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Xu T, Yue F, He J, Zhang H, Liu R. Prenatal detection of distal 18p deletion by chromosomal microarray analysis: Three case reports and literature review. Medicine (Baltimore) 2024; 103:e39046. [PMID: 39058883 PMCID: PMC11272248 DOI: 10.1097/md.0000000000039046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 07/02/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Chromosome 18p deletion syndrome is caused by total or partial deletion of the short arm of chromosome 18 and associated with cognitive impairment, growth retardation and mild facial dysmorphism. However, most studies on the genotype-phenotype correlations in the 18p region are diagnosed postnatally. Prenatal reports involving 18p deletions are limited. METHODS Three pregnant women opted for invasive prenatal testing due to noninvasive prenatal testing indicating high risk for chromosome 18 abnormalities. Karyotypic analysis and chromosomal microarray analysis (CMA) were performed simultaneously. The pregnancy outcomes for all cases were followed up. Meanwhile, we also made a literature review on prenatal phenotypes of 18p deletions. RESULTS G-banding analysis showed that 2 fetuses presented abnormal karyotypes: 45,XN,der(18)t(18;21)(p11; q11),-21 (case 2) and 46,XN,18p- (case 3). The karyotype of case 1 was normal. Meanwhile, CMA detected 4.37 Mb (case 1), 7.26 Mb (case 2) and 14.97 Mb (case 3) deletions in chromosome 18p region. All 3 pregnancies were terminated finally according to genetic counseling based upon abnormal CMA results. CONCLUSION Prenatal diagnosis of 18p deletion syndrome is full of challenges due to the phenotypic diversity, incomplete penetrance and lack of prenatal phenotypes. Increased nuchal translucency and holoprosencephaly are common prenatal phenotypes of distal 18p deletion. For fetuses carrying 18p deletions with atypical sonographic phenotypes, noninvasive prenatal testing could be adopted as an effective approach.
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Affiliation(s)
- Tangfei Xu
- Center for Reproductive Medicine, Center for Prenatal Diagnosis, First Hospital, Jilin University, Changchun, China
- Jilin Engineering Research Center for Reproductive Medicine and Genetics, Jilin University, Changchun, China
| | - Fagui Yue
- Center for Reproductive Medicine, Center for Prenatal Diagnosis, First Hospital, Jilin University, Changchun, China
- Jilin Engineering Research Center for Reproductive Medicine and Genetics, Jilin University, Changchun, China
| | - Jing He
- Center for Reproductive Medicine, Center for Prenatal Diagnosis, First Hospital, Jilin University, Changchun, China
- Jilin Engineering Research Center for Reproductive Medicine and Genetics, Jilin University, Changchun, China
| | - Hongguo Zhang
- Center for Reproductive Medicine, Center for Prenatal Diagnosis, First Hospital, Jilin University, Changchun, China
- Jilin Engineering Research Center for Reproductive Medicine and Genetics, Jilin University, Changchun, China
| | - Ruizhi Liu
- Center for Reproductive Medicine, Center for Prenatal Diagnosis, First Hospital, Jilin University, Changchun, China
- Jilin Engineering Research Center for Reproductive Medicine and Genetics, Jilin University, Changchun, China
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Papamichail M, Eleftheriades A, Manolakos E, Papamichail A, Christopoulos P, Manegold-Brauer G, Eleftheriades M. Prenatal diagnosis of 18p deletion and 8p trisomy syndrome: literature review and report of a novel case. BMC Womens Health 2024; 24:241. [PMID: 38622524 PMCID: PMC11017580 DOI: 10.1186/s12905-024-03081-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 04/07/2024] [Indexed: 04/17/2024] Open
Abstract
18p deletion syndrome constitutes one of the most frequent autosomal terminal deletion syndromes, affecting one in 50,000 live births. The syndrome has un-specific clinical features which vary significantly between patients and may overlap with other genetic conditions. Its prenatal description is extremely rare as the fetal phenotype is often not present during pregnancy. Trisomy 8p Syndrome is characterized by heterogenous phenotype, with the most frequent components to be cardiac malformation, developmental and intellectual delay. Its prenatal diagnosis is very rare due to the unspecific sonographic features of the affected fetuses. We present a very rare case of a fetus with multiple anomalies diagnosed during the second trimester whose genomic analysis revealed a 18p Deletion and 8p trisomy Syndrome. This is the first case where this combination of DNA mutations has been described prenatally and the second case in general. The presentation of this case, as well as the detailed review of all described cases, aim to expand the existing knowledge regarding this rare condition facilitating its diagnosis in the future.
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Affiliation(s)
- Maria Papamichail
- Postgraduate Programme "Maternal Fetal Medicine" Medical School, National & Kapodistrian University of Athens, Athens, Greece
| | - Anna Eleftheriades
- Department of Obstetrics and Gynaecology, Women' Hospital, University Hospital of Basel, University of Basel, Basel, Switzerland.
| | - Emmanouil Manolakos
- Clinical Laboratory Genetics, Access To Genome (ATG), Athens-Thessaloniki-Greece, Athens, Greece
| | | | - Panagiotis Christopoulos
- 2nd Department of Obstetrics and Gynecology, Medical School, Aretaieio University Hospital, National & Kapodistrian University of Athens, Athens, Greece
| | - Gwendolin Manegold-Brauer
- Department of Gynaecological Ultrasound and Prenatal Diagnostics, Women' Hospital, University Hospital of Basel, University of Basel, Basel, Switzerland
| | - Makarios Eleftheriades
- 2nd Department of Obstetrics and Gynecology, Medical School, Aretaieio University Hospital, National & Kapodistrian University of Athens, Athens, Greece
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Zhang Y, Chen J, Feng Z, Li W. Prenatal diagnosis and genetic counseling of an inherited unbalanced chromosome abnormalities in a Chinese family. Mol Cytogenet 2022; 15:34. [PMID: 35971114 PMCID: PMC9380353 DOI: 10.1186/s13039-022-00614-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 08/03/2022] [Indexed: 11/24/2022] Open
Abstract
Background Unbalanced chromosome abnormalities (UBCA) are either gains or losses or large genomic regions, but the affected person is not or only minimally clinically affected. Copy number variants (CNVs) are an important source of normal and pathogenic genome variations. CNVs and UBCA identified in prenatal cases need careful considerations and correct interpretation if those are harmless or harmful variants from the norm. Case presentation A 25-year-old, gravida 1, para 0, woman underwent amniocentesis at 18 weeks of gestation because the noninvasive prenatal testing (NIPT) results revealed a 6.8 Mb duplication from 2q11.1 to 2q11.2. Chromosomal microarray analysis (CMA) was performed on uncultured amniocytes. GTG-banding karyotype analysis on cultured amniocytes was performed. Results Chromosomal GTG-banding of the cultured amniocytes revealed a karyotype of 46,XX. CMA detected a 6.8-Mb chromosomal duplication in the region of 2q11.1q11.2 (arr[GRCh37] 2q11.1q11.2(95,327,873_102,088,148)x3). Conclusion Chromosomal microdeletions and microduplications are difficult to detect by conventional cytogenetics, combination of prenatal ultrasound, karyotype analysis, NIPT, CMA and genetic counseling is helpful for the prenatal diagnosis of UBCA and chromosomal microdeletions/microduplications.
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Affiliation(s)
- Ying Zhang
- Reproductive Medicine Center, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, People's Republic of China.,Prenatal Diagnosis Center, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, People's Republic of China.,Hubei Clinical Research Center for Reproductive Medicine, Shiyan, Hubei, People's Republic of China.,Biomedical Engineering College, Hubei University of Medicine, Shiyan, Hubei, People's Republic of China
| | - Juan Chen
- Reproductive Medicine Center, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, People's Republic of China.,Prenatal Diagnosis Center, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, People's Republic of China.,Hubei Clinical Research Center for Reproductive Medicine, Shiyan, Hubei, People's Republic of China.,Biomedical Engineering College, Hubei University of Medicine, Shiyan, Hubei, People's Republic of China
| | - Zonghui Feng
- Prenatal Diagnosis Center, Maternity and child Care Hospital of Huaihua, Huaihua, Hunan, People's Republic of China
| | - Wencheng Li
- Prenatal Diagnosis Center, Maternity and child Care Hospital of Huaihua, Huaihua, Hunan, People's Republic of China.
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Shi Y, Li X, Ju D, Li Y, Zhang X, Zhang Y. Abnormal chromosomes identification using chromosomal microarray. J OBSTET GYNAECOL 2022; 42:2025-2032. [PMID: 35659171 DOI: 10.1080/01443615.2022.2074786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
In this study, we presented a case series to highlight the chromosomal microarray (CMA) in identifying chromosomal abnormalities which is undetectable by conventional karyotyping or known abnormal chromosomes without clear diagnosis. Extensive studies showed that CMA was gradually accepted as a prenatal invasive testing during pregnancy. The aim of this study was to evaluate the diagnostic effect of CMA for foetuses with abnormal chromosomes unrecognised by conventional karyotyping. Pregnant women who need prenatal diagnosis with all indications were enrolled in this study. For aberrant cytogenetic findings that cannot be defined by routine karyotyping, single nucleotide polymorphism array (SNP-array) was used. Six cases with abnormal karyotype were included in the study. With higher resolution of translocation breakpoints, CMA could detect smaller chromosomal imbalances that were undetectable by karyotyping. This study highlights the value of CMA for the detection of submicroscopic abnormalities in foetuses that cannot be detected by conventional karyotyping. Impact StatementWhat is already known on this subject? Chromosomal microarray (CMA) offers additional diagnostic benefits by revealing submicroscopic imbalances or copy number variations (CNVs) that are too small to be identified on a standard G-banded chromosome preparation.What do the results of this study add? We added a case series to highlight the CMA in identifying chromosomal abnormalities not detectable by conventional karyotyping or known abnormal chromosomes without clear diagnosis.What are the implications of these findings for clinical practice and/or further research? This study highlights the value of CMA in the case of associated foetuses with submicroscopic abnormalities that cannot detect by conventional karyotyping.
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Affiliation(s)
- Yunfang Shi
- Tianjin Medical University General Hospital, Tianjin, China
| | - Xiaozhou Li
- Tianjin Medical University General Hospital, Tianjin, China
| | - Duan Ju
- Tianjin Medical University General Hospital, Tianjin, China
| | - Yan Li
- Tianjin Medical University General Hospital, Tianjin, China
| | - Xiuling Zhang
- Tianjin Medical University General Hospital, Tianjin, China
| | - Ying Zhang
- Tianjin Medical University General Hospital, Tianjin, China
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Song J, Jiang W, Zhang C, Wang B. Prenatal diagnosis and genetic counseling of a 10p11.23q11.21 duplication associated with normal phenotype. Mol Cytogenet 2022; 15:21. [PMID: 35659699 PMCID: PMC9164483 DOI: 10.1186/s13039-022-00598-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 05/11/2022] [Indexed: 11/13/2022] Open
Abstract
Background Copy number variants (CNVs) are an important source of normal and pathogenic genome variations. Unbalanced chromosome abnormalities (UBCA) are either gains or losses or large genomic regions, but the affected person is not or only minimally clinically affected. CNVs and UBCA identified in prenatal cases need careful considerations and correct interpretation if those are harmless or harmful variants from the norm. Case presentation A 24-year-old, gravida 1, para 0, woman underwent amniocentesis at 17 weeks of gestation because the noninvasive prenatal testing (NIPT) results revealed a 12.4 Mb duplication from 10p11.2 to 10q11.2. GTG-banding karyotype analysis was performed on cultured amniocytes. Chromosomal microarray analysis (CMA) on uncultured amniocytes was performed. Results Chromosomal GTG-banding of the cultured amniocytes revealed a karyotype of 46,XX,dup(10)(p11.2q11.2). CMA detected a 12.5-Mb chromosomal duplication in the region of 10p11.23q11.21 (arr[GRCh37] 10p11.23q11.21(30,345,109_42,826,062) × 3). Conclusion The present report enlarges the known UBCA region 10p11.22-10q11.22 to 10p11.23-10q11.22. Also it highlights that an integration of prenatal ultrasound, NIPT, karyotype analysis, CMA and genetic counseling is helpful for the prenatal diagnosis of chromosomal deletions/duplications.
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Affiliation(s)
- Jieping Song
- Department of Clinical Laboratory, Maternal and Child Health Hospital of Hubei Province, Wuhan, Hubei, People's Republic of China
| | - Wei Jiang
- Department of Clinical Laboratory, Maternal and Child Health Hospital of Hubei Province, Wuhan, Hubei, People's Republic of China
| | - Chengcheng Zhang
- Department of Clinical Laboratory, Maternal and Child Health Hospital of Hubei Province, Wuhan, Hubei, People's Republic of China
| | - Bo Wang
- Department of Clinical Laboratory, Maternal and Child Health Hospital of Hubei Province, Wuhan, Hubei, People's Republic of China.
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Han M, Wei L, Liu F, Gao X. Familial microdeletion 18p11.32 to 18p11.31 in a Chinese family with normal phenotype. Mol Cytogenet 2022; 15:12. [PMID: 35331298 PMCID: PMC8943926 DOI: 10.1186/s13039-022-00590-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 03/11/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Chromosomal imbalances of several megabasepair in size are normally deleterious for the carrier. Still, rarely reported are so-called "unbalanced chromosome abnormalities" (UBCAs), which are either gains or losses or equally large genomic regions, but the affected person is not or only minimally clinically affected. The knowledge of such UBCAs is imperative also in chromosomal microarray analysis (CMA) or noninvasive prenatal testing (NIPT). CASE PRESENTATION A maternally inherited del(18)(p11.32p11.31) was identified in a over two generations in a Chinese family with normal phenotype. The affected region encompasses 19 genes, among which TGIF1 is expressed in fetal and adult nervous system. TGIF1 deletions and /or mutations have been seen in cases with holoprosencephaly but also non-affected individuals, suggesting incomplete penetrance and variable expressivity. CONCLUSIONS Deletions in the terminal region of chromosome 18 short arm have been reported previously in clinically healthy persons. Here a further family with an UBCA in 18p11.3 is added to the literature, suggesting a careful genetic counselling in comparable, especially prenatal cases.
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Affiliation(s)
- Miaomiao Han
- Department of Obstetrics and Gynecology, Maternal and Child Health Hospital of Dongxihu District, Wuhan, Hubei, China
| | - Lei Wei
- Department of Center for Reproductive Medicine, TaiHe Hospital, Hubei University of Medicine, Shiyan, Hubei, People's Republic of China
| | - Fang Liu
- Department of Gynecology, Huangshi Love & Health Hospital Affiliated To Hubei Polytechnic University, Huangshi, Hubei, People's Republic of China
| | - Xia Gao
- Department of Obstetrics, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, People's Republic of China.
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Jin Q, Qiang R, Cai B, Wang X, Cai N, Zhen S, Zhai W. The genotype and phenotype of chromosome 18p deletion syndrome: Case series. Medicine (Baltimore) 2021; 100:e25777. [PMID: 33950970 PMCID: PMC8104293 DOI: 10.1097/md.0000000000025777] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 04/06/2021] [Accepted: 04/15/2021] [Indexed: 01/04/2023] Open
Abstract
RATIONALE The chromosome 18p deletion syndrome is a syndrome with a deletion of all or a portion of the short arm of the chromosome 18. The phenotypes of the chromosome 18p deletion syndrome vary widely among individuals due to differences in size and breakpoints and the involved genes on the deletions. Given the varied and untypical clinical presentation of this syndrome, the prenatal diagnosis of the syndrome still presents as a challenge. PATIENT CONCERNS We described 4 China cases with different chromosomal breakpoints. In case 1, a woman who with mild phenotypes gave birth to a severely deformed fetus. Three other cases were for prenatal diagnosis. Their phenotypes are the increased nuchal translucency (INT) and the noninvasive prenatal testing (NIPT) indicated deletions on the chromosome 18p and severe hydronephrosis respectively. DIAGNOSIS The 4 cases were diagnosed with chromosome 18p deletion syndrome through karyotype analysis and array-based comparative genomic hybridization (array-CGH). INTERVENTIONS Karyotype analysis and array-based comparative genomic hybridization were used to analyze the abnormal chromosome. OUTCOMES Case 1 and case 2 revealed 11.51 and 12.39 Mb deletions in 18p11.32p11.21. Case 3 revealed 7.1 Mb deletions in 18p11.3218p11.23. Case 4 revealed 9.9 Mb deletions in 18p11.3218p11.22. LESSONS In our report, we are the first to report that mother and progeny who have the same chromosomal breakpoint have different phenotypes, significantly. In addition, we found a new phenotype of chromosome 18p deletion syndrome in fetus, which can enrich the phenotypes of this syndrome in the prenatal diagnosis. Finally, we demonstrate that the individuals with different chromosomal breakpoints of 18p deletion syndrome have different phenotypes. On the other hand, the individuals with the same chromosomal breakpoints of 18p deletion syndrome may also have remarkably different phenotypes.
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Tamaki Y, Katagiri Y, Umemura N, Takeshita N, Morita M. Noninvasive prenatal testing aids identification of tetrasomy 18p: A case report. Case Rep Womens Health 2020; 27:e00236. [PMID: 32642449 PMCID: PMC7334301 DOI: 10.1016/j.crwh.2020.e00236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 06/22/2020] [Accepted: 06/23/2020] [Indexed: 11/01/2022] Open
Abstract
Tetrasomy 18p syndrome (Online Mendelian Inheritance in Man 614290) is a rare chromosomal disorder that is seen in approximately 1 in every 180,000 live births. It is caused by the presence of isochromosome 18p, which is a supernumerary marker composed of two copies of the short arms of chromosome 18. Isochromosome 18p is one of the most commonly observed isochromosomes. We report tetrasomy 18p syndrome diagnosed prenatally after noninvasive prenatal testing (NIPT) was positive for trisomy 18. Tetrasomy 18p was finally diagnosed by G-banding and fluorescence in situ hybridization of chromosome 18p, before invasive confirmatory testing the karyotype findings by NIPT showed an increase in the DNA fragments from chromosome 18p, indicating duplication of chromosome 18p. NIPT can detect not only trisomy 13, 18, and 21, but also structural chromosomal anomalies, such as deletions and duplications. An NIPT report "positive for trisomy 18" indicates the possibility of tetrasomy 18p, and detailed analysis of NIPT data can reveal subchromosomal copy number variations, to a certain extent, before definitive diagnostic testing.
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Affiliation(s)
- Yuko Tamaki
- Department of Obstetrics and Gynecology, Toho University Omori Medical Center, Japan
| | - Yukiko Katagiri
- Department of Obstetrics and Gynecology, Toho University Omori Medical Center, Japan
| | - Nahomi Umemura
- Department of Obstetrics and Gynecology, Toho University Omori Medical Center, Japan
| | - Naoki Takeshita
- Department of Obstetrics and Gynecology, Toho University Sakura Medical Center, Japan
| | - Mineto Morita
- Department of Obstetrics and Gynecology, Toho University Omori Medical Center, Japan
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Zhao G, Dai P, Gao S, Zhao X, Wang C, Liu L, Kong X. A case of prenatal diagnosis of 18p deletion syndrome following noninvasive prenatal testing. Mol Cytogenet 2019; 12:53. [PMID: 31890033 PMCID: PMC6925888 DOI: 10.1186/s13039-019-0464-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 12/06/2019] [Indexed: 12/21/2022] Open
Abstract
Background Chromosome 18p deletion syndrome is a disease caused by the complete or partial deletion of the short arm of chromosome 18, there were few cases reported about the prenatal diagnosis of 18p deletion syndrome. Noninvasive prenatal testing (NIPT) is widely used in the screening of common fetal chromosome aneuploidy. However, the segmental deletions and duplications should also be concerned. Except that some cases had increased nuchal translucency or holoprosencephaly, most of the fetal phenotype of 18p deletion syndrome may not be evident during the pregnancy, 18p deletion syndrome was always accidentally discovered during the prenatal examination. Case presentations In our case, we found a pure partial monosomy 18p deletion during the confirmation of the result of NIPT by copy number variation sequencing (CNV-Seq). The result of NIPT suggested that there was a partial or complete deletion of X chromosome. The amniotic fluid karyotype was normal, but result of CNV-Seq indicated a 7.56 Mb deletion on the short arm of chromosome 18 but not in the couple, which means the deletion was de novo deletion. Finally, the parents chose to terminate the pregnancy. Conclusions To our knowledge, this is the first case of prenatal diagnosis of 18p deletion syndrome following NIPT.NIPT combined with ultrasound may be a relatively efficient method to screen chromosome microdeletions especially for the 18p deletion syndrome.
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Affiliation(s)
- Ganye Zhao
- Genetics and Prenatal Diagnosis Center, The First Affiliated Hospital of Zhengzhou University, Henan Engineering Research Center for Gene Editing of Human Genetic Disease, Erqi District, Zhengzhou, China
| | - Peng Dai
- Genetics and Prenatal Diagnosis Center, The First Affiliated Hospital of Zhengzhou University, Henan Engineering Research Center for Gene Editing of Human Genetic Disease, Erqi District, Zhengzhou, China
| | - Shanshan Gao
- Genetics and Prenatal Diagnosis Center, The First Affiliated Hospital of Zhengzhou University, Henan Engineering Research Center for Gene Editing of Human Genetic Disease, Erqi District, Zhengzhou, China
| | - Xuechao Zhao
- Genetics and Prenatal Diagnosis Center, The First Affiliated Hospital of Zhengzhou University, Henan Engineering Research Center for Gene Editing of Human Genetic Disease, Erqi District, Zhengzhou, China
| | - Conghui Wang
- Genetics and Prenatal Diagnosis Center, The First Affiliated Hospital of Zhengzhou University, Henan Engineering Research Center for Gene Editing of Human Genetic Disease, Erqi District, Zhengzhou, China
| | - Lina Liu
- Genetics and Prenatal Diagnosis Center, The First Affiliated Hospital of Zhengzhou University, Henan Engineering Research Center for Gene Editing of Human Genetic Disease, Erqi District, Zhengzhou, China
| | - Xiangdong Kong
- Genetics and Prenatal Diagnosis Center, The First Affiliated Hospital of Zhengzhou University, Henan Engineering Research Center for Gene Editing of Human Genetic Disease, Erqi District, Zhengzhou, China
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