18例闭经患者的分子-细胞遗传学研究

目的探讨荧光原位杂交（fluorescencein situhybridization,FISH）和高分辨比较基因组杂交（highresolution-comparative genomic hybridization,HR-CGH）技术在闭经研究中的应用价值。方法17例原发闭经和1例继发闭经患者经常规妇科检查、B超及内分泌功能检查后,应用染色体核型分析,部分染色体异常患者采用FISH和HR-CGH技术相结合的分子-细胞遗传学检查诊断结果,并对其临床症状及发病机制进行了探讨。结果17例原发闭经患者中,7例为46,XX的正常女性核型;10例携带有异常染色体核型,所占比例为58.8%,其中3例为46,XY的女性患者,2例为45,X及45,X/46,XX的Turner＇s患者;其余5例均为携带有X染色体结构异常,包括X染色体部分单体、X等臂染色体和X/Y嵌合体等异常核型患者;1例继发性闭经患者为X染色体与常染色体易位的异常核型。结论应用FISH和HR-CGH技术与高分辨染色体显带技术,精确诊断患者的染色体核型,可为临床的诊断和治疗提供医学遗传学依据。

Molecular and cytogenetic study on 18 cases of amenorrhea: the use of fluorescence in situ hybridization and high resolution-comparative genomic hybridization

Objective To explore the use of fluorescence in situ hybridization (FISH) and high resolution-comparative genomic hybridization (HR-CGH) techniques in amenorrhea study. Methods After routine gynecologic examination, ultrasonography and endocrine examination, 17 cases of primary amenorrhea and 1 case of secondary amenorrhea were analysed by using chromosomal diagnoses including multiplex FISH and HR-CGH analyses. Results Among 17 cases of primary amenorrhea, 7 revealed a 46,XX karyotype; 10 cases (58.8%) had abnormal karyotype, including 3 cases of 46,XY females, 2 cases of Turner's syndrome with 45,X and 45,X/46,XX, and other 5 cases with abnormal structure of X chromosome (including partial monosomy of X, X isochromosome and X/Y mosaic). The karyotype of the patient with secondary amenorrhea was translocation between X chromosome and euchromosome. Conclusion The using of FISH and HR-CGH can correctly diagnose the patients' karyotypes, and provide absolutely necessarily medical genetic data for clinical diagnosis and therapy.