Turner综合征患儿标记染色体的来源研究

目的 了解Turner综合征患儿标记染色体的来源，以指导遗传咨询及治疗。方法 在染色体核型分析的基础上，对32例Turner综合征患者进行回顾性分析。对3例含有标记染色体的患儿进一步用荧光原位杂交技术研究标记染色体的来源。结果 3例含有标记染色体的Turner综合征患儿中，确定1例患儿的标记染色体来源于Y染色体，含有性别决定基因；1例来源于X染色体；另外1例未能确定其来源，该标记染色体可能来源于性染色体的其他片段或其他端着丝粒染色体。结论 Turner综合征患者的标记染色体大多来源于性染色体（X染色体、Y染色体），也可能来源于其他端着丝粒染色体。有必要同时应用X染色体和Y染色体特异性探针对Turner综合征患者进行标记染色体的荧光原位杂交分析，以明确标记染色体的来源。     

组合探针荧光原位杂交检测骨髓增生异常综合征常见染色体异常

目的：评价组合探针荧光原位杂交（fluorescence in site hybridization,FISH)在检测骨髓增生异常综合征（myelodysplastic syndrome,MDS）常见染色体异常中的价值。方法：应用YAC248F5（5q31)、YAC938G5（7q32）、CEP8、YAC912C3（20q12）4种DNA探针，对核型未知的20例MDS患者进行FISH检测－5／5q-、－7／7q-、＋8、20q－等常见染色体异常，并与常规细胞遗传学分析结果相比较。结果：20例MDS患者中，组合探针FISH检出13例有常见染色体异常（其中5例＋8，1例－5／5q-，5例20q-,1例5q-合并20q-，复杂异常1例）；而常规细胞遗传学发现5例常见染色体异常，1例＋21，复杂异常1例，标记染色体1例，正常5例。结论：组合探针FISH是筛查MDS患者常见染色体异常的有效手段。     

9号环状染色体综合征的荧光原位杂交分析

目的 对1例9号环状染色体综合征患儿进行细胞分子遗传学分析,探索9号环状染色体与临床表型的关系.方法 采用染色体G显带核型分析和TelVision 9p探针和TelVision 9q探针进行双色荧光原位杂交,识别和定位1例9号环状染色体患儿.结果 患儿核型为45,X,-9/46,XX,r(9)(p24q34)/46,XX,r(9;9)(p24q34;p24q34)(4/92/4).双色荧光原位杂交显示9号环状染色体上没有杂交信号,提示9号环状染色体短臂末端缺失片段至少有115 kb,长臂末端缺失片段至少有95 kb.与其它报道的环状9号染色体综合征、9号染色体短臂和长臂部分单体综合征相比,本例患者兼有环状9号染色体综合征的临床特征以及9号染色体短臂和长臂部分单体综合征的一些特征.结论 由于缺失的断裂点之间亚显微结构的不同、环的不稳定性、基因与表型相互作用以及胎儿环境条件的不同等原因,具有相同断裂点的9号环状染色体综合征患者可以有不同的临床表型,单倍基因剂量不足对临床表型发挥了重大作用.     

Identification of mosaicism in Prader-Willi syndrome using fluorescent in situ hybridization

We report on our findings of 4 patients with mosaicism for a deletion of chromosome 15, most commonly associated with Prader-Willi syndrome (PWS). We examined a series of typical and atypical PWS patients in order to identify cytogenetically undetected deletions, using fluorescence in situ hybridization. In 4 of the patients analyzed we detected a deletion in 14–60% of peripheral blood leukocytes, using four commercially available probes. Our results indicate that mosaicism may play a role in the etiology of some PWS cases. These findings may be especially useful in patients who display discrepancies between clinical phenotype and established diagnostic criteria. Methylation and microsatellite polymorphism analyses of 2 patients with low-level mosaicism failed to identify the deletion. We propose that fluorescence in situ hybridization is the most effective method for detecting somatic mosaicism, since a large number of cells can be individually examined for the presence or absence of a specific deletion. © 1996 Wiley-Liss, Inc.     

Putative monosomy 21 in two patients: clinical findings and investigation using fluorescence in situ hybridization

Complete monosomy 21 is claimed to be a rare chromosomal disorder in which the cytogenetic investigation is bedevilled by technical difficulties. We describe the disparate clinical features in two patients in whom an initial diagnosis of monosomy 21 was made by routine karyotyping. Fluorescence in situ hybridisation (FISH) confirmed a translocation of chromosome 21 material to the short arm of chromosome 5 and to the X chromosome, respectively. The usefulness of FISH in the investigation of subtle chromosomal rearrangements is hereby demonstrated. These findings also cast doubt on the existence of "pure" monosomy 21 as an entity, and suggest that partial monosomy 21 is a more likely occurrence.     

用荧光原位杂交技术产前诊断唐氏综合征

目的 用荧光原位杂交技术（Fluorescence in situ hybridization,FISH)快速产前诊断唐氏综合征。方法 采集23名孕妇14～24周的羊水标本，应用荧光标记的针对21号染色体特殊位点的探针（locus-sperifie probe,LSI）及X/Y染色体着丝粒探针（centromeric probe,CEP）对未培养的羊水间期细胞进行FISH；同步进行羊水细胞培养，行常规细胞遗传学染色体核型分析，以核型分析为标准，对FISH技术进行评价。结果 23份标本发生母血污染2例，培养失败1例，将其余20份羊水标本的FISH杂交结果与其染色体核型分析结果进行了比较。FISH分析羊水间期细胞性染色体数目正常者19例（XX11例，XY8例）与羊水中期细胞染色体核型分析结果一致，有1例羊水间期细胞FISH结果为X/XY，染色体核型分析结果为46，XY，因此，FISH与染色体核型分析结果的符合率为95%（19/20）；LSI21探针的FISH结果中21号染色体数目异常者1例，核型分析为典型的21三体，取脐血行G显带染色体核型分析得以验证为47，XY， 21。产前诊断染色体正常者追踪至分娩，新生儿行外周血染色体检查结果皆为正常核型。结论 荧光原位杂交技术可用于羊水间期细胞快速产前诊断唐氏综合征。     

Novel androgen receptor gene mutations in Australian patients with complete androgen insensitivity syndrome

We have identified androgen receptor (AR) gene mutations in eight Australian subjects with complete androgen insensitivity syndrome (AIS). Four individuals, from three families, have novel mutations that introduce premature termination codons. Two siblings have the nonsense mutation Glu681X, and another subject has the nonsense mutation p.Ser884X. The other subject has a CA insertion at codon 829 (c.2847_2848insCA), causing a frameshift mutation that introduces four nonsense amino acids prior to a Stop codon. All the termination codons occur in the ligand binding domain, and cause reduced androgen binding in patient genital skin fibroblasts. Four further patients have missense mutations. One subject has two different mutations, p.Ala645Asp in the hinge region of the receptor, and p.Arg752Gln in the ligand binding domain. Both these mutations have previously been reported in patients with AIS, but the combination of these two mutations in one subject is unique. Another subject has a novel c.2533G>C transversion at the first nucleotide in exon 5, introducing the amino acid change p.Gly724Ala at a highly conserved residue in the ligand binding domain. Androgen binding is normal in fibroblasts from this subject, although other point mutations at this amino acid totally abolish binding. Two other subjects have mutations previously described as causing AIS, namely p.Arg779Trp and p.Val889Met substitutions in the ligand binding domain of the receptor. The p.Arg779Trp mutation is associated with the detection of a truncated AR protein in this patient's fibroblasts, suggesting the mutation renders the receptor susceptible to proteolysis.     

多重荧光原位杂交技术检测多发性骨髓瘤复杂核型异常

目的 探讨多重荧光原位杂交(multiplex fluorescence in situ hybridization,M-FISH)技术在多发性骨髓瘤(multiple myeloma,MM)复杂核型异常(complex chromosomal aberrations,CCAs)检测中的价值.方法 对10例常规细胞遗传学(conventional cytogenetics,CC)方法检测具有复杂核型的MM患者应用M-FISH技术确定复杂染色体的重排及标记染色体的组成.结果 M-FISH证实了CC显示的29种结构异常,并进一步明确了1p-、6q-、9q-、9q+、+8q+×2、14q+、?14q、der(4)、der(22)、der(1)t(1;?)(q10;?)、der(3)、del(7)的具体来源;同时也发现CC分析没有发现或不能识别的21种异常,其中t(2;15)(q33;q22)、t(6;7)(q23;q34)、t(8;11)(q24;q23)、t(1;14)(q10;q32)和t(X;1)(q26;q25)是新发现的核型异常.这10例随访的MM患者病例资料中9例已死亡,中位生存期仅为23个月,较公认的MM患者的平均生存期34个月明显缩短.结论 对伴有CCAs的MM患者,M-FISH技术可以明确CC分析中复杂染色体异常,并发现和纠正CC分析中漏检及误检的异常,为MM的染色体异常研究提供了一种重要的方法,已经成为精确染色体核型分析所不可缺少的手段之一.     

Novel molecular defects in the androgen receptor gene of Mexican patients with androgen insensitivity

The androgen insensitivity syndrome (AIS) is an X-linked form of male pseudohermaphroditism caused by mutations in the androgen receptor (AR) gene. In the present study, we analyzed the AR gene in 8 patients, 4 sporadic and 2 familial cases with the syndrome, using exon-specific polymerase chain reaction, single-stranded conformational polymorphism and sequencing analysis and identified six new single base mutations, including one nonsense mutation at the hinge region of the receptor. These molecular lesions occurred in the steroid-binding domain (SBD) and all but one affected the first nucleotide of their respective codons. A nonsense mutation in exon 4, which converts a glutamine into a premature termination signal (Q657stop), a missense mutation changing arginine instead of glycine (G743R) and a conservative substitution of leucine with valine at amino acid 830 (L830V) were detected in patients with CAIS. Three other missense mutations located in exons 4 (L701I), 5 (A765S), and 6 (Q802R) were present in individuals bearing a partial form of AIS. These data allow us to reaffirm the view that nonsense mutations in the AR results almost invariably in a CAIS phenotype and underly the importance of the SBD for the AR functional activity.     

A multicenter investigation with interphase fluorescence in situ hybridization using X- and Y-chromosome probes

Twenty-six laboratories used X and Y chromosome probes and the same procedures to process and examine 15,600 metaphases and 49,400 interphases from Phaseolus vulgaris-leucoagglutinin (PHA)-stimulated lymphocytes. In Part I, each laboratory scored 50 metaphases and 200 interphases from a normal male and a normal female from its own practice. In Part II, each laboratory scored 50 metaphases and 200 interphases on slides prepared by a central laboratory from a normal male and a normal female and three mixtures of cells from the male and female. In Part III, each laboratory scored 50 metaphases (in samples of 5, 10, 15, and 20) and 100 interphases (in samples of 5, 10, 15, 20, and 50) on new, coded slides of the same specimens used in Part II. Metaphases from male specimens were scored as 98–99% XY with no XX cells, and 97–98% of interphases were scored as XY with 0.04% XX cells. Metaphases from female specimens were scored as 96–97% XX with 0.03% XY cells, and 94–96% of interphases were scored as XX with 0.05% XY cells. Considering the data as a model for any probe used with fluorescence in situ hybridization (FISH), a statistical approach assessing the impact of analytical sensitivity on the numbers of observations required to assay for potential mosaicisms and chimerisms is discussed. The workload associated with processing slides and scoring 50 metaphases and 200 interphases using FISH averaged 27.1 and 28.6 minutes, respectively. This study indicates that multiple laboratories can test/develop guidelines for the rapid, efficacious, and cost-effective integration of FISH into clinical service. Am. J. Med. Genet. 76:318–326, 1998. © 1998 Wiley-Liss, Inc.     

荧光原位杂交技术检测肺癌患者痰液中部分染色体数量的改变

目的应用染色体特异性探针对痰液脱落细胞进行荧光原位杂交(fluorescence in situ hybridization,FISH)用以分析肺癌的染色体畸变,探讨FISH技术辅助诊断肺癌的可行性和有效性。方法选用3、7、17号染色体着丝粒探针,p16、p53探针对40例疑似肺癌患者痰液的脱落细胞进行FISH研究。结果肺癌患者痰液脱落细胞中3、7、17号染色体数目和p16、p53畸变阳性率分别为41.9%、45.2%、41.9%、54.9%、51.6%,其中p16、p53畸变率较高。FISH联合应用五种探针诊断肺癌的敏感性为80.6%,特异性为77.8%,诊断效率为80.0%。结论肺癌的发生、发展与染色体的畸变有关,应用FISH技术检测肺癌患者痰液细胞染色体数目畸变,可作为肺癌诊断的一项辅助方法。     

Detection of kinase amplifications in gastric cancer archives using fluorescence in situ hybridization

To test the feasibility of using bacterial artificial chromosomes (BAC) containing kinases for pathological diagnosis using fluorescence in situ hybridization (FISH), 10 BAC probes containing a gene amplified in 5% or more of a pilot cohort were selected from a previous survey using arbitrarily selected BAC clones harboring 100 kinases. In this report, we describe the prevalence and association with the clinicopathological profile of these selected 10 BAC probes in 365 gastric cancer tissues. FISH analyses using these 10 BAC probes containing loci encoding EGFR, ERBB2(HER2), EPHB3, PIK3CA, MET, PTK7, ACK1, STK15, SRC, and HCK showed detectable amplifications in paraffin-embedded tissue in 2.83% to 13.6% of the gastric cancer tissues. Considerable numbers of the cases showed the co-amplification of two or more of the probes that were tested. BAC probes located within a genome neighborhood, such as PIK3CA, EPHB3, and ACK1 at 3q26-29 or HCK, SRC, and STK15 at 20q11-13.1, were often co-amplified in the same cases, but non-random co-amplifications of genes at distant genomic loci were also observed. These findings provide basic information regarding the creation of a strategy for personalizing gastric cancer therapy, especially when using multiple kinase inhibitors.     

荧光原位杂交技术检测多发性骨髓瘤分子遗传学改变及其意义

目的 研究多发性骨髓瘤(multiple myeloma,MM)患者1q21扩增、13q14缺失、TP53基因缺失及IgH易位的发生率及预后意义.方法 应用CD138单克隆抗体磁珠分选结合间期荧光原位杂交技术检测43例MM患者上述各种核型异常.结果 43例患者中28例(65.1%)出现了1q21的扩增,30例(69.7%)出现了13q14的缺失,8例(18.6%)出现了TP53基因的缺失,29例(67.4%)出现了IgH易位.1q21扩增、13q14缺失和TP53基因缺失与MM高死亡率有密切相关性.结论 1q21扩增、13q14缺失、TP53基因缺失及IgH易位是MM常见的核型异常,1q21扩增、13q14缺失和TP53基因缺失是MM的预后不良因子.     

G-显带技术、荧光原位杂交和比较基因组杂交技术在产前诊断中的应用

目的 探讨G显带、荧光原位杂交(fluorescencein situ hybridization,FISH)和比较基因组杂交(comparative genomic hybridization,CGH)技术在产前诊断中应用的程序及意义.方法 采集102例妊娠16周～24周胎儿的羊水,采用G显带、G显带/FISH和G显带/FISH/CGH三阶梯的核型诊断程序,并分析其在产前诊断中的意义.结果 102例胎儿中,经第1阶梯诊断核型98例,诊断困难2例,失败2例;第2阶梯诊断核型2例,诊断困难1例,失败1例;第3阶梯诊断核型2例.经3阶梯诊断程序核型的诊断率达100%(102/102例),异常核型7例(7/102例,6.68 0A),其中第1、第2和第3阶梯分别诊断异常核型4例(4/7例,57.1 oA)、1例(1/7例,14.3%)和2例(2/7例,28.5%).结论 在产前诊断中实施3阶梯诊断程序有助于提高核型的确诊率,规范染色体诊断流程.     

荧光原位杂交检测卵巢癌8号染色体畸变

目的：探讨卵巢癌染色体改变与卵巢癌发生、发展及预后的关系。方法：应用荧光原位杂交技术对卵巢癌、卵巢良性肿瘤及正常卵巢标本各12例进行8号染色体检测。结果：本组12例卵巢癌8号染色体出现单体、三体或四体畸变，畸变率100％（12／12）；卵巢良性肿瘤8号染色体出现三体畸变，畸变率25％（3／12）；正常卵巢8号染色体无畸变，卵巢癌与卵巢良性肿瘤及正常卵巢比较，差异有显著性（P＜0．001）。结论：卵巢癌第8号染色体畸变与卵巢癌发生、发展密切相关，其改变发生在卵巢癌早期，与患者临床分期、病理分化相关。     

用间期核双标记荧光原位杂交技术检测BCL2原癌基因易位

目的 建立一个准确易行的诊断非何杰金氏淋巴瘤的实验室指标。方法 建立了以BCL2酵母人工染色体克隆yA153A6、以及免疫球蛋白重链基因（IgH)噬菌体克隆H24为探针的双标记荧光原位杂交技术,用以在间期核中检测BCL2原癌基因易位,结果 在滤泡性淋巴瘤细胞系SU-DHL-6细胞中,BCL2和IgH的杂交信号呈非随机分布,与一个BCL2等位基因易位到14号染色体IgH基因之上相对应,一个BCL2和一个IgH杂交信号始终紧密相连,而在正常淋巴细胞中,这两种基因的杂交信号至少保持1/10核直径的距离。结论 该方法客观明了,准确易行,不受标本中分裂相数量和质量的限制。可望成为临床诊断非何杰金氏淋巴瘤的常规手段。     

Malignant sex cord–stromal tumour in a patient with the androgen insensitivity syndrome

A malignant sex cord–stromal tumour that occurred in a 56-year-old patient with the androgen insensitivity syndrome is reported. Although hamartomas composed of sex cord cells are common in the testes of patients with this syndrome, unequivocal neoplasms of sex cord type are rare. The tumour described herein most closely resembled, but lacked the overall morphology of, a juvenile granulosa cell tumour, and Charcot-Böttcher filaments, indicative of Sertoli cell differentiation, were seen on electron microscopy. The features of the androgen insensitivity syndrome and the various tumours that have been reported in patients with this syndrome are briefly reviewed.     

性腺发育不全患者荧光原位杂交和BAC-FISH的诊断

目的 探讨荧光原位杂交(fluorescence in situ hybridization,FISH)和BAC-FISH(bacterial artificial Chromosonle-FISH)在性腺发育不全患者临床医学遗传学诊断中的应用.方法 对5例临床检查诊断为性腺发育不全患者进行染色体荧光Q显带、G显带核型分析、FISH和BAC-FISH等分子-细胞遗传学检查诊断.结果 5例性腺发育不全患者中2例为46,XY核型的单纯性性腺发育不全,另外3例分别为45,X/47,XXX;45,X/46,XY或45,X/46,X,der(Y)嵌合体核型的混合性性腺发育不全.结论 性染色体的异常是导致患者性腺发育不全的原因,结合应用FISH和BAC-FISH等分子-细胞检测技术可为性腺发育不全患者的临床诊断和治疗提供准确的医学遗传学依据.     

Identification of Y chromatin directly in gonadal tissue by fluorescence in situ hybridization (FISH): Significance for Ullrich‐Turner syndrome screening in the cytogenetics laboratory

The presence of Y chromatin in individuals with Ullrich‐Turner syndrome (UTS) confers a risk for gonadoblastoma. In mosaic cases, little is known about Y chromatin distribution in gonads. Fluorescence in situ hybridization (FISH) is a direct approach to assess the extent of Y chromatin mosaicism in gonads. Gonadal tissue from four patients with mosaic karyotypes were analyzed by routine cytogenetics and FISH with X and Y centromere probes. Y chromatin was present in gonads in varying percentages in these patients. The distribution of Y chromatin in gonads of UTS individuals did not completely correlate with that found in blood lymphocytes. The finding of Y chromatin in the blood samples from these patients prompted the development of a screening strategy in our cytogenetics laboratory to detect low‐level Y chromatin mosaicism in patients with UTS. Am. J. Med. Genet. 91:377–382, 2000. © 2000 Wiley‐Liss, Inc.