一例妊娠的羊膜腔穿刺术中因46,XY,der(14)t(13;14)(q32.2;p13)/46,XY的镶嵌式非平衡易位导致的镶嵌式远端13q重复,胎儿结局良好,围产期非整倍体细胞系逐渐减少,培养羊膜细胞与未培养羊膜细胞之间存在细胞遗传学差异

IF 2 4区 医学 Q2 OBSTETRICS & GYNECOLOGY Taiwanese Journal of Obstetrics & Gynecology Pub Date : 2024-09-01 DOI:10.1016/j.tjog.2024.07.005
Chih-Ping Chen , Fang-Tzu Wu , Shu-Yuan Chang , Peih-Shan Wu , Yen-Ting Pan , Chen-Chi Lee , Wen-Lin Chen , Meng-Shan Lee , Chien-Ling Chiu , Wayseen Wang
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Array comparative genomic hybridization (aCGH) analysis on the DNA extracted from cultured amniocytes revealed arr 13q32.2q34 × 2∼3, consistent with 45% mosaicism for distal 13q duplication. Repeat amniocentesis at 24 weeks of gestation revealed a karyotype of 46,XY,der(14)t(13;14)(q32.2;p13)[14]/46,XY[16] (46.6% mosaicism). The parental karyotypes were normal. aCGH analysis on the DNA extracted from uncultured amniocytes revealed arr 13q32.2q34 × 2.38, consistent with 30–40% mosaicism for distal 13q duplication. Interphase fluorescence <em>in situ</em> hybridization (FISH) analysis on uncultured amniocytes detected 22.8% (23/101 cells) mosaicism for distal 13q duplication. Prenatal ultrasound findings were unremarkable. At 39 weeks of gestation, a 3616-g phenotypically normal baby was delivered. 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引用次数: 0

摘要

病例报告 一位 37 岁的高龄产妇在妊娠 17 周时进行了羊膜腔穿刺,结果显示其核型为 46,XY,add(14)(p13)[17]/46,XY[13](56.6%)。羊膜腔穿刺显示核型为 46,XY,add(14) (p13)[17]/46,XY[13] (56.6%嵌合)。对从培养羊膜细胞中提取的 DNA 进行的阵列比较基因组杂交(aCGH)分析显示,13q32.2q34 × 2∼3,与 45% 的远端 13q 重复嵌合一致。妊娠 24 周时再次进行羊膜腔穿刺,发现核型为 46,XY,der(14)t(13;14)(q32.2;p13)[14]/46,XY[16](嵌合率 46.6%)。对从未培殖羊膜细胞中提取的 DNA 进行 aCGH 分析,结果显示 13q32.2q34 × 2.38,与 30-40% 的远端 13q 重复嵌合一致。对未培养羊膜细胞进行的间期荧光原位杂交(FISH)分析检测出22.8%(23/101个细胞)的远端13q重复嵌合。产前超声检查结果无异常。妊娠 39 周时,娩出了一个 3616 克表型正常的婴儿。脐血、脐带和胎盘的核型分别为46,XY,der(14)t(13;14)(q32.2;p13)[20]/46,XY[20](50%嵌合)、46,XY,der(14)t(13;14)(q32.2;p13)[14]/46,XY[26](35%嵌合)和46,XY(40/40个细胞)(0%嵌合)。在 4 个半月和 1 岁时进行随访,外周血核型为 46,XY,der(14)t(13;14)(q32.2;p13)[18]/46,XY[22](45% 嵌合)。对 4 个半月大的颊粘膜细胞进行的相间 FISH 分析显示,2.7%(3/110 个细胞)存在远端 13q 复制的嵌合现象,而正常对照组的嵌合率为 1%(1/100 个细胞)。结论羊膜腔穿刺术中的马赛克不平衡易位与良好的胎儿结局、围产期非整倍体细胞系的逐渐减少以及培养羊膜细胞和未培养羊膜细胞之间的细胞遗传学差异有关。
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Mosaic distal 13q duplication due to mosaic unbalanced translocation of 46,XY,der(14)t(13;14)(q32.2;p13)/46,XY at amniocentesis in a pregnancy associated with a favorable fetal outcome, perinatal progressive decrease of the aneuploid cell line and cytogenetic discrepancy between cultured amniocytes and uncultured amniocytes

Objective

We present mosaic distal 13q duplication due to mosaic unbalanced translocation 46,XY,der(14)t(13;14)(q32.2;p13)/46,XY at amniocentesis in a pregnancy associated with a favorable fetal outcome.

Case report

A 37-year-old, gravida 2, para 0, woman underwent amniocentesis at 17 weeks of gestation because of advanced maternal age. Amniocentesis revealed a karyotype of 46,XY, add(14) (p13)[17]/46,XY[13] (56.6% mosaicism). Array comparative genomic hybridization (aCGH) analysis on the DNA extracted from cultured amniocytes revealed arr 13q32.2q34 × 2∼3, consistent with 45% mosaicism for distal 13q duplication. Repeat amniocentesis at 24 weeks of gestation revealed a karyotype of 46,XY,der(14)t(13;14)(q32.2;p13)[14]/46,XY[16] (46.6% mosaicism). The parental karyotypes were normal. aCGH analysis on the DNA extracted from uncultured amniocytes revealed arr 13q32.2q34 × 2.38, consistent with 30–40% mosaicism for distal 13q duplication. Interphase fluorescence in situ hybridization (FISH) analysis on uncultured amniocytes detected 22.8% (23/101 cells) mosaicism for distal 13q duplication. Prenatal ultrasound findings were unremarkable. At 39 weeks of gestation, a 3616-g phenotypically normal baby was delivered. The karyotypes of cord blood, umbilical cord and placenta were 46,XY,der(14)t(13;14)(q32.2;p13)[20]/46,XY[20] (50% mosaicism), 46,XY,der(14)t(13;14)(q32.2;p13)[14]/46,XY[26] (35% mosaicism) and 46,XY (40/40 cells) (0% mosaicism), respectively. When follow-ups at the age of 4½ months and the age of one year, the peripheral blood had the karyotype of 46,XY,der(14)t(13;14)(q32.2;p13)[18]/46,XY[22] (45% mosaicism). Interphase FISH analysis on buccal mucosal cells at the age of 4½ months revealed 2.7% (3/110 cells) mosaicism for distal 13q duplication, compared with 1% (1/100 cells) in the normal control. The neonate was normal in phenotype and development.

Conclusions

Mosaic unbalanced translocation at amniocentesis can be associated with a favorable fetal outcome, perinatal progressive decrease of the aneuploid cell line and cytogenetic discrepancy between cultured amniocytes and uncultured amniocytes.

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来源期刊
CiteScore
3.60
自引率
23.80%
发文量
207
审稿时长
4-8 weeks
期刊介绍: Taiwanese Journal of Obstetrics and Gynecology is a peer-reviewed journal and open access publishing editorials, reviews, original articles, short communications, case reports, research letters, correspondence and letters to the editor in the field of obstetrics and gynecology. The aims of the journal are to: 1.Publish cutting-edge, innovative and topical research that addresses screening, diagnosis, management and care in women''s health 2.Deliver evidence-based information 3.Promote the sharing of clinical experience 4.Address women-related health promotion The journal provides comprehensive coverage of topics in obstetrics & gynecology and women''s health including maternal-fetal medicine, reproductive endocrinology/infertility, and gynecologic oncology. Taiwan Association of Obstetrics and Gynecology.
期刊最新文献
Editorial Board Instructions to Authors Evaluation of atherogenic indices in patients with endometrioma: A case-control study Progesterone receptor isoform B in the stroma of squamous cervical carcinoma: An independent favorable prognostic marker correlating with hematogenous metastasis Minimally invasive surgery for endometrial cancer: The better choice?
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