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Babu R, Van Dyke DL, Bhattacharya S, Dev VG, Liu M, Kwon M, Gu G, Koduru P, Rao N, Williamson C, Fuentes E, Fuentes S, Papa S, Kopuri S, Lal V. A rapid and reliable chromosome analysis method for products of conception using interphase nuclei. Mol Genet Genomic Med 2018; 6:370-381. [PMID: 29573570 PMCID: PMC6014463 DOI: 10.1002/mgg3.381] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 01/04/2018] [Accepted: 02/01/2018] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Karyotype determination has a central role in the genetic workup of pregnancy loss, as aneuploidy (trisomy and monosomy) and polyploidy (triploidy and tetraploidy) are the cause in at least 50% of first trimester, 25% of second trimester, and 11% of third trimester miscarriages. There are several limitations with the current approaches of obtaining a karyotype using traditional cytogenetics, fluorescence in situ hybridization with a limited number of probes, and chromosomal microarray. These include culture failure, incomplete results, lower sensitivity, and longer reporting time. METHODS To overcome current limitations, a novel molecular assay is developed with a Standard Resolution Interphase Chromosome Profiling probe set which is a variation of the recently developed High Resolution probe set. It generates a molecular karyotype that can detect all major changes commonly associated with pregnancy loss. Initial familiarization of signal patterns from the probe set was used, followed by validation of the method using 83 samples from miscarriages in a blind study from three different laboratories. Finally, the clinical utility of the method was tested on 291 clinical samples in two commercial reference laboratory settings on two different continents. RESULTS The new molecular approach not only identified all the chromosome changes observed by current methods, but also significantly improved abnormality detection by characterizing derivative chromosomes and finding subtle subtelomeric rearrangements, balanced and unbalanced. All Robertsonian translocations were also detected. The abnormality rate was 54% on clinical samples from commercial laboratory 1 and 63% from laboratory 2. CONCLUSION The attributes of this method make it an ideal choice for the genetic workup of miscarriages, namely (1) near 100% successful results, (2) greater sensitivity than conventional chromosome analysis or FISH panels, (3) rapid reporting time, and (4) favorable comparisons with chromosomal microarray.
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Affiliation(s)
- Ramesh Babu
- Department of Research and Development, InteGen LLC, Orlando, FL, USA
| | - Daniel L Van Dyke
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Saurabh Bhattacharya
- Departments of Cytogenetics and Administration, Dr. Lal PathLabs Ltd., New Delhi, India
| | - Vaithilingam G Dev
- Department of Clinical Cytogenetics, Genetics Associates Inc., Nashville, TN, USA
| | - Mingya Liu
- Department of Clinical Cytogenetics, Genetics Associates Inc., Nashville, TN, USA
| | - Minjae Kwon
- Department of Clinical Cytogenetics, Genetics Associates Inc., Nashville, TN, USA
| | - Guangyu Gu
- Department of Clinical Cytogenetics, Genetics Associates Inc., Nashville, TN, USA
| | - Prasad Koduru
- Department of Pathology, UT Southwestern Medical Center, Dallas, TX, USA
| | - Nagesh Rao
- Department of Pathology and Laboratory Medicine, David Geffen UCLA School of Medicine, Los Angeles, CA, USA
| | - Cynthia Williamson
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Ernesto Fuentes
- Department of Research and Development, InteGen LLC, Orlando, FL, USA
| | - Sarah Fuentes
- Department of Research and Development, InteGen LLC, Orlando, FL, USA
| | - Stephen Papa
- Department of Research and Development, InteGen LLC, Orlando, FL, USA
| | - Srikanthi Kopuri
- Department of Research and Development, InteGen LLC, Orlando, FL, USA
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