应用多重连接探针扩增技术快速高通量检测染色体非整倍体

目的评价多重连接探针扩增技术(multiplex ligation-dependent probe amplification,MLPA)在染色体非整倍体诊断中的应用价值。方法应用MLPA技术检测了150例羊水标本、50例外周血标本,所有标本均进行常规染色体核型分析,应用Cof-falyser9.0MLPA-DATA数据分析软件获得MLPA结果,比对MLPA和染色体核型分析结果的准确性,评价两种技术的符合率,总结MLPA技术临床应用过程中的关键要点。结果MLPA扩增后探针信号强度与质控相比比率大于1.3判定为重复,小于0.7判定为缺失。150例羊水标本,MLPA显示非整倍体染色体数目异常14例,与羊水染色体培养核型分析结果相同;50例外周血标本,MLPA异常21例,与培养结果符合率100%。DNA质量和浓度是实验成败的关键,Coffalyser9.0MLPA-DATA数据分析软件可以实现MLPA数据处理通量化。结论MLPA技术用于普通的染色体非整倍体数目检测快速、特异、敏感,弥补了常规染色体培养周期长等缺点,对于大量的产前诊断羊水标本,可以实现高通量检测,具较高的临床应用价值。     

温州地区1350例羊水细胞染色体核型结果分析

目的探讨羊水细胞培养对孕中期高危孕妇进行产前诊断的必要性及有效性,分析产前诊断的高危孕妇羊水细胞染色体核型,了解孕中期异常核型出现的频率,类型及与各种产前诊断指征之间的关系。方法对1350例具有产前诊断指征的孕妇在妊娠16-23周时行羊膜腔穿刺术,抽取羊水进行细胞培养及染色体制备,并对核型结果进行分析。结果羊水细胞培养成功并进行核型分析的为1339例,成功率为99.2%;染色体核型多态性22例（1.64%）,检出异常核型53例（3.96%）。异常核型中以三体较为多见。结论羊膜腔穿刺进行羊水培养染色体检查是安全、可靠的染色体异常的产前诊断方法。三体综合征为孕期主要的异常核型;夫妇一方染色体异常、异常超声波检查结果、唐氏高风险、高龄是产前诊断主要的指征。对高危妊娠妇女进行羊水染色体核型检查是必须的。     

应用多重连接依赖式探针扩增技术快速高通量诊断胎儿染色体非整倍体异常

目的 评价多重连接依赖式探针扩增技术(multiplex ligation-dependent probe amplification,MLPA)在染色体非整倍体诊断中的应用价值,为我国羊水染色体诊断提供一种快速、特异、高通量的分子诊断手段.方法 应用MLPA技术检测了500份羊水标本,所有标本均进行荧光原位杂交(fluorescence in situ hybridization,FISH)技术检测和常规染色体核型分析,应用RH-MLPA-v511数据分析软件获得MLPA结果,比较MLPA技术与FISH和染色体核型分析结果的准确性,总结MLPA技术临床应用过程中的关键要点.结果 在500份羊水标本中,MLPA检测成功率97%.3个工作日完成结果的为92%,需重复检测的为5%,失败为3%.对染色体非整倍体异常检测敏感性和准确性100%.证实38例非整倍体病例探针信号比值＞正常二倍体4s,2例疑似三体结果＞2s.分析了21号染色体8条探针的杂交效率,21三体患者8条探针中平均4条探针比值＞1.3.结论 MLPA技术具有快速、特异、敏感、高通量、成本低等特点,可用于产前染色体非整倍体数目的快速检测,是传统染色体培养方法的补充,临床应用价值较高.

Abstract：

Objective To assess the diagnostic value of multiplex ligation-dependent probe amplification (MLPA) for detection of common chromosome aneuploidy in amniotic fluid (AF) cells in order to obtain an accurate, rapid, cost-effective and high-throughput method in routine prenatal clinical practice.Methods The MLPA test was performed on 500 AF samples by using kit P095 and the results were obtained by using analysis software RH-MLPA-v511. The results were compared with that from fluorescence in situ hybridization (FISH) and traditional karyotyping (TK). The technical critical issues were analyzed in routine diagnostic application. Results The absolute specificity and sensitivity of the MLPA test to detect the aneuploidy were 100%. For the 500 AF samples, the success rate of the MLPA tests was 97%. Among them 92% were finished within three working days and 5% required more days for repeating. The test failure rate was 3%. The results confirmed that for the 38 detectable aneuploid samples,the probe reliability weighted mean ratio values were more than 4SD compared to normal diploids and the 2 suspected trisomy samples were more than 2SD. In this study, authors analyzed hybridization efficiencies of 8 probes for chromosome 21, and the presence of a trisomy was considered if at least 4 of the 8 probes gave probe ratio of ＞1.3. Conclusion The data suggested that MLPA is a rapid, simple and reliable method for large scale testing for aneuploidy of chromosomes 13, 18, 21, X, or Y in AF. The MLPA technology is complementary to AF culture and valuable for prenatal diagnosis.     

应用多重连接依赖式探针扩增技术快速高通量诊断胎儿染色体非整倍体异常

Objective To assess the diagnostic value of multiplex ligation-dependent probe amplification (MLPA) for detection of common chromosome aneuploidy in amniotic fluid (AF) cells in order to obtain an accurate, rapid, cost-effective and high-throughput method in routine prenatal clinical practice.Methods The MLPA test was performed on 500 AF samples by using kit P095 and the results were obtained by using analysis software RH-MLPA-v511. The results were compared with that from fluorescence in situ hybridization (FISH) and traditional karyotyping (TK). The technical critical issues were analyzed in routine diagnostic application. Results The absolute specificity and sensitivity of the MLPA test to detect the aneuploidy were 100%. For the 500 AF samples, the success rate of the MLPA tests was 97%. Among them 92% were finished within three working days and 5% required more days for repeating. The test failure rate was 3%. The results confirmed that for the 38 detectable aneuploid samples,the probe reliability weighted mean ratio values were more than 4SD compared to normal diploids and the 2 suspected trisomy samples were more than 2SD. In this study, authors analyzed hybridization efficiencies of 8 probes for chromosome 21, and the presence of a trisomy was considered if at least 4 of the 8 probes gave probe ratio of ＞1.3. Conclusion The data suggested that MLPA is a rapid, simple and reliable method for large scale testing for aneuploidy of chromosomes 13, 18, 21, X, or Y in AF. The MLPA technology is complementary to AF culture and valuable for prenatal diagnosis.     

荧光原位杂交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。方法采集116名孕妇孕16~23周的羊水标本,应用荧光标记的21号染色体特殊位点探针（21q22,DSCR2）、13号染色体特殊位点探针（13q14,DLEU1）及18号染色体探针、X/Y染色体着丝粒探针（CEP）对未经培养的羊水间期细胞进行FISH检测;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。结果 FISH与羊水细胞核型分析相符的染色体数目正常108例,数目异常6例,另各有1例染色体核型分析分别显示为平衡易位、臂内倒位异常,FISH结果显示正常。6例数目异常胎儿引产时抽脐血染色体检查结果与羊水产前诊断结果一致。结论 FISH技术用于快速诊断胎儿常见染色体数目异常,具有简便、快速、特异性强等优点,临床有较高的应用价值。     

荧光原位杂交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。方法采集116名孕妇孕16~23周的羊水标本,应用荧光标记的21号染色体特殊位点探针(21q22,DSCR2)、13号染色体特殊位点探针(13q14,DLEU1)及18号染色体探针、X/Y染色体着丝粒探针(CEP)对未经培养的羊水间期细胞进行FISH检测;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。结果 FISH与羊水细胞核型分析相符的染色体数目正常108例,数目异常6例,另各有1例染色体核型分析分别显示为平衡易位、臂内倒位异常,FISH结果显示正常。6例数目异常胎儿引产时抽脐血染色体检查结果与羊水产前诊断结果一致。结论 FISH技术用于快速诊断胎儿常见染色体数目异常,具有简便、快速、特异性强等优点,临床有较高的应用价值。     

FQ-PCR技术检测乙型肝炎患者血清及单个核细胞中的HBV-DNA

目的研究慢性乙肝患者外用血单个核细胞(PBMC)中HBV-DNA的存在及其与血清HBV-DNA的关系。方法用荧光定量聚合酶链反应(FQ-PCR)技术检测55例慢性乙肝患者的血清和外周血单个核细胞中的HBV-DNA。结果HBeAg( )组血清与PBMC中HBV-DNA的阳性率分别为96％(24／25)和100％(25／25);HBV-DNA含量(以均值±标准差,拷贝／ml表示)分别为7.16±0.83和4.56±0.78,两者存在相关性(r=0.445,P<0.05),HBeAg(-)组血清与PBMC中HBV-DNA的阳性率分别为46.7％(14／30)和56.7％(17／30),HBV-DNA含量分别为5.81±1.07和4.09±1.14,两者存在相关性(r=0.549,P<0.05)。结论HBV可存在于感染者PBMC中,PBMC中HBV的存在与HBV病毒的传播和病情进展有一定相关性,慢性乙肝患者的血清和PBMC中HBV-DNA的联合检测可作为临床对患者病情的判断和药物治疗的辅助指标。     

SNP芯片技术产前鉴别额外小标记染色体

目的 用SNP芯片技术对1例产前发现的疑难额外小标记染色体(small supernumerary marker chromosome,sSMC)进行鉴定,明确其遗传物质的来源并推测其发生机制.方法 对1例染色体核型分析提示携带来源不明sSMC的胎儿进行SNP芯片全基因组扫描检测,结果用荧光原位杂交技术(fluorescence in situ hybridization,FISH)验证.结果 胎儿染色体核型示46,X,+mar,芯片结果确定sSMC为Yp11.2-11.3重复、Yq11.2区域缺失,FISH结果证明sSMC来源于Y染色体.结论 明确胎儿核型为46,X,idic(Y)(pter→ p11.2∶∶11.2→pter).Yq11.2区的缺失与男性无精症相关.芯片技术可一次性排除23对染色体大于1 Mb的微缺失和重复,明确遗传学机制,适用于疑难病例的鉴别和微缺失重复综合征的产前诊断.     

424例男性不育症患者的染色体分析——附世界首报核型一例

不育症是现代男性的常见疾病，也是人类生殖研究中一个重要的课题。据世界卫生组织（WHO）资料显示，不育症患者约占育龄夫妇的15％。在引起男性不育诸多因素中，染色体异常是重要因素之一。我们将近一年来所检查的424例男性不育症患者染色体结果进行总结分析。     

应用多重连接依赖式探针扩增技术快速高通量诊断胎儿染色体非整倍体异常

Objective To assess the diagnostic value of multiplex ligation-dependent probe amplification (MLPA) for detection of common chromosome aneuploidy in amniotic fluid (AF) cells in order to obtain an accurate, rapid, cost-effective and high-throughput method in routine prenatal clinical practice.Methods The MLPA test was performed on 500 AF samples by using kit P095 and the results were obtained by using analysis software RH-MLPA-v511. The results were compared with that from fluorescence in situ hybridization (FISH) and traditional karyotyping (TK). The technical critical issues were analyzed in routine diagnostic application. Results The absolute specificity and sensitivity of the MLPA test to detect the aneuploidy were 100%. For the 500 AF samples, the success rate of the MLPA tests was 97%. Among them 92% were finished within three working days and 5% required more days for repeating. The test failure rate was 3%. The results confirmed that for the 38 detectable aneuploid samples,the probe reliability weighted mean ratio values were more than 4SD compared to normal diploids and the 2 suspected trisomy samples were more than 2SD. In this study, authors analyzed hybridization efficiencies of 8 probes for chromosome 21, and the presence of a trisomy was considered if at least 4 of the 8 probes gave probe ratio of ＞1.3. Conclusion The data suggested that MLPA is a rapid, simple and reliable method for large scale testing for aneuploidy of chromosomes 13, 18, 21, X, or Y in AF. The MLPA technology is complementary to AF culture and valuable for prenatal diagnosis.