羊水细胞进行FISH检测,同时行羊水细胞染色体核型分析。结果 FISH检测98例成功96例（97.9%）,其中染色体数目正常93例（48例为46,XX;45例为46,XY）染色体数目异常3例（2例47,XX,＋21;1例47,XX＋18）。FISH诊断结果与核型分析结果一致,染色体数目异常的3例与传统核型分析结果完全一致。结论 FISH技术用于产前诊断常见染色体非整倍体,具有简便、快速、特异性强敏感性高、所用样本量少等优点。     

用荧光原位杂交技术对200例孕妇羊水标本的产前诊断

目的探讨荧光原位杂交（fluorescenceinsituhybridization,FISH）技术在快速产前诊断胎儿染色体数目异常中的价值。方法对200例孕18—23周、有产前诊断指征者,在B超引导下经腹抽取羊水后,应用18号、x、Y染色体着丝粒探针以及13q14和21q22特异性探针,对未培养的羊水间期细胞进行荧光原位杂交（FISH）,然后用荧光显微镜进行观察,并用荧光成像系统进行摄像和后期处理。结果200例产前诊断者中,羊水间期细胞染色体数目正常者192例,染色体数目异常者8例;染色体数目正常的192例中,经核型分析,发现染色体结构异常5例,其中易位3例,倒位2例。结论FISH可以．涣诛、准确饷讼断胎儿染聋．伙拊目异常但对婆盎．伙曹圭柏异常的论断骼力有限     

荧光原位杂交技术在染色体异常中的应用研究

目的应用荧光原位杂交（FISH）技术及细胞学对照,研究FISH产前诊断染色体异常的临床应用。方法应用5种（21、13、18、X和Y）FISH探针,平行细胞染色体分析进行565名孕妇产前诊断检测。结果565例产前诊断病历,共检出非整倍体异常核型19例,FISH检测与细胞染色体分析结果一致。结论荧光原位杂交（13,18,21,X和Y）探针,能有效检测间期羊水细胞的绝大多数非整倍体异常,且24～48h出结果。能缓解妊娠妇女的焦虑情绪。     

荧光原位杂交技术在检测胎儿染色体数目异常中的应用

目的探讨荧光原位杂交（fluorescence in situ hybridization,FISH）技术在检测胎儿染色体数目异常中的临床应用价值。方法对50例孕16～22周妊娠妇女羊水间期细胞进行FISH（13、21、18、X、Y）快速产前诊断,以常规羊水细胞培养染色体核型分析作为FISH检测结果对照。结果被检50例羊水间期细胞均获得诊断结果,其中48例为正常胎儿,两例为异常胎儿（1例为48,XXY＋21,另1例为47,XXX）。FISH检测与常规染色体核型分析结果一致。结论FISH检测胎儿染色体数目异常具有快速、简便等优点,结果准确可靠,有较大临床应用价值。     

用荧光原位杂交和核型分析技术对200例羊水标本的产前诊断

目的探讨荧光原位杂交(fluorescence in situ hybridization,FISH)技术和羊水细胞培养、核型分析技术在产前诊断胎儿染色体数目和结构异常中的价值。方法对200例孕18-23w、有产前诊断指征者,在B超引导下经腹抽取羊水后,一部分羊水应用13、18、21及X、Y染色体探针,对未培养的羊水间期细胞进行荧光原位杂交检测(FISH)。另一部分羊水进行细胞培养,进行染色体核型分析。结果 200例产前诊断者中,经FISH检测,羊水间期细胞染色体数目正常者189例,染色体数目异常者11例(其中7例47,XN,+21,1例47,XX,+18,2例45,X,1例47,XXY),此11例经引产后取脐血,经核型分析证实。进行细胞培养的标本中有2例培养失败,再次抽取羊水后培养成功。异常12例,其中数目异常11例,结构异常1例(新发罗氏易位),多态性9例。结论 FISH可以快速、准确的诊断胎儿染色体数目异常,核型分析可以全面的诊断胎儿染色体数目和结构异常,产前诊断中应将两者结合运用。     

用FISH技术快速诊断胎儿常见染色体数目异常

目的探讨荧光原位杂交(FISH)技术在产前诊断中的应用价值.方法采用13、18、21、X和Y染色体特异性DNA探针,对114例孕15～37w孕妇的羊水间期核进行FISH检测,同时行常规羊水细胞核型分析.结果与羊水细胞核型分析相符的染色体正常111例,异常3例,(47,XX 21、47,XY 21和46,XX,-21, t(21;21);另有1例核型为46,XY,t(15;18)(q26;q22),FISH信号显示正常.3例数目异常胎儿引产时抽脐血染色体检查结果与产前诊断一致.结论FISH技术用于产前诊断常见染色体数目异常,具有简便、快速、特异性强等优点,但有一定的局限性.应与常规核型分析相结合方可为临床提供更为真实可靠的信息.     

荧光原位杂交技术在羊水细胞染色体非整倍体产前诊断中的应用

目的探讨荧光原位杂交(FISH)技术在羊水胎儿染色体非整倍体产前诊断中的应用。方法对188例孕18-23周有产前诊断指征的孕妇选用13、18、21、X、Y特异性探针进行羊水间期细胞分析,并与羊水细胞中期细胞培养结果进行对照。结果在188例羊水FISH检测中均检测成功,其中正常核型175例,数目异常核型3例,与中期羊水染色体细胞培养结果一致,另有5例正常变异,5例结构异常FISH技术未能检出。结论荧光原位杂交(FISH)技术检测羊水胎儿染色体数目异常过程简单、快速、灵敏度较高、特异性较强,对于非整倍体产前诊断具有重要意义。     

荧光原位杂交技术在产前诊断中的应用价值探讨

目的探讨荧光原位杂交技术(fluorescence in situ hybridization,FISH)在羊水产前诊断中的应用价值。方法 2644例符合羊水产前诊断指征的孕妇在抽羊水行染色体检查的同时,用常见非整倍体探针对未培养的羊水间期细胞行FISH检查,其中1661例唐氏高风险孕妇采用LSI 21(红色)、71例18三体高风险孕妇采用CEP 18(天蓝色)、912例高龄或超声异常征象及其它早孕用药、不良孕史等因素孕妇采用LSI 21(红色)/LSI 13(绿色)/CEP 18(天蓝色)/CEP X(绿色)/CEP Y(红色)探针,对2644例羊水核型分析和FISH结果进行比较。结果 FISH检出染色体数目异常102例,检出率3.9%(102/2644),核型分析发现异常病例124例,检出率4.7%(124/2644),两者比较无显著差异(P0.05)。124例异常核型中99例为染色体数目异常,占异常核型的79.8%(99/124),FISH全部检出,其中97例两种方法结果完全一致,两例结果不符(一例FISH:18三体,核型分析:三倍体;另一例FISH:13、18、21、X三体,核型分析:三倍体)。124例异常核型中22例染色体结构异常,占异常核型的17.7%(22/124),分别为:罗氏易位5例,相互易位8例,倒位4例,X长臂等臂1例,1号染色体部分重复1例,标记染色体1例,20号染色体长臂双着丝粒1例,9号染色体含不明来源物1例,FISH未能检出,假阴性率0.8%(22/2644)。124例异常核型中3例存在染色体结构和数目双重变化,为罗氏不平衡易位,FISH检出其数目异常。结论 FISH在羊水产前诊断中对于常见非整倍体具有快速、准确的特点,但需严格掌握指征。     

Down syndrome with pure partial trisomy 21q22 due to a paternal insertion (4;21) uncovered by uncultured amniotic fluid interphase FISH

OBJECTIVE: To emphasize the usefulness and reliability of fluorescence in situ hybridization (FISH) on uncultured amniotic fluid cells in the prenatal diagnosis of common chromosomal aneuploidies. METHODS: FISH analyses utilizing centromeric, locus-specific or whole chromosome paint DNA probes specific for chromosomes X, Y, 13, 18, 21, and 4 were performed on uncultured amniotic fluid cells or the peripheral blood specimen from the father. Routine chromosome analysis was carried out as well. RESULTS: A prenatal case with partial trisomy 21 due to a paternal cryptic insertion (4;21) was ascertained by a rapid overnight FISH on uncultured amniotic fluid cells. The fetus was delivered at term and had classical features of Down syndrome. CONCLUSION: Our results stress the importance of FISH on uncultured amniotic fluid cells to supplement routine cytogenetics, especially in cases with abnormal ultrasound findings.     

应用荧光原位杂交产前诊断未培养羊水细胞非整倍体

目的探讨荧光原位杂交(fluorescenceinsituhybridization,FISH)诊断未培养羊水细胞非整倍体的临床应用价值。方法对55例孕16～32周未培养羊水细胞进行FISH快速产前诊断,应用多色FISH对另4条染色体(X、Y、13号和18号)进行检测。以经母腹穿刺取胎血常规核型分析作为FISH检测结果对照。结果被检55例羊水未培养细胞均获得诊断结果,发现两例异常胎儿。1例为标准型21三体;另1例为21三体嵌合体。FISH检测与常规核型分析结果一致。结论FISH检测未培养羊水细胞非整倍体具有快速、简便、所用样本量少的优势,结果准确可靠,可达到产前诊断要求,有较大临床应用价值。     

Role of multicolor fluorescence in situ hybridization (FISH) in simultaneous detection of probe sets for chromosome 18, X and Y in uncultured amniotic fluid cells.

Major aneuploidies diagnosed prenatally involve the autosomes 13, 18, and 21, and sex chromosomes. Fluorescence in situ hybridization (FISH) allows rapid analysis of chromosome copy number in interphase cells. The purpose of this study was to evaluate the role of multicolor fluorescence in situ hybridization in simultaneous detection of probe sets for chromosome 18, X, and Y in uncultured amniotic fluid cells as a safer alternative method for aneuploidy detection prenatally. Fifty amniotic fluid samples were analyzed by FISH and standard cytogenetics. Mean time to obtain results was three days for fluorescence in situ hybridization and 20 days for karyotype. Fluorescence in situ hybridization was informative in 43 samples (86%), and within this group, two aneuploidies were correctly identified. This evaluation demonstrates that FISH with X, Y, and 18 alpha satellite DNA probes could accurately and rapidly detect aneuploidies involving these chromosomes and could be used in any prenatal clinical laboratory.     

未培养羊水荧光原位杂交快速检测60例胎儿常见染色体数目异常

目的 应用细菌人工染色体(bacterial artificial chromosome,BAC)克隆自行制备荧光探针,对胎儿常见染色体数目异常(13,18,21,X,Y)行快速产前诊断.方法 利用中国医学遗传学国家重点实验室BAC库中相应染色体特异位点克隆,自行制备荧光探针.经外周血淋巴细胞染色体杂交验证后,用于胎儿未培养羊水的快速荧光原位杂交fluorescence in situ hybridization,FISH)检测,已检测60例羊水标本.结果 所有探针特异性均为100%,杂交成功率为97.86%;FISH结果与常规核型分析一致,检出21三体2例,18三体1例.有两例涉及其它染色体的结构异常未能检出.结论 自制探针用于未培养羊水快速FISH,使用标本量少、快速、简便,可有效检出上述5种染色体的数目异常,但本法不能检出其他染色体的数目异常和结构异常,其应用仍有一定局限性.     

应用荧光原位杂交快速产前诊断唐氏综合征

目的建立稳定的荧光原位杂交(fluorescence in situ hybridization,FISH)技术并用于唐氏综合征的产前诊断.方法对126例孕17w～24w未培养羊水细胞进行FISH快速产前诊断,以培养羊水细胞常规G显带核型分析作为FISH检测结果对照.结果被检126例羊水未培养细胞均获得诊断结果,发现4例异常胎儿.3例为标准型唐氏综合征;另1例为嵌合体.FISH检测与常规核型分析结果一致.结论FISH用于唐氏综合征产前诊断具有快速、简便、所用样本量少的优势,结果准确可靠,可达到产前诊断要求,有较大临床应用价值.     

荧光原位杂交技术在遗传病诊断中的应用

目的探讨荧光原位杂交(fluorescenceinsituhybridization,FISH)技术在遗传病和产前诊断中的应用价值。方法应用着丝粒探针、特异性序列探针及染色体涂染探针等对36例常规核型分析疑有染色体异常患者的外周血和45例进行产前诊断的孕妇羊水间期细胞或中期分裂相进行FISH检测。结果检出的染色体异常类型有45,X、45,X/46,XX、45,X/46,Xr(X)、46,X,i(Xq)、47,XXY、46,XX,t(4;7)、47,XYY、47,XXX、47,XXY,inv(7)、46,XY,inv(7)、47,XX, 21,同时产前诊断出两例异常胎儿,分别是47,XX, 18和46,XY,der(15)t(Y;15)。结论FISH技术可以准确、快速地诊断各种染色体异常,是传统细胞遗传学的必要补充,可广泛用于遗传病诊断及产前诊断。     

Amniotic fluid interphase fluorescence in situ hybridization (FISH) for detection of aneuploidy; experiences in 130 prenatal cases

The major aneuploidies diagnosed prenatally involve the autosomes 13, 18, 21, and sex chromosomes X and Y. Fluorescence in situ hybridization (FISH) allows rapid analysis of chromosome copy number in interphase cells. We retrospectively reviewed 130 amniotic fluid interphase FISH analyses from January 1997 to December 2001. The review was done in order to assess the role of interphase FISH among the patients who were at the risk of fetal aneuploidies. The sample was considered to be aneuploid when 70% of or more than the total number of hybridized nuclei displayed the same abnormal hybridization pattern for a specific probe. All of 130 cases but one met the criteria. The results were considered as informative and they were obtained in 24-48 hr. The overall detection rate for aneuploidies was 100% (2 cases of trisomy 21, 2 cases of trisomy 18, and 1 case of Turner syndrome). In comparison to cytogenetics, the rates of both sensitivity and specificity were 100%. The experiment demonstrates that FISH can provide a rapid and accurate clinical method for prenatal identification of chromosome aneuploidies. The experiment can also serve as an adjunctive test to help cytogenetics to reduce significant amount of emotional stress of patients and physicians through early decision making process.     

Routine prenatal diagnosis of aneuploidy by FISH studies in high-risk pregnancies

This study is a prospective clinical trial with fluorescent in situ hybridization (FISH) as a "routine" test for prenatal detection of the most common aneuploidies in high-risk pregnancies. Since April 1996, FISH studies with multicolor, commercially available, specific probes for chromosomes 13, 18, 21, X, and Y have been routinely performed in our cytogenetic laboratory on uncultured chorionic villous samplings (CVS), amniotic fluid samples, or fetal blood obtained by cordocentesis from patients with major or minor fetal anomalies detected by ultrasonography. Among the 4,193 prenatal samples analyzed between April 1996 and June 1998, routine FISH studies were ordered by the referring physicians on 301 (7.2%) cases. Aneuploidies were detected in 32 (10.6%) samples. Fourteen trisomy-21, 10 trisomy-18, 3 trisomy-13, 4 monosomies of X, and 1 case of triploidy were diagnosed by FISH. All 1,505 hybridizations were informative, and all 301 results were available and reported to the referring physicians in 24-48 hr. All relevant FISH results were confirmed by subsequent cytogenetic analysis. In 10 (3.8%) cases with normal FISH results, the final cytogenetic analysis revealed abnormal chromosomal rearrangements that could not be detected by the routine FISH studies. We conclude that rapid FISH analysis of interphase, uncultured fetal cells is an accurate and very sensitive method for routine prenatal diagnosis of the most common aneuploidies in high-risk pregnancies.     

Routine prenatal diagnosis of aneuploidy by FISH studies in high‐risk pregnancies

This study is a prospective clinical trial with fluorescent in situ hybridization (FISH) as a “routine” test for prenatal detection of the most common aneuploidies in high‐risk pregnancies. Since April 1996, FISH studies with multicolor, commercially available, specific probes for chromosomes 13, 18, 21, X, and Y have been routinely performed in our cytogenetic laboratory on uncultured chorionic villous samplings (CVS), amniotic fluid samples, or fetal blood obtained by cordocentesis from patients with major or minor fetal anomalies detected by ultrasonography. Among the 4,193 prenatal samples analyzed between April 1996 and June 1998, routine FISH studies were ordered by the referring physicians on 301 (7.2%) cases. Aneuploidies were detected in 32 (10.6%) samples. Fourteen trisomy‐21, 10 trisomy‐18, 3 trisomy‐13, 4 monosomies of X, and 1 case of triploidy were diagnosed by FISH. All 1,505 hybridizations were informative, and all 301 results were available and reported to the referring physicians in 24–48 hr. All relevant FISH results were confirmed by subsequent cytogenetic analysis. In 10 (3.8%) cases with normal FISH results, the final cytogenetic analysis revealed abnormal chromosomal rearrangements that could not be detected by the routine FISH studies. We conclude that rapid FISH analysis of interphase, uncultured fetal cells is an accurate and very sensitive method for routine prenatal diagnosis of the most common aneuploidies in high‐risk pregnancies. Am. J. Med. Genet. 90:233–238, 2000. © 2000 Wiley‐Liss, Inc.