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1、北京医学2014年第36卷第7期·550··论著·无创胎儿游离DNA检测技术在产前胎儿非整倍体筛查中的应用评价穆煜王庆孙芾王厚芳常玲AfnanMasoud唐莹【摘要】目的探讨无创胎儿染色体非整倍体检测技术(non-invasivefetaltrisomytest,NIFTY)在胎儿染色体非整倍体产前筛查应用中的特异性和灵敏度。方法利用新一代高通量并行测序技术对母体外周血中的胎儿游离DNA(cell-freeDNA,cfDNA)进行定量分析,根据相应DNA含量的变化推断胎儿染色体的异常状况。结果2012年3月至2013年5月,检测孕1
2、2~24周的孕妇外周血标本,对233份已结束妊娠的孕妇数据进行分析评估。其中结果为染色体非整倍体高风险11例,低风险结果222例。在高风险病例中21三体5例;18三体3例;13三体1例;性染色体X0异常2例。所有高风险结果经细胞遗传学检测后确认与母血胎儿cfDNA检测结果一致,检测特异性100.0%。筛查低风险结果222例,均已分娩,临床证实为正常婴儿,检测灵敏度100.0%。结论无创胎儿游离DNA检测是一种很好的胎儿非整倍体异常的产前筛查技术。相对于目前普遍采用的孕早期或孕中期血清学产前筛查技术,胎儿cfDNA检测更加可靠,无创性
3、的取样过程对孕妇和胎儿无损伤,具有更好的敏感度和特异性。【关键词】产前筛查无创胎儿游离DNA非整倍体染色体Evaluationofprenatalscreeningforfetalchromosomalaneuploidiesbynon-invasivefetalcell-freeDNAtestMuYu,WangQing,SunFei,WangHoufang,ChangLing,AfnanMasoud,TangYing.DepartmentofPathologyandLaboratoryMedicine,BeijingUnitedF
4、amilyHospital,Beijing100015,ChinaCorrespondingauthor:SunFei,Email:sun.fei@ufh.com.cn【Abstract】ObjectiveToevaluatethespecificityandsensitivityofnon-invasivefetaltrisomytest(NIFTY)andstudytheprospectsandfeasibilityofdetectedfetalDNAinmaternalbloodforprenatalscreeningoffe
5、talchromosomala-neuploidies.MethodsNIFTYutilizesnewgenerationhigh-throughputmassivelyparallelDNAsequencingtechnologiestoquantitativelyanalyzefetalcell-freeDNAcirculatinginmaternalplasma.AccordingtothealteredconcentrationofDNAtoestimatethefetalchromosomenumbers.ResultsF
6、romMar,2012toMay,2013,233pregnantwomenintotalwerede-tectedwhosegestationalagesrangedfrom12~24weeks.Allofthemhadthepregnanciesterminatedbynormaldeliveryorearlyterminationsduetoabnormalfetus.Elevenhighriskpregnanciesweredetectedduringthisperiod.Inthesehighriskcases,5were
7、Trisomy21,3wereTrisomy18,1wasTrisomy13and2weresexualchromosomeX0.AllNIFTYscreenedhighriskcaseswereconfirmedbycytogenetictests.Thespecificityofthetestwas100%.222werelowriskforabnormalchromosomeandnoabnormalbabywasfoundafterbirth,therefore,thetestsensitivitywas100%.Concl
8、usionMaternalperipheralbloodfetalcfDNAtestisaverygoodtestmethodtodetectfetalchromosomalaneuploidies.Comparingtothefir