Laboratory Medicine ›› 2023, Vol. 38 ›› Issue (6): 553-558.DOI: 10.3969/j.issn.1673-8640.2023.06.009
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ZHANG Chu, WANG Jianhong(), LI Rui, XIAO Yanhua, WANG Heng, ZHANG Pinxiao, XU Ningxin, XIA Banban
Received:
2022-04-04
Revised:
2022-08-03
Online:
2023-06-30
Published:
2023-08-22
CLC Number:
ZHANG Chu, WANG Jianhong, LI Rui, XIAO Yanhua, WANG Heng, ZHANG Pinxiao, XU Ningxin, XIA Banban. Results of non-invasive prenatal testing-plus in 5 696 pregnant women[J]. Laboratory Medicine, 2023, 38(6): 553-558.
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URL: https://www.shjyyx.com/EN/10.3969/j.issn.1673-8640.2023.06.009
送检指征 | 例数 | 21-三体综合征高风险/例 | 18-三体综合征高风险/例 | 13-三体综合征高风险/例 | 性染色体异常高风险/例 | CNV | NIPT-plus高风险/ [例(%)] | 确诊/例 | 阳性预测值/ [%(例/例)] | |
---|---|---|---|---|---|---|---|---|---|---|
微缺失/例 | 微重复/例 | |||||||||
唐氏筛查临界风险 | 2 572 | 4 | 1 | 3 | 15 | 13 | 24 | 60(2.33) | 5 | 8.33(5/60) |
单纯高龄 | 1 299 | 8 | 1 | 0 | 10 | 4 | 5 | 28(2.16) | 10 | 35.71(10/28) |
唐氏筛查高风险 | 397 | 8 | 0 | 0 | 6 | 0 | 4 | 18(4.53) | 10 | 55.56(10/18) |
NT增厚 | 50 | 0 | 0 | 0 | 0 | 0 | 2 | 2(4.00) | 0 | 0.00(0/2) |
其他 | 1 367 | 3 | 1 | 0 | 14 | 8 | 14 | 40(2.93) | 11 | 27.50(11/40) |
合计 | 5 685 | 23 | 3 | 3 | 45 | 25 | 49 | 148(2.60) | 36 | 24.32(36/148) |
送检指征 | 例数 | 21-三体综合征高风险/例 | 18-三体综合征高风险/例 | 13-三体综合征高风险/例 | 性染色体异常高风险/例 | CNV | NIPT-plus高风险/ [例(%)] | 确诊/例 | 阳性预测值/ [%(例/例)] | |
---|---|---|---|---|---|---|---|---|---|---|
微缺失/例 | 微重复/例 | |||||||||
唐氏筛查临界风险 | 2 572 | 4 | 1 | 3 | 15 | 13 | 24 | 60(2.33) | 5 | 8.33(5/60) |
单纯高龄 | 1 299 | 8 | 1 | 0 | 10 | 4 | 5 | 28(2.16) | 10 | 35.71(10/28) |
唐氏筛查高风险 | 397 | 8 | 0 | 0 | 6 | 0 | 4 | 18(4.53) | 10 | 55.56(10/18) |
NT增厚 | 50 | 0 | 0 | 0 | 0 | 0 | 2 | 2(4.00) | 0 | 0.00(0/2) |
其他 | 1 367 | 3 | 1 | 0 | 14 | 8 | 14 | 40(2.93) | 11 | 27.50(11/40) |
合计 | 5 685 | 23 | 3 | 3 | 45 | 25 | 49 | 148(2.60) | 36 | 24.32(36/148) |
NIPT-plus结果 | 例数 | 介入性产前诊断 | 阳性预测值/ [%(例/例)] | NIPT-plus假阴性/例 | NIPT-plus假阳性率/[%(例/例)] | 确诊孕妇终止妊娠率/[%(例/例)] | |
---|---|---|---|---|---|---|---|
例数/例 | 确诊数/例 | ||||||
21-三体综合征高风险 | 23 | 23 | 15 | 65.22(15/23) | 0 | 0.14(8/5 670) | 100.00(15/15) |
18-三体综合征高风险 | 3 | 3 | 2 | 66.67(2/3) | 1 | 0.02(1/5 683) | 100.00(2/2) |
13-三体综合征高风险 | 3 | 3 | 0 | 0.00(0/3) | 0 | 0.05(3/5 685) | 0.00(0/0) |
性染色体异常高风险 | 45 | 32 | 8 | 25.00(8/32) | 87.50(7/8) | ||
微缺失/微重复 | 74 | 41 | 17 | 41.46(17/41) | 25.53(4/17) |
NIPT-plus结果 | 例数 | 介入性产前诊断 | 阳性预测值/ [%(例/例)] | NIPT-plus假阴性/例 | NIPT-plus假阳性率/[%(例/例)] | 确诊孕妇终止妊娠率/[%(例/例)] | |
---|---|---|---|---|---|---|---|
例数/例 | 确诊数/例 | ||||||
21-三体综合征高风险 | 23 | 23 | 15 | 65.22(15/23) | 0 | 0.14(8/5 670) | 100.00(15/15) |
18-三体综合征高风险 | 3 | 3 | 2 | 66.67(2/3) | 1 | 0.02(1/5 683) | 100.00(2/2) |
13-三体综合征高风险 | 3 | 3 | 0 | 0.00(0/3) | 0 | 0.05(3/5 685) | 0.00(0/0) |
性染色体异常高风险 | 45 | 32 | 8 | 25.00(8/32) | 87.50(7/8) | ||
微缺失/微重复 | 74 | 41 | 17 | 41.46(17/41) | 25.53(4/17) |
CNV结果 | 染色体位置 | 片段大小/Mb | 来源 | 超声结果 | 母亲临床 表型 | 是否终止 妊娠 |
---|---|---|---|---|---|---|
微缺失 | ||||||
孕妇1 | 18q21.2q23 Chr18:52320001_78020000 | 25.70 | 未知 | NT正常,中晚孕正常 | 无随访 | 是 |
孕妇2 | 4q34.3q35.2 Chr4:183180000_190940000 | 7.76 | 未知 | 胎儿晶状体回声高,考虑白内障 | 无随访 | 是 |
孕妇3 | 16p13.11p12.3 Chr16:15480000_18180000 | 2.70 | 母亲 | NT正常,中晚孕正常 | 无异常 | 否 |
孕妇4 | 10q11.22q11.23 Chr10:46960000_51800000 | 4.84 | 母亲 | NT正常,中晚孕正常 | 无异常 | 否 |
微重复 | ||||||
孕妇5 | 22q11.21 Chr22:18880000_21480000 | 2.60 | 母亲 | NT正常,中晚孕正常 | 无异常 | 否 |
孕妇6 | 1q21.1q21.2 Chr1:144000000_147780000 | 3.78 | 母亲 | 中晚孕脐绕颈1周,新生儿卵圆孔未闭,心房水平左向右分流,早产儿脑 | 无异常 | 否 |
CNV结果 | 染色体位置 | 片段大小/Mb | 来源 | 超声结果 | 母亲临床 表型 | 是否终止 妊娠 |
---|---|---|---|---|---|---|
微缺失 | ||||||
孕妇1 | 18q21.2q23 Chr18:52320001_78020000 | 25.70 | 未知 | NT正常,中晚孕正常 | 无随访 | 是 |
孕妇2 | 4q34.3q35.2 Chr4:183180000_190940000 | 7.76 | 未知 | 胎儿晶状体回声高,考虑白内障 | 无随访 | 是 |
孕妇3 | 16p13.11p12.3 Chr16:15480000_18180000 | 2.70 | 母亲 | NT正常,中晚孕正常 | 无异常 | 否 |
孕妇4 | 10q11.22q11.23 Chr10:46960000_51800000 | 4.84 | 母亲 | NT正常,中晚孕正常 | 无异常 | 否 |
微重复 | ||||||
孕妇5 | 22q11.21 Chr22:18880000_21480000 | 2.60 | 母亲 | NT正常,中晚孕正常 | 无异常 | 否 |
孕妇6 | 1q21.1q21.2 Chr1:144000000_147780000 | 3.78 | 母亲 | 中晚孕脐绕颈1周,新生儿卵圆孔未闭,心房水平左向右分流,早产儿脑 | 无异常 | 否 |
胎儿编号 | CNV结果 | 相关疾病症状和体征 |
---|---|---|
胎儿1 | 微缺失 | 严重智力障碍,肌张力减退,语言发育迟缓,运动发育迟缓,特殊面容(杯状耳、肉耳、面容粗糙、斜视、上斜睑裂、喇叭状鼻孔等),短颈,手足畸形,过度通气,步态共济失调,癫痫,胼胝体发育不良,胃食管反流,小头畸形,隐睾(男性)等 |
胎儿2 | 微缺失 | 严重的生长发育迟缓,特殊面容,指/趾畸形,智力障碍,自闭症,注意力缺陷,多动障碍,睡眠障碍;巨脑室,特殊面容,心血管系统异常(肺动脉瓣狭窄、动脉导管未闭、房间隔缺损、室间隔缺损),手足异常,肌张力低下,胃食管反流,复发性鼻炎;腭裂,先天性心脏病,听力障碍,智力障碍,自闭症谱系障碍,双侧隐睾,整体发育迟缓,语言发育延迟 |
胎儿3 | 微缺失 | 小头畸形,学习障碍,癫痫,语言和运动功能发育迟缓,身材矮小,行为异常(攻击性行为、自杀倾向、社会交往障碍)等。同时,该区域存在外显不全的情况,部分携带者无明显的临床症状 |
胎儿4 | 微缺失 | 轻度发育迟缓,智力障碍,特殊面容;整体发育迟缓,肌张力减退,色素性视网膜病,眼球震颤,吞咽功能障碍,慢性便秘,胃食管反流等 ;癫痫,多灶性痫样放电,肌张力减退,轻度上睑下垂,鼻小柱短小,轻度视神经萎缩,腹泻,慢性鼻窦炎,中耳炎等 |
胎儿5 | 微重复 | 存在外显不全的情况,患儿表型从正常或几乎正常到严重,差异较大。常见的临床症状有:智力障碍(97%)、精神运动发育迟滞(67%)、生长受限(63%)、肌张力低下(43%),说话鼻音重等。腭咽发育不全、腭裂、先天性心脏病、耳聋、肾生殖系统畸形、胸腺缺如、无脾、认知障碍等,但也有其特定的表型,包括上位眉毛、眼睑下斜或伴下垂、轻度的小颌/缩颌、脸部细长等 |
胎儿6 | 微重复 | 存在外显不全的情况,近端覆盖外显率约为17.3%,远端覆盖外显率约为 29.1%。部分重复片段携带者无异常表型,患者主要表征有轻度/中度智力障碍、轻度/中度发育迟缓、轻度特殊面容(前额凸出、眼距宽、低耳位、内眦赘皮、宽而扁的鼻梁等)、巨头畸形、脑胼胝体和小脑蚓部发育不全、自闭症、学习困难,部分患者还会表现出注意缺陷多动障碍、精神分裂症、法洛四联症、先天性心脏病、癫痫、脊柱弯曲和轻度生殖器畸形等 |
胎儿编号 | CNV结果 | 相关疾病症状和体征 |
---|---|---|
胎儿1 | 微缺失 | 严重智力障碍,肌张力减退,语言发育迟缓,运动发育迟缓,特殊面容(杯状耳、肉耳、面容粗糙、斜视、上斜睑裂、喇叭状鼻孔等),短颈,手足畸形,过度通气,步态共济失调,癫痫,胼胝体发育不良,胃食管反流,小头畸形,隐睾(男性)等 |
胎儿2 | 微缺失 | 严重的生长发育迟缓,特殊面容,指/趾畸形,智力障碍,自闭症,注意力缺陷,多动障碍,睡眠障碍;巨脑室,特殊面容,心血管系统异常(肺动脉瓣狭窄、动脉导管未闭、房间隔缺损、室间隔缺损),手足异常,肌张力低下,胃食管反流,复发性鼻炎;腭裂,先天性心脏病,听力障碍,智力障碍,自闭症谱系障碍,双侧隐睾,整体发育迟缓,语言发育延迟 |
胎儿3 | 微缺失 | 小头畸形,学习障碍,癫痫,语言和运动功能发育迟缓,身材矮小,行为异常(攻击性行为、自杀倾向、社会交往障碍)等。同时,该区域存在外显不全的情况,部分携带者无明显的临床症状 |
胎儿4 | 微缺失 | 轻度发育迟缓,智力障碍,特殊面容;整体发育迟缓,肌张力减退,色素性视网膜病,眼球震颤,吞咽功能障碍,慢性便秘,胃食管反流等 ;癫痫,多灶性痫样放电,肌张力减退,轻度上睑下垂,鼻小柱短小,轻度视神经萎缩,腹泻,慢性鼻窦炎,中耳炎等 |
胎儿5 | 微重复 | 存在外显不全的情况,患儿表型从正常或几乎正常到严重,差异较大。常见的临床症状有:智力障碍(97%)、精神运动发育迟滞(67%)、生长受限(63%)、肌张力低下(43%),说话鼻音重等。腭咽发育不全、腭裂、先天性心脏病、耳聋、肾生殖系统畸形、胸腺缺如、无脾、认知障碍等,但也有其特定的表型,包括上位眉毛、眼睑下斜或伴下垂、轻度的小颌/缩颌、脸部细长等 |
胎儿6 | 微重复 | 存在外显不全的情况,近端覆盖外显率约为17.3%,远端覆盖外显率约为 29.1%。部分重复片段携带者无异常表型,患者主要表征有轻度/中度智力障碍、轻度/中度发育迟缓、轻度特殊面容(前额凸出、眼距宽、低耳位、内眦赘皮、宽而扁的鼻梁等)、巨头畸形、脑胼胝体和小脑蚓部发育不全、自闭症、学习困难,部分患者还会表现出注意缺陷多动障碍、精神分裂症、法洛四联症、先天性心脏病、癫痫、脊柱弯曲和轻度生殖器畸形等 |
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