Cell-free DNA screening for sex chromosome aneuploidies by non-invasive prenatal testing in maternal plasma

Yipeng Wang1, Shanshan Li1, Wei Wang1, Yaping Dong1, Meng Zhang1, Xin Wang1, Chenghong Yin1
1Prenatal Diagnostic Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, 100026, China

Tóm tắt

Abstract Background Non-invasive prenatal testing (NIPT) has been confirmed as the most accurate screening test for trisomies 21, 18, and 13. However, reports on NIPT performance in sex chromosome aneuploidies (SCA) based on real clinical data are still limited. Methods High-throughput massively parallel genomic sequencing (MPS) technique was used to screen for fetal SCAs as part of the research to determine the potential value of NIPT in detecting fetal SCAs in the second trimester. A number of 12,243 consecutive cases from a single center were included in this study. Results The positive predictive value (PPV) of NIPT in the present study was 57.6%, which was divided and categorized by individual SCAs as follows: 21.4% for Turner syndrome (45,X), 75.0% for Triple X syndrome (47,XXX), 90.9% for Klinefelter syndrome (47,XXY), and 75.0% for XYY syndrome (47,XYY). Conclusion The NIPT-based SCA test cannot be used as a diagnostic method, and performing an invasive confirmation test on NIPT-based SCA-positive cases is strongly recommended.

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Tài liệu tham khảo

Nicolaides KH. Nuchal translucency and other first-trimester sonographic markers of chromosomal abnormalities. Am J Obstet Gynecol. 2004;191:45–67.

Nussbaum RL, McInnes RR, Willard HF, Thompson MW. Thompson and Thompson genetics in medicine, ed 6. Philadelphia: Saunders; 2004.

Tartaglia NR, Howell S, Sutherland A, Wilson R, Wilson L. A review of trisomy X (47,XXX). Orphanet J Rare Dis. 2010;5:8.

Taylor-Phillips S, Freeman K, Geppert J, Agbebiyi A, Uthman O, Madan J, Clarke A, Quenby S, Clarke A. Accuracy of non-invasive prenatal testing using cell-free DNA for detection of Down, Edwards and Patau syndromes: a systematic review and meta-analysis. BMJ Open. 2016;6:e010002.

Mardy A, Wapner RJ. Confined placental mosaicism and its impact on confirmation of NIPT results. Am J Med Genet C Semin Med Genet. 2016;172:118–22.

Russo ML, Blakemore KJ. A historical and practical review of first trimester aneuploidy screening. Semin Fetal Neonatal Med. 2014;19:183–7.

Visootsak J, Graham JM Jr. Klinefelter syndrome and other sex chromosomal aneuploidies. Orphanet J Rare Dis. 2006;1:42.

Gil MM, Quezada MS, Revello R, Akolekar R, Nicolaides KH. Analysis of cell-free DNA in maternal blood in screening for fetal aneuploidies: updated meta-analysis. Ultrasound Obstet Gynecol. 2015;45:249–66.

Jiang F, Ren J, Chen F, Zhou Y, Xie J, Dan S, Su Y, Xie J, Yin B, Su W, Zhang H, Wang W, Chai X, Lin L, Guo H, Li Q, Li P, Yuan Y, Pan X, Li Y, Liu L, Chen H, Xuan Z, Chen S, Zhang C, Zhang H, Tian Z, Zhang Z, Jiang H, Zhao L, Zheng W, Li S, Li Y, Wang J, Wang J, Zhang X. Noninvasive fetal trisomy (NIFTY) test: an advanced noninvasive prenatal diagnosis methodology for fetal autosomal and sex chromosomal aneuploidies. BMC Med Genet. 2012;5:57.

Chen S, Lau TK, Zhang C, Xu C, Xu Z, Hu P, Xu J, Huang H, Pan L, Jiang F, Chen F, Pan X, Xie W, Liu P, Li X, Zhang L, Li S, Li Y, Xu X, Wang W, Wang J, Jiang H, Zhang X. A method for noninvasive detection of fetal large deletions/duplications by low coverage massively parallel sequencing. Prenat Diagn. 2013;33:584–90.

Kornman L, Palma-Dias R, Nisbet D, Scott F, Menezes M, da Silva Costa F, McLennan A. Non-invasive prenatal testing for sex chromosome aneuploidy in routine clinical practice. Fetal Diagn Ther. 2018;44(2):85–90.

Porreco RP, Garite TJ, Maurel K, Marusiak B, Obstetrix Collaborative Research Network, Ehrich M, van den Boom D, Deciu C, Bombard A. Noninvasive prenatal screening for fetal trisomies 21, 18, 13 and the common sex chromosome aneuploidies from maternal blood using massively parallel genomic sequencing of DNA. Am J Obstet Gynecol. 2014;211365:e1–12.

Yao H, Jiang F, Hu H, Gao Y, Zhu Z, Zhang H, Wang Y, Guo Y, Liu L, Yuan Y, Zhou L, Wang J, Du B, Qu N, Zhang R, Dong Y, Xu H, Chen F, Jiang H, Liu Y, Zhang L, Tian Z, Liu Q, Zhang C, Pan X, Yang S, Zhao L, Wang W, Liang Z. Detection of fetal sex chromosome aneuploidy by massively parallel sequencing of maternal plasma DNA: initial experience in a Chinese hospital. Ultrasound Obstet Gynecol. 2014;44:17–24.

Chiu RW, Akolekar R, Zheng YW, Leung TY, Sun H, Chan KC, Lun FM, Go AT, Lau ET, To WW, Leung WC, Tang RY, Au-Yeung SK, Lam H, Kung YY, Zhang X, van Vugt JM, Minekawa R, Tang MH, Wang J, Oudejans CB, Lau TK, Nicolaides KH, Lo YM. Non-invasive prenatal assessment of trisomy 21 by multiplexed maternal plasma DNA sequencing: large scale validity study. BMJ. 2011;342:c7401.

Chen EZ, Chiu RW, Sun H, Akolekar R, Chan KC, Leung TY, Jiang P, Zheng YW, Lun FM, Chan LY, Jin Y, Go AT, Lau ET, To WW, Leung WC, Tang RY, Au-Yeung SK, Lam H, Kung YY, Zhang X, van Vugt JM, Minekawa R, Tang MH, Wang J, Oudejans CB, Lau TK, Nicolaides KH, Lo YM. Noninvasive prenatal diagnosis of fetal trisomy 18 and trisomy 13 by maternal plasma DNA sequencing. PLoS One. 2011;6:e21791.

Bianchi DW, Platt LD, Goldberg JD, Abuhamad AZ, Sehnert AJ, Rava RP. Genome-wide fetal aneuploidy detection by maternal plasma DNA sequencing. Obstet Gynecol. 2012;119:890–901.

Song Y, Liu C, Qi H, Zhang Y, Bian X, Liu J. Noninvasive prenatal testing of fetal aneuploidies by massively parallel sequencing in a prospective Chinese population. Prenat Diagn. 2013;33:700–6.

Mazloom AR, Dzakula Z, Oeth P, Wang H, Jensen T, Tynan J, McCullough R, Saldivar JS, Ehrich M, van den Boom D, Bombard AT, Maeder M, McLennan G, Meschino W, Palomaki GE, Canick JA, Deciu C. Noninvasive prenatal detection of sex chromosomal aneuploidies by sequencing circulating cell-free DNA from maternal plasma. Prenat Diagn. 2013;33:591–7.

Menuti MT, Chandrasekaran S, Khalek N, Dugoff L. Cell-free DNA screening and sex chromosome aneuploidies. Prenat Diagn. 2015;35:980–5.

Li H, Yu L, Zhu H, Luo Y, Qian Y, Chen M, Sun Y, Yan K, Yang Y, Liu B, Wang L, Huang Y, Hu J, Xu J, Dong M. The application of NIPT using combinatorial probe-anchor synthesis to identify sex chromosomal aneuploidies (SCAs) in a cohort of 570 pregnancies. Mol Cytogenet. 2018;11:59.

McGowan-Jordan J, Simons A, Schmid M. An International System for Human Cytogenomic Nomenclature (2016). Cytogenet Genome Res. 2016;149:1–2.

Caspersson T, Farber S, Foley GE, Kudynowski J, Modest EJ, Simonsson E, Wagh U, Zech L. Chemical differentiation along metaphase chromosomes. Exp Cell Res. 1968;49:219–22.

Wang T, Duan C, Shen C, Xiang J, He Q, Ding J, Wen P, Zhang Q, Wang W, Liu M, Li H, Li H, Zhang L. Detection of complex deletions in chromosomes 13 and 21 in a fetus by noninvasive prenatal testing. Mol Cytogenet. 2016;9:3.

Sebire NJ, Snijders RJ, Brown R, Southall T, Nicolaides KH. Detection of sex chromosome abnormalities by nuchal translucency screening at 10-14 weeks. Prenat Diagn. 1998;18:581–4.

Cheung SW, Patel A, Leung TY. Accurate description of DNA-based noninvasive prenatal screening. N Engl J Med. 2015;372:1675–7.

Sekizawa A, Farina A, Okai T. Cell-free fetal DNA in plasma of pregnant women: clinical potential and origin. Taiwanese J Obstetr Gynecol. 2005;44:116–22.

Canick JA, Palomaki GE, Kloza EM, Lambert-Messerlian GM, Haddow JE. The impact of maternal plasma DNA fetal fraction on next generation sequencing tests for common fetal aneuploidies. Prenat Diagn. 2013;33:667–74.

Choi H, Lau TK, Jiang FM, Chan MK, Zhang HY, Lo PS, Chen F, Zhang L, Wang W. Fetal aneuploidy screening by maternal plasma DNA sequencing: ‘false positive’ due to confined placental mosaicism. Prenat Diagn. 2013;33:198–200.

Lau TK, Jiang FM, Stevenson RJ, Lo TK, Chan LW, Chan MK, Lo PS, Wang W, Zhang HY, Chen F, Choy KW. Secondary findings from non-invasive prenatal testing for common fetal aneuploidies by whole genome sequencing as a clinical service. Prenat Diagn. 2013;33:602–8.

Yao H, Zhang L, Zhang H, Jiang F, Hu H, Chen F, Jiang H, Mu F, Zhao L, Liang Z, Wang W. Noninvasive prenatal genetic testing for fetal aneuploidy detects maternal trisomy X. Prenat Diagn. 2012;32:1114–6.

Devi AS, Metzger DA, Luciano A, Benn PA. 45,X/46,XX mosaicism in patients with idiopathic premature ovarian failure. Fertil Steril. 1998;70:89–93.

Russell LM, Strike P, Browne CE, Jacobs PA. X chromosome loss and aging. Cytogenet Genome Res. 2007;116:181–5.

Nicolaides KH, Musci TJ, Struble CA, Singelaki A, Gil MM. Assessment of fetal sex chromosome aneuploidy using directed cell-free DNA analysis. Fetal Diagn Ther. 2014;35:1–6.