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Wang S, Bu N, Yun Y, Shi X, Wang S, Gao Y. RNA-Seq Analysis of Testes from Mice Exposed to Neodymium Oxide. TOXICS 2023; 11:952. [PMID: 38133353 PMCID: PMC10748220 DOI: 10.3390/toxics11120952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/15/2023] [Accepted: 11/20/2023] [Indexed: 12/23/2023]
Abstract
(1) Objective: Rare earth neodymium oxide (Nd2O3) is refined and used extensively around the world, and the occupational and environmental safety of rare piles of the earth has attracted considerable attention. Nd2O3 enters the human body through the respiratory system, reaches various organs through blood circulation, and accumulates to produce toxic effects. At present, little is known about the reproductive toxicity of Nd2O3. Non-coding RNAs participate in a variety of physiological activities and are very important for spermatogenesis. However, it is unknown whether they are involved in Nd2O3-induced reproductive toxicity. Therefore, we conducted a pathological analysis, sperm quality testing, and RNA-seq on the testicular tissue of mice exposed to Nd2O3 to find the key genes and regulatory pathways of male reproductive damage and explore the early biomarkers and mechanisms of reproductive damage caused by Nd2O3. (2) Methods: After exposure of mice to Nd2O3, we carried out a pathological analysis and RNA-seq analysis for miRNAs/lncRNAs/circRNAs/mRNAs on the testicular tissue of mice, and the total RNAs were used to investigate miRNA/lncRNA/circRNA/mRNA expression profiles by strand-specific RNA sequencing at the transcriptome level to help uncover RNA-related mechanisms in Nd2O3-induced toxicity. (3) Results: Nd2O3 damaged testis and sperm morphology, significantly decreased the number of sperm, and deformed the sperm head and tail. RNA-seq analysis showed that the expression level of mRNA/miRNA/circRNA/lncRNA in the testicular tissue of mice exposed to Nd2O3 is abnormal. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis demonstrated that the functional enrichment of differentially expressed genes (DEGs) and their target genes was closely related to the related pathway of spermatogenesis. Furthermore, some miRNAs/lncRNAs/circRNAs that were greatly upregulated or inducibly expressed, implying their potential value as candidate markers for Nd2O3-induced reproductive toxicity, help us to further investigate the mechanisms of key genes, key signaling pathways, and inter-gene regulation for Nd2O3-induced reproductive toxicity. (4) Conclusions: This study provides the first database of a Nd2O3-induced transcriptome. This information is useful for the development of biomarkers of Nd2O3-induced reproductive injury and promotes understanding of the reproductive toxicity mechanism of Nd2O3.
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Affiliation(s)
- Shurui Wang
- Baotou Medical College, Baotou 014042, China; (S.W.); (Y.Y.); (X.S.)
| | - Ning Bu
- Center for Global Health, The Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China;
| | - Yudan Yun
- Baotou Medical College, Baotou 014042, China; (S.W.); (Y.Y.); (X.S.)
| | - Xuemin Shi
- Baotou Medical College, Baotou 014042, China; (S.W.); (Y.Y.); (X.S.)
| | - Suhua Wang
- Wulanchabu Medical College, Wulanchabu 012001, China
| | - Yanrong Gao
- Baotou Medical College, Baotou 014042, China; (S.W.); (Y.Y.); (X.S.)
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Clinical, Cytogenetic and Molecular Cytogenetic Outcomes of Cell-Free DNA Testing for Rare Chromosomal Anomalies. Genes (Basel) 2022; 13:genes13122389. [PMID: 36553656 PMCID: PMC9777917 DOI: 10.3390/genes13122389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 12/13/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022] Open
Abstract
The scope of cell-free DNA (cfDNA) testing was expanded to the genome, which allowed screening for rare chromosome anomalies (RCAs). Since the efficiency of the test for RCAs remains below the common aneuploidies, there is a debate on the usage of expanded tests. This study focuses on the confirmatory and follow-up data of cases with positive cfDNA testing for RCAs and cases with screen-negative results in a series of 912 consecutive cases that underwent invasive testing following cfDNA testing. Chorion villus sampling (CVS), amniocentesis (AS), fetal blood sampling, and term placenta samples were investigated using classical cytogenetic and molecular cytogenetic techniques. Out of 593 screen-positive results, 504 (85%) were for common aneuploidies, 40 (6.7%) for rare autosomal trisomies (RATs), and 49 (8.3%) for structural chromosome anomalies (SAs). Of the screen-positives for RATs, 20 cases were evaluated only in fetal tissue, and confined placental mosaicism (CPM) could not be excluded. Among cases with definitive results (n = 20), the rates of true positives, placental mosaics, and false positives were 35%, 45%, and 10%, respectively. Among screen-positives for SAs, 32.7% were true positives. The confirmation rate was higher for duplications than deletions (58.3% vs. 29.4%). The rate of chromosomal abnormality was 10.9% in the group of 256 screen-negatives with pathological ultrasound findings. This study provides further data to assess the efficiency of expanded cfDNA testing for RATs and SAs. The test efficiency for cfDNA seems to be higher for duplications than for deletions, which is evidence of the role of expert ultrasound in identifying pregnancies at increased risk for chromosome anomalies, even in pregnancies with screen-negatives. Furthermore, we discussed the efficiency of CVS vs. AC in screen-positives for RATs.
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Sherer DM, Hsieh V, Hall A, Gerren A, Walters E, Dalloul M. Current Perspectives of Prenatal Cell-free DNA Screening in Clinical Management of First-Trimester Septated Cystic Hygroma. Int J Womens Health 2022; 14:1499-1518. [PMID: 36325393 PMCID: PMC9621220 DOI: 10.2147/ijwh.s328201] [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: 04/28/2022] [Accepted: 08/08/2022] [Indexed: 11/07/2022] Open
Abstract
First-trimester septated cystic hygroma occurs in approximately 1 in 268 pregnancies and has long been associated with a markedly increased risk of fetal aneuploidy and, among euploid fetuses, an increased risk of structural anomalies primarily affecting the cardiac and skeletal systems. Invasive prenatal diagnosis – chorionic villus sampling and/or amniocentesis – encompasses the time-honored clinical tools for the next step in management following prenatal sonographic diagnosis of first-trimester septated cystic hygroma. Currently, prenatal cell-free DNA (cfDNA) screening for fetal aneuploidy with select microdeletions is gradually replacing the considerably less sensitive, and labor-intensive combined first-trimester screening. These new technologies have opened potential new venues in the clinical management of this ominous late first-trimester sonographic diagnosis. Advances in cfDNA technologies are now permitting detection of chromosomal copy number variants (CNV) larger than 7Mb across genome and select serious single-gene disorders (mainly impacting skeletal and neurological development), affecting quality of life and may benefit from medical and/or surgical management. This commentary will address the available non-invasive prenatal screening technologies, which clearly enhance immediate genetic analysis modalities applicable in the presence of the complex sonographic finding of first-trimester septated cystic hygroma.
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Affiliation(s)
- David M Sherer
- The Division of Maternal Fetal Medicine, the Department of Obstetrics and Gynecology, State University of New York (SUNY), Downstate Health Sciences University, Brooklyn, New York, USA,Correspondence: David M Sherer, Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, State University of New York (SUNY), Downstate Health Sciences University, 450 Clarkson Avenue, Box 24, Brooklyn, NY, 11203, USA, Tel +001-718-270-2081, Fax +001-718-270-4122, Email
| | - Vicky Hsieh
- The Division of Maternal Fetal Medicine, the Department of Obstetrics and Gynecology, State University of New York (SUNY), Downstate Health Sciences University, Brooklyn, New York, USA
| | - Anika Hall
- The Division of Maternal Fetal Medicine, the Department of Obstetrics and Gynecology, State University of New York (SUNY), Downstate Health Sciences University, Brooklyn, New York, USA
| | - Allison Gerren
- The Division of Maternal Fetal Medicine, the Department of Obstetrics and Gynecology, State University of New York (SUNY), Downstate Health Sciences University, Brooklyn, New York, USA
| | - Erin Walters
- The Division of Maternal Fetal Medicine, the Department of Obstetrics and Gynecology, State University of New York (SUNY), Downstate Health Sciences University, Brooklyn, New York, USA
| | - Mudar Dalloul
- The Division of Maternal Fetal Medicine, the Department of Obstetrics and Gynecology, State University of New York (SUNY), Downstate Health Sciences University, Brooklyn, New York, USA
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Bai X, Zheng L, Ma S, Kan X. Prenatal diagnosis of chromosome 18 long arm deletion syndrome by high-throughput sequencing: Two case reports. Medicine (Baltimore) 2021; 100:e28143. [PMID: 34918667 PMCID: PMC8677896 DOI: 10.1097/md.0000000000028143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 11/17/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Chromosome 18 long arm deletion syndrome is a group of clinical syndromes caused by partial or total genetic material deletion of the long arm of chromosome 18 (18q), whose clinical manifestations are related to presentation and developmental abnormalities in various aspects such as intelligence, face, and movement. Prenatal diagnosis of this syndrome is challenging because of its low incidence and uncharacteristic prenatal clinical performance. In this paper, 2 cases of partial deletion of 18q found in prenatal amniotic fluid examination by high-throughput sequencing were reported and analyzed. PATIENT CONCERNS In patient 1, non-invasive prenatal gene detection at 21 + 2 weeks of gestation suggests a risk of trisomy 18. In patient 2, ultrasound examination at 21 + 2 weeks of gestation revealed a single live fetus, but it was difficult to pinpoint whether the fetus had only 1 umbilical artery to supply blood. DIAGNOSIS AND INTERVENTION The 18q deletion syndrome was diagnosed by chromosome karyotype analysis and high-throughput sequencing. OUTCOMES The pregnancies were terminated due to the abnormal chromosome. LESSON This report adds novel variants to the genetic profile of 18q deletion, in order to enrich the genetic data of long arm deletion of 18 chromosomes and provide better services for pre-screening, diagnosis, and genetic counseling for this disease.
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Tang X, Chen X, Liao Y, Yan B, Hu H, Ming Z, Liu L, Li L, Mao Z, Xiao X. Self-Internal-Reference Probe System for Control-Free Quantification of Mutation Abundance. Anal Chem 2021; 93:13274-13283. [PMID: 34546716 DOI: 10.1021/acs.analchem.1c02877] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Gene mutations are important biomarkers for the diagnosis, classification, monitoring, and prognosis evaluation of cancers and genetic diseases. Both personalized cancer treatment and noninvasive prenatal testing require methods to accurately determine the abundance of mutation. At present, the widely adopted and convenient methods for measuring mutation abundance are mainly based on relative quantification, which requires negative samples and strict control of the analyte amounts. The development of DNA-probe-based methods that can determine the mutation abundance without negative samples nor control of analyte amount is highly preferred. The key to solving this bottleneck lies in whether the probe's response to mutation abundance can be completely independent of the number of targeted DNA strands. Herein, we propose the design of a self-internal-reference probe system. We established a theoretical model of this system and used the model to guide the design of probes. In this model, we provided quantitative corrections to the test results from the internal reference, thereby eliminating the influence of substrate amount. Therefore, the purification and quantification processes toward polymerase chain reaction (PCR) amplicons can be omitted. We applied this system to analyze unquantified PCR products aimed at cancer mutation detection and noninvasive prenatal testing.
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Affiliation(s)
- Xiaofeng Tang
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, P. R. China
| | - Xin Chen
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, P. R. China
| | - Yangwei Liao
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, P. R. China
| | - Bei Yan
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, P. R. China
| | - Hao Hu
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, P. R. China
| | - Zhihao Ming
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, P. R. China
| | - Liquan Liu
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, P. R. China
| | - Longjie Li
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, P. R. China.,School of Life Science and Technology, Wuhan Polytechnic University, Wuhan 430023, P. R. China
| | - Zenghui Mao
- Center of Reproductive Medicine, Changsha Hospital for Maternal and Child Health Care of Hunan Normal University, Changsha 410007, P. R. China
| | - Xianjin Xiao
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, P. R. China
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Christiaens L, Chitty LS, Langlois S. Current controversies in prenatal diagnosis: Expanded NIPT that includes conditions other than trisomies 13, 18, and 21 should be offered. Prenat Diagn 2021; 41:1316-1323. [PMID: 33829520 DOI: 10.1002/pd.5943] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 03/06/2021] [Accepted: 03/22/2021] [Indexed: 11/11/2022]
Abstract
Non-invasive prenatal testing (NIPT) based on analysis of cell free DNA circulating in the maternal plasma has been available clinically to screen for chromosomal abnormalities since 2011. There is significant evidence to suggest that NIPT has revolutionised prenatal screening for the common trisomies 13, 18, and 21. However, the evidence in favour of its extended use to screen for conditions other than these trisomies remains a topic of debate with no national or international organisation supporting clinical implementation for these indications. In the debate presented here - "Expanded NIPT that includes conditions other than trisomies 13, 18, and 21 should be offered" - we will see the pros and cons of screening for a wider range of chromosomal problems. The discussion presented swung the vote from 65% in favour and 35% against before the arguments were voiced to 41% in favour and 59% against. This significant swing in the vote indicates that the majority of our community feel more evidence is required before clinical implementation of extended NIPT.
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Affiliation(s)
- Lieve Christiaens
- Illumina Inc., San Diego, California, USA.,University Hospital of Utrecht, Utrecht, Netherlands
| | - Lyn S Chitty
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.,The UCL Great Ormond Street Institute of Child Health, London, UK
| | - Sylvie Langlois
- Department of Medical Genetics, University of British Columbia, Vancouver, Canada
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Alyafee Y, Alam Q, Tuwaijri AA, Umair M, Haddad S, Alharbi M, Alrabiah H, Al-Ghuraibi M, Al-Showaier S, Alfadhel M. Next-Generation Sequencing-Based Pre-Implantation Genetic Testing for Aneuploidy (PGT-A): First Report from Saudi Arabia. Genes (Basel) 2021; 12:461. [PMID: 33804821 PMCID: PMC8063787 DOI: 10.3390/genes12040461] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 03/12/2021] [Accepted: 03/17/2021] [Indexed: 11/25/2022] Open
Abstract
Recently, high-throughput next-generation sequencing (NGS)-based preimplantation genetic testing for aneuploidies techniques came into use. This technique is essential for successful embryo transfer and accomplishing pregnancy, thus reducing the time and cost of additional cycles. In this study, we describe our first experience in introducing an NGS-based preimplantation genetic testing for aneuploidy (PGT-A) service using next-generation sequencing in King Abdulaziz Medical City located in Riyadh, Saudi Arabia. Our main goal was to report the successful implementation of this new technology in clinical practice and highlight the factors that may affect the results. In total, 200 blastomere biopsies were obtained from 36 in vitro fertilization (IVF) cycles from Saudi couples suffering from prolonged infertility or recurrent embryo transfer failure. NGS-based PGT-A was performed in all embryos. The results were analyzed in five age groups, showing that aneuploidy rates increased with maternal age. Moreover, the results also showed that complex abnormal embryos with (2-5) aneuploidy are the most common type of embryos. Additionally, our data showed that chromosome 16-related abnormality was the most frequent abnormality detected among all reported abnormalities. In conclusion, our study suggests that NGS-based PGT-A is an applicable and reliable technique for routine-based embryo screening, especially for couples suffering from recurrent miscarriages or multiple embryo transfer failures.
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Affiliation(s)
- Yusra Alyafee
- King Abdullah International Medical Research Center (KAIMRC), Medical Genomics Research Department, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNG-HA), Riyadh 11426, Saudi Arabia; (Y.A.); (Q.A.); (A.A.T.); (M.U.); (S.H.); (M.A.)
| | - Qamre Alam
- King Abdullah International Medical Research Center (KAIMRC), Medical Genomics Research Department, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNG-HA), Riyadh 11426, Saudi Arabia; (Y.A.); (Q.A.); (A.A.T.); (M.U.); (S.H.); (M.A.)
| | - Abeer Al Tuwaijri
- King Abdullah International Medical Research Center (KAIMRC), Medical Genomics Research Department, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNG-HA), Riyadh 11426, Saudi Arabia; (Y.A.); (Q.A.); (A.A.T.); (M.U.); (S.H.); (M.A.)
| | - Muhammad Umair
- King Abdullah International Medical Research Center (KAIMRC), Medical Genomics Research Department, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNG-HA), Riyadh 11426, Saudi Arabia; (Y.A.); (Q.A.); (A.A.T.); (M.U.); (S.H.); (M.A.)
| | - Shahad Haddad
- King Abdullah International Medical Research Center (KAIMRC), Medical Genomics Research Department, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNG-HA), Riyadh 11426, Saudi Arabia; (Y.A.); (Q.A.); (A.A.T.); (M.U.); (S.H.); (M.A.)
| | - Meshael Alharbi
- King Abdullah International Medical Research Center (KAIMRC), Medical Genomics Research Department, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNG-HA), Riyadh 11426, Saudi Arabia; (Y.A.); (Q.A.); (A.A.T.); (M.U.); (S.H.); (M.A.)
| | - Hayat Alrabiah
- Reproductive Endocrinology and Infertility Unit, King Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNG-HA), Riyadh 11426, Saudi Arabia; (H.A.); (M.A.-G.); (S.A.-S.)
| | - Maha Al-Ghuraibi
- Reproductive Endocrinology and Infertility Unit, King Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNG-HA), Riyadh 11426, Saudi Arabia; (H.A.); (M.A.-G.); (S.A.-S.)
| | - Sahar Al-Showaier
- Reproductive Endocrinology and Infertility Unit, King Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNG-HA), Riyadh 11426, Saudi Arabia; (H.A.); (M.A.-G.); (S.A.-S.)
| | - Majid Alfadhel
- King Abdullah International Medical Research Center (KAIMRC), Medical Genomics Research Department, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNG-HA), Riyadh 11426, Saudi Arabia; (Y.A.); (Q.A.); (A.A.T.); (M.U.); (S.H.); (M.A.)
- Genetics and Precision Medicine Department (GPM), King Abdullah Specialized Children’s Hospital, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNG-HA), Riyadh 11426, Saudi Arabia
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Wu Y, Zhang L, Lv H, Li Y, Zhu C, Tian W, Zhao L. Applying high-throughput sequencing to identify and evaluate foetal chromosomal deletion and duplication. J Cell Mol Med 2020; 24:9936-9944. [PMID: 32667743 PMCID: PMC7520324 DOI: 10.1111/jcmm.15593] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 06/10/2020] [Accepted: 06/16/2020] [Indexed: 12/11/2022] Open
Abstract
The present study aimed to estimate the clinical performance of non-invasive prenatal testing (NIPT) based on high-throughput sequencing method for the detection of foetal chromosomal deletions and duplications. A total of 6348 pregnant women receiving NIPT using high-throughput sequencing method were included in our study. They all conceived naturally, without twins, triplets or multiple births. Individuals showing abnormalities in NIPT received invasive ultrasound-guided amniocentesis for chromosomal karyotype and microarray analysis at 18-24 weeks of pregnancy. Detection results of foetal chromosomal deletions and duplications were compared between high-throughput sequencing method and chromosomal karyotype and microarray analysis. Thirty-eight individuals were identified to show 51 chromosomal deletions/duplications via high-throughput sequencing method. In subsequent chromosomal karyotype and microarray analysis, 34 subchromosomal deletions/duplications were identified in 26 pregnant women. The observed deletions and duplications ranged from 1.05 to 17.98 Mb. Detection accuracy for these deletions and duplications was 66.7%. Twenty-one deletions and duplications were found to be correlated with the known abnormalities. NIPT based on high-throughput sequencing technique is able to identify foetal chromosomal deletions and duplications, but its sensitivity and specificity were not explored. Further progress should be made to reduce false-positive results.
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Affiliation(s)
- Yueli Wu
- Prenatal Diagnosis Center of Henan Women and Children Hospital and Institute, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Linlin Zhang
- Clinical Laboratory of Henan Women and Children Hospital and Institute, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hong Lv
- Prenatal Diagnosis Center of Henan Women and Children Hospital and Institute, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ying Li
- Prenatal Diagnosis Center of Henan Women and Children Hospital and Institute, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Chongyang Zhu
- Prenatal Diagnosis Center of Henan Women and Children Hospital and Institute, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Weifang Tian
- Prenatal Diagnosis Center of Henan Women and Children Hospital and Institute, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ling Zhao
- Prenatal Diagnosis Center of Henan Women and Children Hospital and Institute, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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