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目的 对比多重连接探针扩增(Multiplex ligation-dependent probe amplification,MLPA)与染色体核型分析技术,明确两种技术在流产绒毛样本检测中的效能,以期建立最优化的实验室检测方案。方法 采集189例稽留流产绒毛样本,同步行MLPA (SALSA P290-B1)和常规染色体核型分析检测,并对检测结果进行统计分析。结果 两种方法综合分析成功187例,占98.94%。其中核型分析成功117例,占61.90%;MLPA能够检测185例,占97.88%。核型分析与MLPA结论一致70例,占37.04%;42例多倍体或非探针目标区染色体异常,MLPA未能检出,占其独立检测样本的22.70%(42/185);72例因培养失败等因素未能成功核型分析,占38.10%。结论 ①独立采用核型分析或MLPA技术均不能有效实现流产绒毛染色体异常的检测分析。②综合考虑检测成本和效能,先行染色体核型分析并同时留取流产绒毛样本,应用MLPA作为核型分析失败的补充方案具有临床可行性。
Objective To establish optimized laboratory testing proposal through comparison of multiplex ligation-dependent probe amplification (MLPA) and conventional karyotyping for the diagnosis of pregnancy loss. Method A cohort of 189 patients underwent side-by-side analysis of chorionic villi samples by both conventional karyotyping and MLPA (SALSA P290-B1) with direct comparison of results. Results 187 samples(98.94%) were analyzed successfully by conventional karyotyping and MLPA. 117 samples (61.90%) were analyzed successfully only by karyotyping and 185 samples (97.88%) were analyzed only by MLPA. 70 samples (37.03%) yielded the same ?ndings with both MLPA and cytogenetic results . 42 samples (22.70% in the MLPA alone samples) were not detected because of inability to characterize structural rearrangements or ploidy changes. 72 samples (38.10%) had no cytogenetic results due to culture failures where MLPA results were available. Conclusions ①Chromosomal abnormalities can’t be detected effectively in single method whether MLPA or conventional karyotyping .②Considering the cost and efficiency, the optimal situation would be to have MLPA available in the laboratory as the complementary examination of the conventional karyotyping.
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