应用实时荧光定量PCR快速分子诊断唐氏综合征

目的探讨一种快速、准确诊断唐氏综合征的方法。方法采用实时荧光定量PCR技术，对25例唐氏患者、50名正常人外周血标本，扩增21号及1号、19号染色体上的多态位点，定量分析比较正常组及唐氏患者组的4对△Ct值。结果唐氏患者组△Ct值明显低于正常组，两组比较差异有统计学意义（P〈0．001）。初步建立了临床应用的参考值范围，可以有效区分出唐氏样本和正常样本。结论应用实时荧光定量PCR技术可快速、准确诊断唐氏综合征，为唐氏综合征的快速产前诊断开辟了新的途径。     

实时荧光定量PCR法筛查唐氏综合征的实验研究

目的建立一种无创性、高特异性的快速筛查唐氏综合征（Down’s syndrome，DS）的检测方法。方法采用实时荧光定量PCR技术对正常人和DS患者外周血样本的有核细胞进行检测，根据△Ct值的差异建立检测方法。结果正常组和唐氏组△Ct值有显著性差异（P〈0．001），初步建立了实时荧光定量PCR筛查唐氏综合征的快速检测方法。结论实时荧光定量PCR具有无创性、特异性高且简单、快速等优点，适用于唐氏综合征产前筛查。     

多重实时定量PCR快速诊断唐氏及爱德华综合征

目的 建立多重实时定量聚合酶链反应(real-time quantitative polymerase chain reaction,RTqPCR)技术,快速分子诊断唐氏及爱德华综合征.方法 应用PCR方法同时扩增位于21号染色体上的淀粉样前蛋白基因(amyloid precursor protein gene,APP)和18号染色体上的胸苷酸合成酶基因(thymidylate synthetase gene,TYMS),以相对定量指标△CT值区分唐氏、爱德华综合征及正常人.用此方法检测4组样本:36名正常人外周血(A组)、15名正常核型的羊水细胞(B组)、21例唐氏综合征(C组)和6例爱德华综合征(D组).结果 A～D 4组样本△CT均值分别为-0.48±0.15、-0.49±0.12、-1.26±0.17和0.25±0.12.B组与A组间差异无统计学意义(P＞0.05);C组与A组、D组与A组间差异有统计学意义(P＜0.01),且无交叉重叠.结论 多重实时荧光定量PCR技术同时快速诊断唐氏及爱德华综合征是可行的.     

荧光定量PCR产前快速诊断唐氏综合征

目的探索荧光定量PCR方法在产前快速诊断唐氏综合征中的作用。方法收集65例妊娠20~24w,进行羊水穿刺胎儿细胞培养染色体核型分析的胎儿羊水,采用荧光定量PCR技术对标本D21S11位点进行PCR扩增、检测,并与染色体核型分析的结果进行对照分析。结果65例未培养羊水标本经过荧光定量PCR检测,发现2例唐氏综合征,显示1:1:1三条或2:1两条D21S11位点等位基因带,63例显示1:1两条带;与细胞培养染色体核型分析的结果基本一致。结论荧光定量PCR技术具有检测速度快、需要模板量少,检测结果准确等特点,可用于染色体异常的产前快速诊断。     

实时荧光定量PCR快速分子诊断唐氏综合征

目的　探讨快速诊断唐氏综合征的检测方法 .方法　采用实时荧光定量PCR技术 ,检测唐氏患者 2 3例、正常人 33例 ,定量分析比较ΔCt值 .结果　正常组和唐氏组ΔCt值有显著性差异 (p <0 .0 0 1) ,并建立了相应的参考值范围 .结论　实时荧光定量PCR具有简单、快速、特异性高等优点 ,可用于快速诊断唐氏综合征     

实时荧光定量PCR快速分子诊断唐氏综合征

目的探讨快速诊断唐氏综合征的检测方法.方法采用实时荧光定量PCR技术,检测唐氏患者23例、正常人33例,定量分析比较ΔCt值.结果正常组和唐氏组ΔCt值有显著性差异(p<0.001),并建立了相应的参考值范围.结论实时荧光定量PCR具有简单、快速、特异性高等优点,可用于快速诊断唐氏综合征.     

应用STR-荧光定量PCR行产前唐氏综合征诊断的初步研究

目的建立快速高效的产前诊断唐氏综合征的方法。方法选取21号染色体上唐氏综合征关键区域内的4个串联重复序列（STR）（D21S1413,D21S1414,D21S1446,D21S1437）作为遗传标记,采用荧光定量PCR扩增技术（QF—PCR）及片段分析技术来检测178例羊水标本,并与羊水标本的染色体核型分析结果相比对,评价QF—PCR方法的特异性和灵敏度。结果所有178例羊水标本中经核型分析证实有19例为21三体,另有2例为性染色体数目异常,19例唐氏综合征样本均可由QF—PCR法扩增检出。19例唐氏综合症样本,采用4对STR引物同时检测,阳性诊断率达100％。结论基于STR的QF—PCR技术具有简单、快速及准确等优点,对唐氏综合征大规模的产前基因诊断具有很好的临床价值。     

双色竞争性荧光定量PCR检测唐氏综合征

目的 建立一种快速检测唐氏综合征(Down syndrome,DS)的双色竞争性荧光定量聚合酶链反应(dual-color competitive quantitative fluorescent polymerase chain reaction,DCC-QF-PCR)方法,并探讨其应用于DS产前诊断的可能性.方法 提取30例DS患者和60名正常人的外周血DNA,设计DSCR和USC2两基因的特异共用引物和双色特异性TaqMan探针,同一反应管中进行两基因的DCC-QF-PCR,并与DSCR和GAPDH两基因的QF-PCR实验结果进行比较.提取46份羊水胎儿细胞的DNA进行DSCR和USC2两基因的DCC-QF-PCR,并与染色体核型分析结果对比;克隆出DSCR和USC2的单克隆基因片段,定量后进行定量配比的DCC-QF-PCR,并计算DSCR∶USC2拷贝数的比值.结果 DCC-QF-PCR检测中,DS患者DSCR∶USC2拷贝数比值范围为1.41～1.74,显著高于正常人的0.93～1.15;而QF-PCR检测中,DSCR∶GAPDH拷贝数比值范围较DSCR∶USC2增大.46份羊水检测中,3份DSCR∶USC2拷贝数比值分别为1.61、1.64和1.54,为DS患儿,其余43份正常,与染色体核型分析结果一致;DSCR与USC2基因定量配比的DCC-QF-PCR所得DSCR∶USC2拷贝数比值范围与配比值差异无统计学意义(P＞0.05),检测结果较为稳定.结论 DCC-QF-PCR具有准确、快速、需模板量少和费用低廉等特点,该方法在DS的基因诊断和产前基因诊断中有较为广泛的应用前景.     

利用双色实时荧光定量PCR法快速进行产前诊断

目的利用双色实时荧光定量PCR法进行21-三体与18-三体的快速产前诊断。方法分别以21号的APP基因与18号染色体的TYMS基因为目的基因设计引物和不同荧光标记的Taqman探针,以相对定量指标△CT值判断21号与18号染色体的数目;并将其检测结果与传统染色体核型分析方法进行对比。结果60例羊水细胞区分出了4例21-三体,3例18三体标本,正常人的△CT值为-0．89±0．22,21-三体患者及18-三体患者的ACT值分别-0．04±0．17和-1．55±0．24,患者与正常人标本组之间无交叉重叠,均有明显差异（P〈0．001）。结论实验建立的双重实时荧光定量PCR能用于快速诊断羊水细胞的21-三体和18-三体等非整倍体。     

孕妇血浆游离DNA在唐氏综合征筛查中的应用

目的探讨孕妇血浆游离DNA定量检测在唐氏综合征筛查中的价值。方法采用实时定量荧光PCR检测孕中期孕妇,唐氏综合征高危孕妇的血浆中3-磷酸甘油醛脱氢酶基因(GAPDH)及男性特有Y性别决定区(sex determ in ingregion Y,S R Y)基因。结果孕中期、唐氏综合征高危孕妇GAPDH拷贝数均值分别为(4.28±1.36)×103copy/m l,(3.08±1.67)×104copy/m l;孕中期、唐氏综合征高危孕妇的SRY拷贝数均值分别为174.02±98.56 copy/m l、1065.01±588.72 copy/m l。孕中期和唐氏高危孕妇血浆游离DNA含量有显著性差异。结论孕妇血浆游离DNA的定量分析在唐氏综合征筛查中有重要的价值。     

同源基因定量PCR方法快速产前诊断Down综合征

目的　探讨同源基因定量PCR方法在预防Down综合征患儿出生及无创性产前诊断中的应用价值。方法　对178名正常对照和38例Down综合征患者同时扩增位于2 1号染色体Down综合征致病关键区域的人肝型磷酸果糖激酶基因(PFKL- CH2 1)和位于1号染色体的人肌型磷酸果糖激酶基因(PFKM- CH1) ,计算机软件(Fluor Chem V2 .0 Stand- Alone)分析PFKM- CH1及PFKL- CH2 1产物的相对比。结果　正常人比值为1.4 0±0 .36 7,Down综合征患者比值为0 .4 6±0 .2 1,经t检验差异有统计学意义。结论　这种定量PCR方法不但能检测2 1三体型,也可检测易位型Down综合征。     

Rapid prenatal diagnosis of trisomy 21 by real-time quantitative polymerase chain reaction with amplification of small tandem repeats and S100B in chromosome 21

Trisomy 21 (Down syndrome) is the most common congenital anomaly, and it occurs in one out of 700-1000 births. Current techniques such as amniocentesis and chorionic villi sampling (CVS) require lengthy laboratory culture procedures and high costs. This study was undertaken to establish a rapid prenatal diagnosis of trisomy 21 using real-time quantitative polymerase chain reaction (PCR) of fetal DNA from amniotic fluid. Real-time quantitative PCR was performed with DNA templates obtained from 14 normal blood samples, 10 normal amniotic fluid samples, 14 Down syndrome blood samples, and 7 Down syndrome amniotic fluid samples. Primers for D21S167 and S100B of chromosome 21 were used. Primers that direct the amplification of the 165-bp fragment of the insulin-like growth factor (IGF)-1 gene on chromosome 12 using a PCR primer were included to generate an internal standard for quantitation. The relative levels of D21S167 and S100B were 2.6 and 2.4 times higher in the blood of Down syndrome patients than those in the control group. The differences between these two groups were statistically significant (p-values were 0.0012 and 0.0016, respectively). The relative levels of D21S167 and S100B were 2.1 and 2.7 times higher in the amniotic fluid of Down syndrome fetuses than those in the control group. The difference between these two groups was statistically significant (p-values were 0.0379 and 0.0379, respectively). Prenatal diagnosis of trisomy 21 by real-time quantitative PCR using STR (small tandem repeats) amplification of D21S167 and S100B is a useful, accurate and rapid diagnostic method. Furthermore, it may also be useful for prenatal diagnosis with fetal DNA from maternal blood, and for preimplantation genetic diagnosis and prenatal counseling.     

荧光定量PCR快速诊断21三体综合征

目的　建立荧光定量PCR技术检测 2 1三体综合征。方法　采用PCR方法同时扩增位于 2 1号染色体上的人肝型磷酸果糖激酶基因 (humanliver typephosphofructokinasegene ,PFKL CH 2 1)和位于 1号染色体上的人肌型磷酸果糖激酶基因 (humanmuscle typephosphofructokinasegene ,PFKM CH1) ,使用SYBRGreenⅠ荧光染料处理产物、琼脂糖电泳后在凝胶成像系统进行分析 ,得出扩增产物的荧光强度对比值。用此方法检测 2 6例 2 1三体综合征患儿及 2 0名正常人。结果　 2 6例 2 1三体综合征患儿PFKL CH2 1/PFKM CH 1扩增产物的荧光强度对比值为 1.5 8± 0 .17,而正常人为 1 0 0± 0 .0 5 ,两者差异有显著性。结论　SYBRGreenⅠ荧光定量PCR技术检测 2 1三体综合征具有准确、快速、安全、实用等特点 ,有较高的临床使用价值。     

Triple marker screening for fetal chromosomal abnormalities in Korean women of advanced maternal age

The purpose of this article is to assess the value of maternal serum triple marker screening of alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), and unconjugated estriol (uE3) for the prenatal diagnosis of fetal chromosomal abnormalities in Korean women of advanced maternal age. Maternal sera were collected from 458 pregnant Korean women aged 35 between 15 and 20 weeks gestation before amniocentesis. A patient- specific second trimester risk for fetal Down's syndrome was calculated using the median values for AFP, hCG, uE3 and maternal age. Twelve fetal chromosomal abnormalities were identified. These included six cases of trisomy 21, one case of 46,XY/47,XY,+21, two cases of trisomy 18, one case of trisomy 13, and two cases of 45, X. A cutoff level of 1:200 detected 85.7% (6/7) of the cases of Down's syndrome and 20% (1/5) of the other aneuploidies, with a 27.3% false positive rate. However, a cutoff level of 1:270 did not result in any gains in detecting Down's syndrome or other aneuploidies at the expense of a false positive rate of 34.3%. Second trimester triple marker testing is an effective screening tool for detecting fetal Down's syndrome in Korean women > or = 35 years old. However, it is not an effective screening tool for non-Down's chromosomal abnormalities.     

Two cases of partial trisomy 21 (pter-q22.1) without the major features of Down syndrome

We report two cases of partial trisomy 21 with clinical features distinct from Down syndrome (DS). These patients presented with moderate mental retardation and short stature, but the typical facial appearance of DS was not observed. Each patient had a similarly sized extra chromosome 21. We performed FISH analysis to examine whether deletions of reported approximately 5 Mb DS critical region (DSCR) might be associated with unusual clinical features in these cases. The results showed that each of their extra chromosomes 21 contained a distal part of chromosome 3p or 14q at the telomeric region of chromosome 21q. The translocation breakpoint of 21q for each patient was located on the centromeric side of DSCR (DSCR was deleted) and the sizes of partial trisomy 21 in respective patients are approximately 34.5 (21pter-q22.12) and approximately 33.0 Mb (21pter-q22.11). In one patient, the additional region of the short arm of chromosome 3 was 3pter-p26.1 from maternal origin, measuring approximately 9 Mb in size. The second patient had an extra 14q32.1-qter of maternal origin, measuring approximately 14 Mb in size. These are one of the shortest partial distal trisomy among reported cases. Taken together, two patients with partial trisomy 21 lack all of DSCR on 21q22, and their distinct clinical features are likely caused by the genes located at 21pter-q22.1 and the distal part of chromosome 3p or 14q.     

Assessment of multiplex fluorescent PCR for screening single cells for trisomy 21 and single gene defects

A great majority of patients seeking preimplantation genetic diagnosis (PGD) are women >35 years of age. In addition to being carriers for single gene defects, these women also have a higher risk of having children with Down's syndrome (trisomy 21). For these patients, it would be advantageous if a diagnostic test for trisomy 21 was developed, which could be used in conjunction with tests for single gene defects. Here, we assessed the feasibility of developing an accurate genetic test for diagnosing trisomy 21 and the mutation causing spinal muscular atrophy (SMA) in single cells using multiplex fluorescence polymerase chain reaction (PCR). Single- and two-round PCR were developed using a combination of primers for the survival motor neuron (SMN) gene exons 7 and 8 and two chromosome 21 short tandem repeats (STRs), D21S226 and D21S11. After only 36 cycles, 88 and 68% of normal single cells were screened for SMA mutations and trisomy 21 respectively. In multiplex PCR using only two primers (SMN exon 7 and D21S11) instead of four, the efficiency of SMA diagnosis was increased to 93%. In the same reactions, the D21S11 alleles were detected in 83% of the normal single cells. Clinical applications of this assay should enable detection of those embryos that have inherited three heterozygous alleles and, therefore, benefit many PGD patients who are at an increased risk of Down's syndrome.     

多重PCR联合DHPLC诊断21三体综合征方法的建立

目的初步建立多重PCR联合DHPLC技术检测21-三体综合征的方法。方法针对21号染色体上特异的3个STR位点(D21S1435、D21S1411、D21S11)设计引物,对100例外周血标本(其中25例21三体标本)提取基因组DNA进行多重PCR扩增,得到的PCR产物通过DHPLC仪进行结果分析。结果 DHPLC分析100例标本中21例为21-三体标本,其中20例21-三体标本的诊断结果与染色体核型分析结果一致,DHPLC技术检测21-三体异常灵敏度和特异度分别为80%,98.67%。结论 DHPLC技术诊断外周血标本结果与染色体核型诊断结果具有同一性,DHPLC技术可以对21三体综合症作出快速、较为准确的诊断。     

Down''s syndrome in twins

Male twins concordant for Down's syndrome and female twins discordant for Down's syndrome were investigated. Both males have trisomy 21 (47, XY, 21 +), and their parents are normal. One of the female twins is mosaic for trisomy 21 (46, XX/47, XX, 21 +) and the other is normal (46, XX). On the basis of multiple parameters, it is suggested that both pairs of twins are mono-zygous, including the female twins discordant for Down's syndrome.
Once the underlying cytogenetic mechanisms are understood and elucidated, genetic counselling can be undertaken.