目的·探讨无创产前检测(non-invasive prenatal testing,NIPT)对染色体17p12区域[包含外周髓鞘蛋白22(peripheral myelin protein 22,PMP22)]拷贝数变异(copy number variations,CNVs)的检测效能及临床应用价值。方法·选取202...目的·探讨无创产前检测(non-invasive prenatal testing,NIPT)对染色体17p12区域[包含外周髓鞘蛋白22(peripheral myelin protein 22,PMP22)]拷贝数变异(copy number variations,CNVs)的检测效能及临床应用价值。方法·选取2020年7月—2024年4月在上海交通大学医学院附属国际和平妇幼保健院行NIPT的孕妇,统计NIPT结果提示17p12区域微缺失/重复高风险个体的临床资料,随访相关个体后续产前诊断和孕妇夫妻双方外周血染色体微阵列分析(chromosomal microarray analysis,CMA)结果,分析NIPT筛查17p12区域微缺失/重复的阳性预测值及假阳性的原因。对已明确诊断携带17p12区域CNVs的胎儿及孕妇进行追踪随访,记录妊娠结局及相关临床表型。结果·共61858例孕妇行NIPT,其中24例(0.04%)结果提示17p12区域CNVs高风险,包括17p12微重复高风险6例、17p12微缺失高风险18例。24例孕妇均进行了后续遗传咨询,其中21例(87.50%)进行介入性产前诊断。介入性产前诊断结果提示胎儿17p12重复异常4例、17p12缺失异常9例、未见异常8例,阳性预测值61.90%(13/21)。对8例胎儿假阳性的孕妇外周血行CMA分析,提示孕妇自身均携带17p12区域微缺失/重复。对NIPT提示母源CNVs高风险的孕妇进一步分析提示,孕妇自身均携带相关CNVs。成功随访其中20例孕妇,除1例因胎儿新发17p12区域微重复选择终止妊娠外,其余均正常分娩。正常分娩的胎儿随访至今(平均年龄1.5岁),暂未报告相关异常。对16例携带17p12区域CNVs的孕妇进行评估,有2例表现出与17p12区域CNVs相关的临床表型特征,其余暂未见异常。结论·NIPT对17p12区域CNVs有较好的检测效能,母体CNVs是导致NIPT检测假阳性的主要原因。展开更多
Objective: This study aims to evaluate the natural history of patients with chronic lymphocytic leukemia (CLL) and a 17p deletion (17p-) and identify the predictive factors within this subgroup. Methods: The sam...Objective: This study aims to evaluate the natural history of patients with chronic lymphocytic leukemia (CLL) and a 17p deletion (17p-) and identify the predictive factors within this subgroup. Methods: The sample of patients with CLL were analyzed by fluorescence in situ hybridization for deletions in chromosome bands 1 lq22, 13q14 and 17p13; trisomy of bands 12q13; and translocation involving band 14q32. The data from 456 patients with or without a 17p- were retrospectively collected and analyzed. Results: The overall response rate (ORR) in patients with a 17p- was 56.9%, and patients with a high percentage of 17p- (defined as more than 25% of cells harbouring a 17p-) had a lower ORR. The median overall survival (OS) in patients with a 17p- was 78.0 months, which was significantly shorter than the OS in patients without this genetic abnormality (median 162.0 months, P〈0.001). Within the subgroup with a 17p-, the progression-free survival was significantly shorter in patients at Binet stage B-C and patients with elevated lactate dehydrogenase (LDH), B symptoms, unmutated IGHVand a high percentage of 17p-. Conclusions: These results indicated that patients with a 17p- CLL have a variable prognosis that might be predicted using simple clinical and laboratory characteristics.展开更多
The human RNA methyltransferase like i gene(RNMTL1)is one of thirteen newly discovered geneswithin a 116 Kb segment of the chromosome 17p13.3 that suffers from a high frequent loss of heterozygosityin human hepatocell...The human RNA methyltransferase like i gene(RNMTL1)is one of thirteen newly discovered geneswithin a 116 Kb segment of the chromosome 17p13.3 that suffers from a high frequent loss of heterozygosityin human hepatocellular carcinoma in China[1-5].To understand the molecular mechanisms underlyingtranscription control of the RNMTL1 gene in human cancers,we decline using of the conventional approachwhere the cis-elements bound by the known transcription factors are primary targets,and carried out thesystematic analyses to dissect the promoter structure and identify/characterize the key cis-elements thatare responsible for its strong expression in cell.The molecular approaches applied included 1,the primerextension for mapping of the transcription starts;2,the transient transfection/reporter assays on a largenumber of deletion and site-specific mutants of the promoter segment for defining the minimal promoterand the crucial elements within;and 3,the electrophoresis mobility shift assay with specific antibodies forreconfirming the nature of the transcription factors and their cognate cis-elements.We have shown that theinteraction of an ATF/CREB element(-38 to-31)and its cognate transcription factors play a predominantrole in the promoter activity of the RNMTL1 gene.The secondary DNA structures of the ATF/CREBelement play a more vital role in the protein-DNA interaction.Finally,we reported a novel mechanismunderlying the YY1 mediated transcription repression,namely,the ATF/CREB dependent transcription-repression by YY1 is executed in absence of its own sequence-specific binding.展开更多
目的探讨17 p 13.3微缺失综合征的临床表型、拷贝数变异、治疗及预后。方法回顾性分析5例17p13.3微缺失综合征患儿临床资料、全外显子组测序结果以及治疗效果。结果5例患儿均表现为身材矮小,例3~5合并有心血管异常。全外显子组测序提示...目的探讨17 p 13.3微缺失综合征的临床表型、拷贝数变异、治疗及预后。方法回顾性分析5例17p13.3微缺失综合征患儿临床资料、全外显子组测序结果以及治疗效果。结果5例患儿均表现为身材矮小,例3~5合并有心血管异常。全外显子组测序提示所有的患儿均存在17p13.3染色体片段缺失,缺失大小为433~1536 kb,主要包括YWHAE、CRK基因,但不包括PAFAH1B1基因。在排除了生长激素禁忌证后,4例接受了重组人生长激素治疗。矮小症患儿的身高在应用重组人生长激素治疗后初期得到改善,但后期治疗效果欠佳。2例满足手术指征而接受外科手术以纠正先天性心脏畸形。结论17p13.3染色体片段缺失可导致17p13.3微缺失综合征,通过全外显子组测序,可以提高对于存在先天性心脏畸形和/或矮小症的儿童的诊断率,及时采取心血管及身高方面的治疗有助于改善患儿预后。展开更多
文摘目的·探讨无创产前检测(non-invasive prenatal testing,NIPT)对染色体17p12区域[包含外周髓鞘蛋白22(peripheral myelin protein 22,PMP22)]拷贝数变异(copy number variations,CNVs)的检测效能及临床应用价值。方法·选取2020年7月—2024年4月在上海交通大学医学院附属国际和平妇幼保健院行NIPT的孕妇,统计NIPT结果提示17p12区域微缺失/重复高风险个体的临床资料,随访相关个体后续产前诊断和孕妇夫妻双方外周血染色体微阵列分析(chromosomal microarray analysis,CMA)结果,分析NIPT筛查17p12区域微缺失/重复的阳性预测值及假阳性的原因。对已明确诊断携带17p12区域CNVs的胎儿及孕妇进行追踪随访,记录妊娠结局及相关临床表型。结果·共61858例孕妇行NIPT,其中24例(0.04%)结果提示17p12区域CNVs高风险,包括17p12微重复高风险6例、17p12微缺失高风险18例。24例孕妇均进行了后续遗传咨询,其中21例(87.50%)进行介入性产前诊断。介入性产前诊断结果提示胎儿17p12重复异常4例、17p12缺失异常9例、未见异常8例,阳性预测值61.90%(13/21)。对8例胎儿假阳性的孕妇外周血行CMA分析,提示孕妇自身均携带17p12区域微缺失/重复。对NIPT提示母源CNVs高风险的孕妇进一步分析提示,孕妇自身均携带相关CNVs。成功随访其中20例孕妇,除1例因胎儿新发17p12区域微重复选择终止妊娠外,其余均正常分娩。正常分娩的胎儿随访至今(平均年龄1.5岁),暂未报告相关异常。对16例携带17p12区域CNVs的孕妇进行评估,有2例表现出与17p12区域CNVs相关的临床表型特征,其余暂未见异常。结论·NIPT对17p12区域CNVs有较好的检测效能,母体CNVs是导致NIPT检测假阳性的主要原因。
基金supported by grants from the National Nature Science Foundation of China (No. 81200395, 81370632)the National Science and Technology supporting Program (No. 2014BAI09B12)+1 种基金the Fundamental Application and Advanced Technology Research Program of Tianjin (No. 15JCYBJC27900)the National Public Health Grand Research Foundation (No. 201202017)
文摘Objective: This study aims to evaluate the natural history of patients with chronic lymphocytic leukemia (CLL) and a 17p deletion (17p-) and identify the predictive factors within this subgroup. Methods: The sample of patients with CLL were analyzed by fluorescence in situ hybridization for deletions in chromosome bands 1 lq22, 13q14 and 17p13; trisomy of bands 12q13; and translocation involving band 14q32. The data from 456 patients with or without a 17p- were retrospectively collected and analyzed. Results: The overall response rate (ORR) in patients with a 17p- was 56.9%, and patients with a high percentage of 17p- (defined as more than 25% of cells harbouring a 17p-) had a lower ORR. The median overall survival (OS) in patients with a 17p- was 78.0 months, which was significantly shorter than the OS in patients without this genetic abnormality (median 162.0 months, P〈0.001). Within the subgroup with a 17p-, the progression-free survival was significantly shorter in patients at Binet stage B-C and patients with elevated lactate dehydrogenase (LDH), B symptoms, unmutated IGHVand a high percentage of 17p-. Conclusions: These results indicated that patients with a 17p- CLL have a variable prognosis that might be predicted using simple clinical and laboratory characteristics.
文摘The human RNA methyltransferase like i gene(RNMTL1)is one of thirteen newly discovered geneswithin a 116 Kb segment of the chromosome 17p13.3 that suffers from a high frequent loss of heterozygosityin human hepatocellular carcinoma in China[1-5].To understand the molecular mechanisms underlyingtranscription control of the RNMTL1 gene in human cancers,we decline using of the conventional approachwhere the cis-elements bound by the known transcription factors are primary targets,and carried out thesystematic analyses to dissect the promoter structure and identify/characterize the key cis-elements thatare responsible for its strong expression in cell.The molecular approaches applied included 1,the primerextension for mapping of the transcription starts;2,the transient transfection/reporter assays on a largenumber of deletion and site-specific mutants of the promoter segment for defining the minimal promoterand the crucial elements within;and 3,the electrophoresis mobility shift assay with specific antibodies forreconfirming the nature of the transcription factors and their cognate cis-elements.We have shown that theinteraction of an ATF/CREB element(-38 to-31)and its cognate transcription factors play a predominantrole in the promoter activity of the RNMTL1 gene.The secondary DNA structures of the ATF/CREBelement play a more vital role in the protein-DNA interaction.Finally,we reported a novel mechanismunderlying the YY1 mediated transcription repression,namely,the ATF/CREB dependent transcription-repression by YY1 is executed in absence of its own sequence-specific binding.
文摘目的探讨17 p 13.3微缺失综合征的临床表型、拷贝数变异、治疗及预后。方法回顾性分析5例17p13.3微缺失综合征患儿临床资料、全外显子组测序结果以及治疗效果。结果5例患儿均表现为身材矮小,例3~5合并有心血管异常。全外显子组测序提示所有的患儿均存在17p13.3染色体片段缺失,缺失大小为433~1536 kb,主要包括YWHAE、CRK基因,但不包括PAFAH1B1基因。在排除了生长激素禁忌证后,4例接受了重组人生长激素治疗。矮小症患儿的身高在应用重组人生长激素治疗后初期得到改善,但后期治疗效果欠佳。2例满足手术指征而接受外科手术以纠正先天性心脏畸形。结论17p13.3染色体片段缺失可导致17p13.3微缺失综合征,通过全外显子组测序,可以提高对于存在先天性心脏畸形和/或矮小症的儿童的诊断率,及时采取心血管及身高方面的治疗有助于改善患儿预后。