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QF-PCR: a valuable first-line prenatal and postnatal test for common aneuploidies in South Africa

机译:QF-PCR:南非常见非整倍体的有价值的一线产前和产后检测

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Quantitative fluorescence-polymerase chain reaction (QF-PCR) is useful for the detection of aneuploidies involving chromosomes 13, 18, 21, X and Y. Due to the rapid turn-around time and reduced cost compared to traditional karyotyping, QF-PCR has been used as an alternative test for both pre- and postnatal aneuploidy detection in Johannesburg, South Africa since 2001. An internal review of 13,396 aneuploidy tests processed using QF-PCR between January 2015 and December 2019 was performed, and the results showed that the majority (similar to 88) of cases were postnatal tests, with prenatal samples accounting for only similar to 12 of cases. The most common aneuploidies detected were Trisomy 21 (20.6), Trisomy 18 (3.7) and Trisomy 13 (2.4), while sex chromosome aneuploidies were only detected in < 1 of cases. The average percentage of positive cases over the 5-year period was 32.1 for postnatal samples and 11.3 for prenatal samples. QF-PCR testing of the common aneuploidies is being used appropriately, and the high percentage of positive cases demonstrates the value of QF-PCR as prenatal and postnatal tests, particularly in limited resource settings. The higher proportion of positive postnatal cases suggests that referrals are clinically appropriate. However, there is under- and uneven utilization of genetic services in many provinces in South Africa, and the state of prenatal genetic services is poor, as reflected by the low number of prenatal referrals. These results demonstrate the need for programs which will improve the genetic knowledge of referring doctors and the general public, thereby improving the broader utilisation of QF-PCR aneuploidy diagnostic testing, so that patients receive appropriate diagnoses and subsequent management.
机译:定量荧光聚合酶链反应 (QF-PCR) 可用于检测涉及 13、18、21、X 和 Y 染色体的非整倍体。 由于与传统核型分析相比,QF-PCR 的周转时间短且成本更低,自 2001 年以来,QF-PCR 已被用作南非约翰内斯堡产前和产后非整倍体检测的替代测试。对 2015 年 1 月至 2019 年 12 月期间使用 QF-PCR 处理的 13,396 例非整倍体检测进行了内部审查,结果显示,大多数(接近 88%)病例是产后检测,产前样本仅占相似的 12% 病例。最常见的非整倍体是21三体(20.6%)、18三体(3.7%)和13三体(2.4%),而性染色体非整倍体仅在<1%的病例中检测到。在5年期间,产后样本和产前样本的平均阳性病例百分比分别为32.1%和11.3%。常见非整倍体的QF-PCR检测正在得到适当使用,阳性病例的高比例表明QF-PCR作为产前和产后检测的价值,特别是在资源有限的环境中。产后阳性病例的比例较高,表明转诊在临床上是合适的。然而,南非许多省份对遗传服务的利用不足和不均衡,产前遗传服务的状况很差,产前转诊人数少就反映了这一点。这些结果表明,需要制定计划来改善转诊医生和公众的遗传知识,从而提高QF-PCR非整倍体诊断检测的更广泛利用,以便患者得到适当的诊断和后续管理。

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