SNP微阵列、核型分析与FISH在产前性染色体嵌合诊断中的应用
回顾性分析82例产前性染色体嵌合病例,比较核型分析、SNP微阵列和FISH的一致性。82例中64例三法结果一致,18例存在差异;核型分析识别无X剂量变化的非整倍体及平衡易位嵌合,SNP微阵列更易检出<10 Mb的嵌合拷贝数变异,结果不一致时FISH可进一步验证。
要点
- 核型分析可识别X剂量无明显变化的非整倍体及平衡易位嵌合。
- SNP微阵列更有效检测<10 Mb的嵌合拷贝数变异。
- 两法结果不一致时,应使用FISH进一步验证。
核心结论
- 联合SNP微阵列、核型分析和FISH可有效诊断性染色体嵌合。
研究设计与样本
- 回顾性分析10825例接受羊膜腔穿刺的高危妊娠中检出的82例性染色体嵌合病例,比较核型分析、SNP微阵列和FISH结果的一致性。
主要发现
- 10825例高危妊娠中检出82例(0.76%)性染色体嵌合。
- 82例中60例(73.2%)为X或Y染色体非整倍体嵌合,22例(26.8%)为嵌合伴结构异常。
- 64例三种方法结果一致,18例方法间存在差异。
- 18例差异中12例核型分析和FISH诊断为嵌合而SNP微阵列结果正常。
- SNP微阵列额外识别3例嵌合X染色体拷贝数变异;3例Turner嵌合仅由FISH诊断,核型和SNP微阵列均正常。
临床怎么用
- 当X染色体剂量无明显变化时,核型分析可有效识别非整倍体和平衡易位嵌合。
- SNP微阵列对检测<10 Mb的嵌合拷贝数变异更有效。
- 核型分析与SNP微阵列结果不一致时,应使用FISH进一步验证。
以上解读依据论文摘要(全文未开放获取或许可不允许翻译转载)。
原文
OBJECTIVE: This study conducted a comparative analysis of chromosomal karyotyping, SNP-array, and FISH results in 82 prenatal cases of mosaicism involving the sex chromosomes. METHODS: A retrospective analysis was conducted on 82 cases of mosaicism involving the sex chromosomes; the analysis focused on the concordance and discrepancies among karyotyping, SNP-array, and FISH results. RESULTS: Among 10,825 high-risk pregnancies undergoing amniocentesis, 82 cases (0.76%) of mosaicism involving the sex chromosomes were detected. These included 60 cases (73.2%) of X or Y chromosome aneuploidy mosaicism and 22 cases (26.8%) with mosaicism accompanied by structural abnormalities. Of the 82 cases, 64 showed consistent results across karyotyping, SNP-array, and FISH, while 18 cases exhibited discrepancies between methods. Among the 18 discordant cases, 12 were diagnosed as mosaicism by karyotyping and FISH but showed normal results on SNP-array. SNP-array identified three additional cases of mosaic X chromosome copy number variations (CNVs). In three cases, Turner mosaicism was diagnosed solely by FISH; both karyotype and SNP-array findings were normal. CONCLUSIONS: This study demonstrates that the combination of SNP-array, karyotyping, and FISH can effectively diagnose mosaicism involving the sex chromosomes. Karyotype analysis can effectively identify aneuploidy and balanced translocation mosaicism when X chromosome dosage shows no significant change, whereas SNP array is more effective in detecting mosaic copy number variations < 10 Mb. In cases of discrepant results between the two methods, FISH should be utilized for further verification.
引用
- Luo X, Niu H, Chen X, et al. How Are SNP-Array, Karyotyping, and FISH Applied in Prenatal Practice? A Focus on Diagnosis of Mosaicism Involving the Sex Chromosomes. Prenat Diagn. 2026. PMID: 41997698. doi:10.1002/pd.70160
供执业医师工作参考,不替代临床判断;数值与分级以指南原文为准。