闭经患者细胞遗传学检查的临床意义

目的 :分析闭经患者细胞遗传学的检查结果及其临床意义。方法 :对每例闭经患者进行常规妇科检查及细胞遗传学检查 ,包括外周血淋巴细胞培养制备染色体 ,G显带与C显带 ,必要时进行高分辨显带或银染处理 ,或同时用内分泌及超声检查。结果 :2 33例闭经患者中 ,88例染色体异常 ,占 37 78% ,包括染色体数异常、缺失、倒位及嵌合。结论 :染色体异常是闭经的主要原因之一 ,染色体核型分析对确诊闭经的病因、治疗及确定预后必不可少     

与闭经有关的遗传学问题

闭经(amenorrhea)并非一种独立疾病,而是多种妇科疾病中的一种常见症状。临床研究显示,导致闭经的一些疾病存在明显的遗传倾向。因此,对这些疾病的遗传学病因的探索是多年来的一个研究热点。遗传学研究以基因和染色体为核心内容,随着遗传学在20世纪早、中期之后突飞猛进的发展,     

776对原发不孕夫妇病因及细胞遗传学分析

目的 :探讨原发不孕的原因及诊断方法。方法 :1.夫妇双方一同就诊 ;2 .女方常规妇科检查、实验室及物理检查 ;3.分析男方精液 ,以WHO检验手册标准分析结果 ;4 .细胞遗传学染色体检查。结果 :776对原发不孕患者中 ,单纯女方异常 313对 ,占4 0 .34% ;单纯男方异常 178对 ,占 2 2 .94 % ;双方均异常 2 85对 ,占 36.73%。发现染色体异常 10 3例 ,异常检出率为 13.2 7%。结论 :1.重视男性不育和严格的精液检查在不孕症的诊断中至关重要 ;2 .在原发不孕中 ,染色体异常是重要原因之一 ,染色体异常导致的不孕多数是不可逆的 ,所以婚前的细胞遗传学检查染色体分析尤为重要 ,在了解自己的生育状况后 ,才可能正确选择婚姻和配偶     

染色体G显带结合荧光原位杂交技术检测原发闭经患者性染色体异常的价值

目的探讨荧光原位杂交(FISH)技术检测原发闭经患者的性染色体异常的价值。方法收集2004年5月至2005年8月复旦大学妇产科医院诊断为原发闭经患者93例,进行血清促性腺激素水平的测定,染色体常规的G显带和FISH检测,并比较G带结果与FISH结果。结果93例患者中高促性腺激素水平有41例,低促性腺激素水平5例,促性腺激素水平正常47例。41例高促性腺激素水平的患者中,28例染色体G带显示异常,均为性染色体数目或结构的异常;FISH检测又发现9例性染色体数目异常的嵌合体,嵌合比例为11%～18%。结论原发闭经患者,特别是高促性腺激素水平患者,性染色体异常占一定比例。应在常规染色体G显带的基础上,辅以FISH检测性染色体,以更好明确病因,为有效治疗提供线索。     

月经紊乱患者的细胞遗传学分析

目的 分析原发闭经、继发闭经及月经稀发患者的染色体核型,探讨性染色体异常对性腺发育的影响。方法 将176例患者分为两组,其中82例原发闭经组,94例继发闭经及月经稀发组。每例行外周血培养,制片及G显带,并行染色体核型分析。结果 176例患者发现性染色体异常38例,异常检出率为29.6％(38/176),其中原发闭经组33例,异常检出率为40.2％(33/82);继发闭经及月经稀发组检出性染色体异常5例,异常检出率为5.3％(5/94);两组异常检出率差异有显著性(P<0.05)。性染色体异常大体上分为三大类:含Y染色体(15例),X染色体数目异常(18例),X染色体结构异常(5例),嵌合体均以45,X系为主,共10例。结论 两条完整的染色体是女性性腺发育及正常卵巢功能所必须,性染色体异常是原发闭经的主要原因之一,常规细胞遗传学检查是必要的;继发闭经及月经稀发也不应忽视此项检查。     

性分化异常患者的细胞遗传学病因分析

目的：性分化异常的细胞遗传学病因。方法：每例性分化异常患者取外周血淋巴细胞常规制备染色体。Ｇ带、Ｃ带,高分辨显带及银染技术分析核型。结果：１１１例性分化异常患者中检出染色体异常４５例,数量异常１４例,结构异常３１例,包括缺失、倒位、易位、环状染色体、额外小染色体等。结论：染色体异常是性分化异常的重要原因,分析患者的核型,对于诊断及治疗均有一定意义。     

复发性自然流产的遗传学病因研究进展

复发性自然流产(RSA)是指连续发生2次或2次以上流产者。RSA病因复杂,近年来研究发现其与遗传学因素密切相关,包括胚胎及流产夫妇染色体异常和单核苷酸多态性(SNP)等。现将近年来复发性自然流产的遗传学病因作一综述。     

FISH技术在检测自然流产绒毛组织非整倍体异常中的应用研究

目的:探讨运用荧光原位杂交(FISH)检测自然流产绒毛组织的临床价值,评价它与传统经典的核型分析方法的关系。方法:对157例孕早期自然流产的绒毛组织进行FISH检测,均采用16、22、13、21、18、X、Y号染色体荧光探针检测,判断染色体非整倍体异常情况。同时进行绒毛细胞培养染色体核型分析,作为对照诊断标准。结果:核型分析成功率为48.4%,FISH检测成功率为100%。核型分析成功的76例样本中,64例结果与核型分析结果相一致,以细胞遗传学作为诊断标准,诊断的符合率为84.2%。结论:FISH技术与传统的绒毛细胞培养染色体核型分析相比,过程迅速,方法简单,提高了诊断的成功率,但无法完全取代传统的染色体核型分析,应两者结合应用于临床。     

应用双色间期FISH技术中宫颈脱落细胞取材及制片方法的探讨

目的在双色间期荧光原位杂交技术（FISH）中探讨采集宫颈脱落细胞样本及制片的最佳方法。方法采集在北京大学人民医院门诊就诊174例患者的宫颈脱落细胞,应用新鲜细胞直接涂片（60例）、生理盐水制片（31例）,TCT剩余液体直接制片（37例）、TCT盐水制片（30例）和TCT低渗制片（16例）五种取材制片方法;并应用双色间期FISH法,检测宫颈脱落细胞的TERC基因表达率,对比取材制片的最佳方法。结果在直接涂片法、盐水制片法、TCT制片法、TCT盐水制片法和TCT低渗法五种制片过程中,TERC基因的杂交成功率分别是55.0%、61.3%、37.8%、53.3%和81.3%,其中TCT低渗法杂交成功率与TCT制片组比较,有显著差异（P〈0.05）,与其他方法比较,无明显差异（P〉0.05）;5种制片方法的玻片背景清晰比例分别为38.3%、54.8%、35.1%、60%和75%,各组之间有明显差异（P〈0.05）;5组的无/少信号比例分别为18.3%、16.1%、37.8%、23.3%和18.8%,其中新鲜制片的直接涂片法和盐水制片法与TCT直接制片法比较,有明显差异（P〈0.05）,与其他方法比较无差异（P〉0.05）。结论在应用双色间期FISH技术检测宫颈脱落细胞TERC基因时,以TCT低渗制片和新鲜细胞盐水制片操作方法简单快速,杂交成功率最高。     

胚胎植入前遗传学诊断10个周期的临床分析

目的:初步探讨使用荧光原位杂交(FISH)方法对染色体异常患者进行胚胎植入前遗传学诊断(PGD)的临床意义。方法:7对不孕夫妇采用长方案控制性超排和卵胞浆内单精子注射,受精后d3胚胎活检、卵裂球固定和FISH,d4或d5择合适胚胎移植。结果:7对夫妇共进行10个PGD周期。获卵251个,可供活检胚胎133个,活检卵裂球207个,胚胎活检成功率为96.2%(128/133)。128个成功活检胚胎的197个卵裂球,其单细胞固定率为93.9%(185/197),FISH信号率为90.8%(168/185)。10个周期共移植22个胚胎,3例获得妊娠,并均足月分娩健康婴儿,其中1例孕妇平衡易位携带者于孕中期时,羊水核型分析为平衡易位携带者。结论:应用FISH方法进行PGD,是遗传病高危夫妇预防流产和染色体异常患儿出生的有效手段。     

Efficacy of calcium ionophore A23187 oocyte activation for generating parthenotes for human embryo research

Purpose: Our purpose was to examine the efficacy of Ca-A23187 to activate human oocytes and produce parthenotes for research purposes. We examined the feasibility of using florescence in situ hybridization (FISH) to study the sex chromosome constitution of activated oocytes. Methods: One hundred eight nonfertilized oocytes from our IVF program were exposed to Ca-A23187. Oocyte activation was determined by the presence of pronuclear (PN) development. FISH was done on chromosome preparations using X and Y dual-colored probes. Polyploidic and parthenogenetically activated oocytes from our IVF program served as controls. Results: Of the 108 oocytes, 59 (55%) had no PN, 38 (35%) one PN, 10 (9%) two PN, and 1 (0.9%) three PN. Fifty-seven oocytes (53%) were not recovered following spreading and no chromatin was observed on 14 slides (13%) after FISH. This contrasted with 50 of 227 (22%) and 3 of 227 (1.7%) loss rates, respectively, for controls (P<0.0001). Eight of 49 activated oocytes underwent cleavage. FISH was performed on 37 oocytes. Of 21 zero-PN oocytes, I had no FISH signals, 15 had a single X, 4 had two X's, and I had four X's. For one-PN oocytes, two had no FISH signals, seven had one X, and three had two X's. For two-PN oocytes, two had no FISH signals and two had two X's. FISH results were consistent with a maternal origin of genetic material. Conclusions: Ca-A23187 resulted in a 45% activation rate, with 16% of oocytes progressing to cleavage before degeneration. Oocyte activation with Ca-A23187 allowed the generation of parthenotes for human embryo research. FISH was useful for evaluation of oocytes and parthenotes.     

Prenatal Identification of a Tetraploid Fetus with fish

The first prenatal diagnosis of a tetraploid fetus via fluorescent in situ hybridization (FISH) technology is reported. FISH analysis of uncultured amniotic fluid cells utilizing probes for chromosomes 13, 21, 18, X, and Y revealed that greater than 65% of hybridized nuclei had four signals. Standard cytogenetic analysis revealed a 92, XXXX karyotype     

荧光原位杂交与染色体核型分析应用于自然流产病因学诊断的比较研究

目的:分析并比较荧光原位杂交技术(fluorescence in situ hybridization,FISH)及普通染色体核型分析技术在自然流产中的诊断意义。方法:以早孕自然流产的患者为研究对象,共201例。将同一孕周的患者随机分为A组和B组,A组(n=100)进行绒毛培养加染色体核型分析,B组(n=101)进行FISH分析,另在A、B组孕6~11周患者中每一孕周各随机选取1例,每组6例,共12例同时进行2种技术分析,并比较结果。结果:染色体核型分析成功率为66%,其中核型异常率为30.3%;FISH成功率为100%,其中核型异常率为46.5%;2种检测技术检测出的异常核型率比较有统计学差异(P=0.036)。结论:2种分析技术对异常核型的检出率有明显的差异,FISH更容易成功,更能反应胚胎的染色体数目;染色体核型分析结合FISH技术能有效诊断自然流产的染色体异常。     

Allele dropout in sequential PCR and FISH analysis of single cells (cell recycling)

Purpose: Our purpose was to investigate the feasability of using sequential PCR and FISH analysis of single cells for preimplantation diagnosis. Methods: Protocols for sequential PCR and FISH analysis of a single fibroblast (cell recycling) were optimized for six loci and the rates of allele specific dropout (ADO) were determined. Results: Conditions that allow reliable genotyping of single cells in lysis buffer were not optimal for amplifying fibroblasts fixed to coverslips. After optimizing conditions, we observed a success rate of 85% for both analyses in sequential PCR-FISH experiments in single cells for the four loci studied. The individual success rates for each technique revealed a slightly higher rate for FISH (91–95%) than for PCR (85–87%) for single cells on coverslips. The presence of two hybridization signals in FISH experiments demonstrated that the failure to amplify both alleles from heterozygous cells on coverslips was due to true ADO, and not the loss of chromosomal material. The ADO rate observed on coverslips varied between 10 and 14%, which is significantly higher than that observed in solution, even after meticulous optimization. Conclusions: Sequential PCR and FISH analysis of single cells remains an attractive possibility. However, until the problem of the increased rate of ADO is resolved, cell recycling should not be applied to clinical preimplantation genetic analysis.Presented at the 5th Annual Meeting of the International Working Group on Preimplantation Genetics, Hamburg, Germany, June 28, 1995.     

父源性染色体异常胚胎植入前遗传学诊断的最新研究进展

染色体异常是导致男性不育的一个重要原因。不同类型染色体异常的生殖细胞进行减数分裂时形成不同类型的配子,且各种异常配子所比例的实际值与理论值不相符。另外,正常胚胎率与正常配子率也不一致。本文对染色体结构异常(相互易位、罗伯逊易位、倒位、染色体复杂性重组)和数目异常(性染色体数目异常、常染色体数目异常)男性的正常精子率以及正常胚胎率进行综述。     

Characterization of three small supernumerary marker chromosomes (sSMC) in humans

In the present study, three prenatally detected small supernumerary marker chromosomes (sSMC) were identified by banding cytogenetics and characterized in detail by molecular cytogenetics. In one case an sSMC(10) leading to a pericentric partial trisomy and in two cases heterochromatic sSMC derived from chromosome 22 were characterized. Outcomes were reportedly normal for two of the three cases for whom this information was known.     

Detection of chromosomal aberrations by fluorescence in situ hybridization in cervicovaginal biopsies from women exposed to diethylstilbestrol in utero

Epidemiologic studies have associated estrogens with human neoplasms such as those in the endometrium, cervix, vagina, breast, and liver. Perinatal exposure to natural (17beta-estradiol [17beta-E(2)]) and synthetic (diethylstilbestrol [DES]) estrogens induces neoplastic changes in humans and rodents. Previous studies demonstrated that neonatal 17beta-E(2) treatment of mice results in increased nuclear DNA content of cervicovaginal epithelium that precedes histologically evident neoplasia. In order to determine whether this effect was associated with chromosomal changes in humans, the frequencies of trisomy of chromosomes 1, 7, 11, and 17 were evaluated by the fluorescence in situ hybridization (FISH) technique in cervicovaginal tissue from 19 DES-exposed and 19 control women. The trisomic frequencies were significantly elevated in 4 of the 19 (21%) DES-exposed patients. One patient presented with trisomy of chromosomes 1, 7, and 11, while trisomy of chromosome 7 was observed in one patient. There were two patients with trisomy of chromosome 1. Trisomy of chromosomes 1, 7, 11, and 17 was not observed in the cervicovaginal tissue taken from control patients. These data suggest that DES-induced chromosomal trisomy may be an early event in the development of cervicovaginal neoplasia in humans.