单一性疾病和中枢神经系统异常:前性研究,系统性审查和元分析
Gillian V Blayney1, Eoghan Laffan2, Preethi A Jacob3
1Fetal Medicine Department, Royal Jubilee Maternity Service, Belfast Health and Social Care Trust, Belfast, UK.
Prenatal diagnosis
|December 6, 2023
概括
与标准方法相比,产前外体序列测序显著改善了胎儿中枢神经系统 (CNS) 异常的诊断. 这种先进的基因测试提供了32%的更高的诊断产量,特别是在复杂的病例.
科学领域:
- 医学遗传学 医学遗传学
- 产前诊断 在产前诊断
- 神经发育障碍 神经发育障碍
背景情况:
- 中枢神经系统 (CNS) 异常是产前诊断的一个重要问题.
- 目前的诊断方法,如染色体微阵列 (CMA) 和G-banding karyotype在确定胎儿中枢神经系统异常的遗传原因方面存在局限性.
研究的目的:
- 为了确定产前外体序列测序 (pES) 的额外诊断价值,与CMA或CNS异常胎儿的型相比.
- 量化不同类别的中枢神经系统异常中pES的增量诊断产量.
主要方法:
- 2010年1月至2022年4月期间发表的研究的系统审查和元分析.
- 包括来自MEDLINE,Cochrane,Web of Science,EMBASE和NHS英格兰产前外体队列的数据.
- 使用随机效应模型计算聚合增量收益率.
主要成果:
- 分析了包括1583例病例的30项研究.
- 产前外体序列测定显示,对于任何中枢神经系统异常,总体增量诊断收益率为32%.
- 在孤立的中枢神经系统异常 (27%),多重中枢神经系统异常 (31%) 和皮层发育的特定形 (40%) 中观察到更高的产量.
结论:
- 产前外体序列测定为胎儿中枢神经系统异常的诊断产量提供了显著的增加.
- 在多个中枢神经系统异常的情况下,特别是那些涉及中线,后和皮质的病例中,诊断效用最高.
- pES是改善复杂的产前中枢神经系统疾病的遗传诊断的宝贵工具.
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