Journal of Shanghai Jiao Tong University (Medical Science) >
Detection efficacy of non-invasive prenatal testing for copy number variations in the recurrent 17p12 region
Received date: 2024-10-12
Accepted date: 2024-12-13
Online published: 2025-03-24
Supported by
National Natural Science Foundation of China(81871136);Shanghai Municipal Science and Technology Commission(22Y11906700)
Objective ·To evaluate the detection efficacy and clinical value of non-invasive prenatal testing (NIPT) for identifying copy number variations (CNVs) in the recurrent 17p12 region, including the peripheral myelin protein 22 (PMP22) gene. Methods ·Pregnant women who underwent NIPT in the International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine between July 2020 and April 2024 were enrolled. Clinical data of individuals indicated as high-risk for microdeletions/duplications in the 17p12 region based on NIPT results were collected. Follow-up was conducted to assess the results of subsequent prenatal diagnosis and chromosomal microarray analysis (CMA) performed on peripheral blood from both the pregnant women and their husband. The positive predictive value (PPV) of NIPT for detecting microdeletions/duplications in the 17p12 region, as well as the underlying causes of false positives, was analyzed. Pregnancy outcomes and related clinical phenotypes of fetuses and pregnant women diagnosed with 17p12 CNVs were followed up. Results ·A total of 61 858 pregnant women underwent NIPT testing. NIPT identified 24 cases (0.04%) as high-risk for CNVs in the 17p12 region, including six cases of high-risk 17p12 microduplication and 18 cases of high-risk 17p12 microdeletion. All 24 pregnant women received genetic counseling, and 21 (87.50%) underwent invasive prenatal diagnosis. Invasive prenatal diagnostic confirmed four fetuses with 17p12 microduplications, nine fetuses with 17p12 microdeletions, and eight fetuses with no abnormalities, yielding a PPV of 61.90% (13/21). CMA analysis of maternal peripheral blood in the eight false-positive cases revealed that all mothers carried 17p12 CNVs. Further analysis of pregnant women with NIPT-indicated maternal CNVs revealed that all of them carried relevant CNVs. Among the 20 women with successful follow-up, the majority had normal deliveries, with only one case choosing to terminate the pregnancy due to a de-novo fetal 17p12 microduplication. Normally delivered fetuses (average age: 1.5 years) were followed up without reporting any significant abnormalities. Of the 16 pregnant women carrying 17p12 CNVs, only two exhibited clinical phenotypes associated with these CNVs, while the others remained asymptomatic. Conclusion ·NIPT demonstrates favorable detection efficacy for CNVs in the 17p12 region. Maternal CNVs are the primary cause of false-positive NIPT results for this region.
ZHANG Lanlan , HAN Xu , LI Niu , WANG Jian , LI Shuyuan . Detection efficacy of non-invasive prenatal testing for copy number variations in the recurrent 17p12 region[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2025 , 45(3) : 310 -316 . DOI: 10.3969/j.issn.1674-8115.2025.03.007
1 | PAREYSON D, SCAIOLI V, TARONI F, et al. Phenotypic heterogeneity in hereditary neuropathy with liability to pressure palsies associated with chromosome 17p11.2?12 deletion[J]. Neurology, 1996, 46(4): 1133-1137. |
2 | TOHGE R, SHINOTO Y, TAKAHASHI M. Case of hereditary neuropathy with liability to pressure palsies presenting progressive muscular atrophy with lower motor neuron degeneration in the spinal cord and the brainstem[J]. Neurol Clin Neurosci, 2016, 4(1): 19-21. |
3 | 朱啸巍, 钟平, 栾兴华. PMP22相关性周围神经病的临床及遗传学特点[J]. 中国实用神经疾病杂志, 2021, 24(14): 1265-1270. |
ZHU X W, ZHONG P, LUAN X H. Clinical and genetic characteristics of peripheral neuropathy-associated with PMP22[J]. Chinese Journal of Practical Nervous Diseases, 2021, 24(14): 1265-1270. | |
4 | LO Y M, CORBETTA N, CHAMBERLAIN P F, et al. Presence of fetal DNA in maternal plasma and serum[J]. Lancet, 1997, 350(9076): 485-487. |
5 | AUDIBERT F, DE BIE I, JOHNSON J A, et al. No.348-joint SOGC-CCMG guideline: update on prenatal screening for fetal aneuploidy, fetal anomalies, and adverse pregnancy outcomes[J]. J Obstet Gynaecol Can, 2017, 39(9): 805-817. |
6 | American College of Obstetricians and Gynecologists′ Committee on Practice Bulletins—Obstetrics, Committee on Genetics, Society for Maternal-Fetal Medicine. Screening for fetal chromosomal abnormalities: ACOG practice bulletin, number 226[J]. Obstet Gynecol, 2020, 136(4): e48-e69. |
7 | DUNGAN J S, KLUGMAN S, DARILEK S, et al. Noninvasive prenatal screening (NIPS) for fetal chromosome abnormalities in a general-risk population: an evidence-based clinical guideline of the American College of Medical Genetics and Genomics (ACMG)[J]. Genet Med, 2023, 25(2): 100336. |
8 | HUI L S, ELLIS K, MAYEN D, et al. Position statement from the International Society for Prenatal Diagnosis on the use of non-invasive prenatal testing for the detection of fetal chromosomal conditions in singleton pregnancies[J]. Prenat Diagn, 2023, 43(7): 814-828. |
9 | CHIU R W K, ALLEN CHAN K C, GAO Y, et al. Noninvasive prenatal diagnosis of fetal chromosomal aneuploidy by massively parallel genomic sequencing of DNA in maternal plasma[J]. Proc Natl Acad Sci USA, 2008, 105(51): 20458-20463. |
10 | RIGGS E R, ANDERSEN E F, CHERRY A M, et al. Technical standards for the interpretation and reporting of constitutional copy-number variants: a joint consensus recommendation of the American College of Medical Genetics and Genomics (ACMG) and the Clinical Genome Resource (ClinGen)[J]. Genet Med, 2020, 22(2): 245-257. |
11 | 黄旭升, 何正卿, 苏博洋. 遗传性压力易感性周围神经病[J]. 中华神经科杂志, 2023, 56(4): 442-447. |
HUANG X S, HE Z Q, SU B Y. Hereditary neuropathy with liability to pressure palsies[J]. Chinese Journal of Neurology, 2023, 56(4): 442-447. | |
12 | VAN PAASSEN B W, VAN DER KOOI A J, VAN SPAENDONCK-ZWARTS K Y, et al. PMP22 related neuropathies: Charcot-Marie-Tooth disease type 1A and hereditary neuropathy with liability to pressure palsies[J]. Orphanet J Rare Dis, 2014, 9: 38. |
13 | CHANCE P F, ALDERSON M K, LEPPIG K A, et al. DNA deletion associated with hereditary neuropathy with liability to pressure palsies[J]. Cell, 1993, 72(1): 143-151. |
14 | SAPORTA A S D, SOTTILE S L, MILLER L J, et al. Charcot-Marie-Tooth disease subtypes and genetic testing strategies[J]. Ann Neurol, 2011, 69(1): 22-33. |
15 | STAVROU M, KLEOPA K A. CMT1A current gene therapy approaches and promising biomarkers[J]. Neural Regen Res, 2023, 18(7): 1434-1440. |
16 | YIU E M, BRAY P, BAETS J, et al. Clinical practice guideline for the management of paediatric Charcot-Marie-Tooth disease[J]. J Neurol Neurosurg Psychiatry, 2022, 93(5): 530-538. |
17 | REDON R, ISHIKAWA S, FITCH K R, et al. Global variation in copy number in the human genome[J]. Nature, 2006, 444(7118): 444-454. |
18 | GRATI F R, GROSS S J. Noninvasive screening by cell-free DNA for 22q11.2 deletion: benefits, limitations, and challenges[J]. Prenat Diagn, 2019, 39(2): 70-80. |
19 | LIANG D S, CRAM D S, TAN H, et al. Clinical utility of noninvasive prenatal screening for expanded chromosome disease syndromes[J]. Genet Med, 2019, 21(9): 1998-2006. |
20 | ZANINOVI? L, BA?KOVI? M, JE?EK D, et al. Validity and utility of non-invasive prenatal testing for copy number variations and microdeletions: a systematic review[J]. J Clin Med, 2022, 11(12): 3350. |
21 | VAN DEN BOGAERT K, LANNOO L, BRISON N, et al. Outcome of publicly funded nationwide first-tier noninvasive prenatal screening[J]. Genet Med, 2021, 23(6): 1137-1142. |
22 | CURNOW K J, WILKINS-HAUG L, RYAN A, et al. Detection of triploid, molar, and vanishing twin pregnancies by a single-nucleotide polymorphism-based noninvasive prenatal test[J]. Am J Obstet Gynecol, 2015, 212(1): 79.e1-79.e9. |
23 | RINK B D, STEVENS B K, NORTON M E. Incidental detection of maternal malignancy by fetal cell-free DNA screening[J]. Obstet Gynecol, 2022, 140(1): 121-131. |
24 | HELGESON J, WARDROP J, BOOMER T, et al. Clinical outcome of subchromosomal events detected by whole-genome noninvasive prenatal testing[J]. Prenat Diagn, 2015, 35(10): 999-1004. |
25 | VAN DER MEIJ K R M, SISTERMANS E A, MACVILLE M V E, et al. TRIDENT-2: national implementation of genome-wide non-invasive prenatal testing as a first-tier screening test in the Netherlands[J]. Am J Hum Genet, 2019, 105(6): 1091-1101. |
/
〈 |
|
〉 |