Chromosome Deletion

染色体缺失
  • 文章类型: Journal Article
    背景:TBX6,T-box基因家族的成员,编码转录因子盒6,该因子盒6对脊椎动物的体节分割至关重要。众所周知,TBX6基因中具有常见低态风险单倍型(T-C-A)的反式破坏性变体的复合杂合性导致10%的先天性脊柱侧凸(CS)病例。染色体17q12的缺失是一种罕见的细胞遗传学异常,这通常会导致肾囊肿和糖尿病。然而,受影响的个体通常表现出临床异质性和不完全外显率。
    方法:我们在此介绍一名中国胎儿,该胎儿在妊娠17周时通过超声检查显示患有CS。进行三全外显子组测序(WES)以调查胎儿的潜在遗传缺陷。体外功能实验,包括蛋白质印迹和荧光素酶反式激活测定,进行以确定TBX6的新变体的致病性。
    结果:WES显示胎儿具有c.338_340del的复合杂合变体(p。Ile113del)和TBX6基因的常见低态风险单倍型。体外功能研究表明,p.Ile113del变体对TBX6的表达没有影响,但几乎导致其转录活性的完全丧失。此外,我们在胎儿和母亲的17q12区域发现了1.85Mb缺失。尽管目前没有与胎儿拷贝数变异相关的临床表型,它可以解释孕妇的多发性肾囊肿。
    结论:本研究首次报道了具有单个氨基酸缺失变体和TBX6T-C-A单倍型的中国胎儿。17q12微缺失的临床异质性对产前遗传咨询提出了重大挑战。我们的结果再次表明了产前遗传诊断的复杂性。
    BACKGROUND: TBX6, a member of the T-box gene family, encodes the transcription factor box 6 that is critical for somite segmentation in vertebrates. It is known that the compound heterozygosity of disruptive variants in trans with a common hypomorphic risk haplotype (T-C-A) in the TBX6 gene contribute to 10% of congenital scoliosis (CS) cases. The deletion of chromosome 17q12 is a rare cytogenetic abnormality, which often leads to renal cysts and diabetes mellitus. However, the affected individuals often exhibit clinical heterogeneity and incomplete penetrance.
    METHODS: We here present a Chinese fetus who was shown to have CS by ultrasound examination at 17 weeks of gestation. Trio whole-exome sequencing (WES) was performed to investigate the underlying genetic defects of the fetus. In vitro functional experiments, including western-blotting and luciferase transactivation assay, were performed to determine the pathogenicity of the novel variant of TBX6.
    RESULTS: WES revealed the fetus harbored a compound heterozygous variant of c.338_340del (p.Ile113del) and the common hypomorphic risk haplotype of the TBX6 gene. In vitro functional study showed the p.Ile113del variant had no impact on TBX6 expression, but almost led to complete loss of its transcriptional activity. In addition, we identified a 1.85 Mb deletion on 17q12 region in the fetus and the mother. Though there is currently no clinical phenotype associated with this copy number variation in the fetus, it can explain multiple renal cysts in the pregnant woman.
    CONCLUSIONS: This study is the first to report a Chinese fetus with a single amino acid deletion variant and a T-C-A haplotype of TBX6. The clinical heterogeneity of 17q12 microdeletion poses significant challenges for prenatal genetic counseling. Our results once again suggest the complexity of prenatal genetic diagnosis.
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  • 文章类型: Journal Article
    鉴于听力损失(HL)的个性化管理和治疗的关键作用,早期进行病因调查,和遗传分析显着有助于确定大多数综合征和非综合征HL病例。知道数百个与HL的综合征关联,关于由于连续基因的微缺失或微重复而导致的基因组疾病中HL的全面数据很少。结合对新患者的描述,该患者具有新的3.7Mb的Xq21关键基因座缺失,我们建议对Xq21缺失综合征患者及其家庭成员的临床发现进行未报道的文献综述.最后,我们提出了连续基因综合征中HL的全面综述,以确认细胞基因组微阵列分析在研究无法解释的HL病因中的作用。
    Given the crucial role of the personalized management and treatment of hearing loss (HL), etiological investigations are performed early on, and genetic analysis significantly contributes to the determination of most syndromic and nonsyndromic HL cases. Knowing hundreds of syndromic associations with HL, little comprehensive data about HL in genomic disorders due to microdeletion or microduplications of contiguous genes is available. Together with the description of a new patient with a novel 3.7 Mb deletion of the Xq21 critical locus, we propose an unreported literature review about clinical findings in patients and their family members with Xq21 deletion syndrome. We finally propose a comprehensive review of HL in contiguous gene syndromes in order to confirm the role of cytogenomic microarray analysis to investigate the etiology of unexplained HL.
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  • 文章类型: Case Reports
    迄今为止,只有13项研究描述了10p11.2-p12大量重叠缺失的患者.这些个体具有以智力残疾为特征的共同表型,发育迟缓,明显的面部畸形特征,异常行为,视力障碍,心脏畸形,和男性的隐睾。分子细胞遗传学分析显示,该染色体区域的缺失共享80kb的最小重叠区域(SRO)。其仅含有WAC基因(具有卷曲螺旋的含WW结构域的衔接子)。在这份临床病例报告中,我们报告了一个5岁的女孩,出生在非近亲的父母,带有10p11.22p11.21微删除。她提出了与文献中描述的其他患者重叠的临床特征,如变形性状,说话延迟,和行为异常(多动),即使WAC基因不参与微缺失。我们的结果是第一个强调此处描述的缺失代表了一种连续的基因综合征,足以解释不同的表型,但与文献中报道的先前病例部分重叠。即使不涉及相同的基因。特别是,在这项研究中,我们推测似乎与正常运动发育有关的WAC基因的作用。事实上,我们发现,我们的患者是文献中描述的唯一一个在10p11.22p11.21区域存在大缺失而不涉及WAC基因缺失的患者,and,有趣的是,患者没有运动延迟。
    To date, only 13 studies have described patients with large overlapping deletions of 10p11.2-p12. These individuals shared a common phenotype characterized by intellectual disability, developmental delay, distinct facial dysmorphic features, abnormal behaviour, visual impairment, cardiac malformation, and cryptorchidism in males. Molecular cytogenetic analysis revealed that the deletion in this chromosomal region shares a common smallest region of overlap (SRO) of 80 kb, which contains only the WAC gene (WW-domain-containing adaptor with coiled coil). In this clinical case report, we report a 5-year-old girl, born from non-consanguineous parents, with a 10p11.22p11.21 microdeletion. She presents clinical features that overlap with other patients described in the literature, such as dysmorphic traits, speech delay, and behavioural abnormalities (hyperactivity), even though the WAC gene is not involved in the microdeletion. Our results are the first to highlight that the deletion described here represents a contiguous gene syndrome that is enough to explain the distinct phenotype but partially overlaps with the previous cases reported in the literature, even though the same genes are not involved. In particular, in this study, we speculate about the role of the WAC gene that seems to be associated with normal motor development. In fact, we found that our patient is the only one described in the literature with a large deletion in the 10p11.22p11.21 region without the involvement of the WAC gene deletion, and, interestingly, the patient did not have motor delay.
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  • 文章类型: English Abstract
    OBJECTIVE: To analyze the prognostic value of del(1p32) in patients with newly diagnosed multiple myeloma (MM).
    METHODS: The clinical data of 341 newly diagnosed MM attended in Jiangsu Province Hospital were retrospective analyzed. Clinical characteristic combined with genetic features, especially del(1p32), were analyzed for survival and prognostic of patients.
    RESULTS: Among the 341 patients with newly diagnosed MM, 24(7.0%) patients were del(1p32) positive. The progression-free survival (PFS) and overall survival (OS) were significantly shorter in MM patients with del(1p32) than those without del(1p32) (PFS: P < 0.001;OS: P < 0.001). The COX proportional-hazards model showed that del (1p32) was an independent risk factor for PFS and OS of patients with MM. The patients with both 1q21 gain/amplification and del(1p32), as \"double-hit chromosome 1\", have worse prognosis than those with only 1q21 gain/amplification or only del(1p32) (PFS: P < 0.001; OS: P < 0.001).
    CONCLUSIONS: Del(1p32) is an independent risk factor for PFS and OS of patients with MM. Del(1p32) detection should be widely used in the prognostic analysis for newly diagnosed MM patients.
    UNASSIGNED: 1p32缺失在初诊多发性骨髓瘤患者中的预后意义.
    UNASSIGNED: 分析1p32缺失在初诊多发性骨髓瘤(MM)患者中的预后意义。.
    UNASSIGNED: 回顾性分析2017年4月至2022年12月在江苏省人民医院就诊的341例初诊MM患者的临床资料,结合遗传学特征,尤其是1号染色体遗传学异常中的1p32缺失,分析患者的生存及预后。.
    UNASSIGNED: 341例初诊MM患者中,1p32缺失阳性患者占7.0%(24/341),伴有1p32缺失的MM患者的无进展生存(PFS)显著短于不伴有1p32缺失患者(P < 0.001),总生存(OS)同样更短(P < 0.001)。COX风险回归分析显示,1p32缺失是影响MM患者生存的独立危险因素。同时伴有1q21扩增和1p32缺失,即“1号染色体双打击”MM患者的PFS及OS相较于仅有1q21扩增或仅有1p32缺失MM患者更差(PFS:P < 0.001;OS:P < 0.001)。.
    UNASSIGNED: 1p32缺失是影响MM患者PFS及OS的独立危险因素,1p32缺失应广泛应用于初诊MM的预后判断。.
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  • 文章类型: Journal Article
    虽然患有del(5q)(del(5q)MDS)的骨髓增生异常综合征包括明确定义的血液学亚组,其起源的分子基础仍然未知。使用来自del(5q)MDS患者的CD34+祖细胞上的单细胞RNA-seq(scRNA-seq),我们已经确定了包含缺失的细胞,表征这种遗传损伤对疾病发病机理和治疗反应的转录影响。有趣的是,del(5q)和non-del(5q)细胞都呈现相似的转录损伤,表明所有细胞,不仅仅是那些隐藏删除的人,可能导致异常的造血分化。然而,基因调控网络(GRN)分析揭示了一组显示异常活性的调控子,这些调控子只能在del(5q)细胞中触发改变的造血,指出这些细胞在疾病表型中的作用更加突出。在del(5q)MDS患者中,来那度胺治疗后达到血液学反应,该药物在del(5q)和non-del(5q)细胞中恢复了几种转录变化,但是其他病变仍然存在,这可能是未来潜在复发的原因。此外,血液学反应的缺乏与来那度胺不能逆转转录改变有关。总的来说,这项研究揭示了可能导致del(5q)MDS发病机制和治疗反应的转录改变。
    While myelodysplastic syndromes with del(5q) (del(5q) MDS) comprises a well-defined hematological subgroup, the molecular basis underlying its origin remains unknown. Using single cell RNA-seq (scRNA-seq) on CD34+ progenitors from del(5q) MDS patients, we have identified cells harboring the deletion, characterizing the transcriptional impact of this genetic insult on disease pathogenesis and treatment response. Interestingly, both del(5q) and non-del(5q) cells present similar transcriptional lesions, indicating that all cells, and not only those harboring the deletion, may contribute to aberrant hematopoietic differentiation. However, gene regulatory network (GRN) analyses reveal a group of regulons showing aberrant activity that could trigger altered hematopoiesis exclusively in del(5q) cells, pointing to a more prominent role of these cells in disease phenotype. In del(5q) MDS patients achieving hematological response upon lenalidomide treatment, the drug reverts several transcriptional alterations in both del(5q) and non-del(5q) cells, but other lesions remain, which may be responsible for potential future relapses. Moreover, lack of hematological response is associated with the inability of lenalidomide to reverse transcriptional alterations. Collectively, this study reveals transcriptional alterations that could contribute to the pathogenesis and treatment response of del(5q) MDS.
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  • 文章类型: Case Reports
    染色体18q缺失综合征患者通常会出现低球蛋白血症。在这里,我们描述了两名染色体18q缺失综合征患者,他们表现为迟发性联合免疫缺陷(LOCID),以前没有报道过。患者1是一名29岁的男性,患有18q缺失综合征,他在Yamabiko医疗福利中心接受了26年的严重运动和智力残疾管理。虽然病人几乎没有感染,他在28岁时患上了肺孢子虫肺炎。患者2,一名48岁的女性,患有智力残疾和先天性畸形,被转诊到东京医学牙科大学医院,在她的胸部X线片上发现了异常的双侧肺部阴影。计算机断层扫描显示多发性淋巴结病和肺炎。腹股沟区淋巴结活检显示肉芽肿性淋巴结炎,染色体检查显示18q缺失。基于阵列的基因组杂交分析显示,患者1在18q21.32-q22.3缺失,患者2在18q21.33-qter缺失。两名患者的免疫状态检查显示全球蛋白血症,记忆B细胞和初始CD4+和/或CD8+细胞的数量减少,减少对羧基荧光素二乙酸酯琥珀酰亚胺酯T细胞分裂试验的反应,低水平的T细胞受体重组切除圈和Igκ缺失重组切除圈。因此,两名患者均被诊断为LOCID.尽管18q缺失综合征患者通常会出现体液免疫缺陷,这种疾病可以进一步复杂化的细胞介导的免疫缺陷,导致联合免疫缺陷。因此,18q缺失综合征患者应定期进行细胞/体液免疫能力检测.
    Patients with chromosome 18q deletion syndrome generally experience hypogammaglobulinemia. Herein, we describe two patients with chromosome 18q deletion syndrome who presented with late-onset combined immune deficiency (LOCID), which has not been previously reported. Patient 1 was a 29-year-old male with 18q deletion syndrome, who was being managed for severe motor and intellectual disabilities at the Yamabiko Medical Welfare Center for 26 years. Although the patient had few infections, he developed Pneumocystis pneumonia at the age of 28. Patient 2, a 48-year-old female with intellectual disability and congenital malformations, was referred to Tokyo Medical and Dental University Hospital with abnormal bilateral lung shadows detected on her chest radiography. Computed tomography showed multiple lymphadenopathies and pneumonia. A lymph node biopsy of the inguinal region revealed granulomatous lymphadenitis, and a chromosomal examination revealed 18q deletion. Array-based genomic hybridization analysis revealed deletion at 18q21.32-q22.3 for patient 1 and at 18q21.33-qter for patient 2. Immune status work-up of the two patients revealed panhypogammaglobulinemia, decreased number of memory B cells and naïve CD4+ and/or CD8+ cells, reduced response on the carboxyfluorescein diacetate succinimidyl ester T-cell division test, and low levels of T-cell receptor recombination excision circles and Ig κ-deleting recombination excision circles. Consequently, both patients were diagnosed with LOCID. Although patients with 18q deletion syndrome generally experience humoral immunodeficiency, the disease can be further complicated by cell-mediated immunodeficiency, causing combined immunodeficiency. Therefore, patients with 18q deletion syndrome should be regularly tested for cellular/humoral immunocompetence.
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  • 文章类型: Journal Article
    背景:体细胞拷贝数改变是癌症的标志,为治疗开发提供了独特的机会。这里,我们专注于确定携带染色体8p缺失的肿瘤的特定漏洞。
    方法:我们开发并应用了癌症基因组图谱(TCGA)的综合分析,癌症依存关系图(DepMap),和癌细胞系百科全书,以确定染色体8p特异性漏洞。我们采用正交基因靶向策略,在体外和体内,包括短发夹RNA介导的基因敲除和CRISPR/Cas9介导的基因敲除以验证漏洞。
    结果:我们确定了SLC25A28(也称为MFRN2),作为携带染色体8p缺失的肿瘤的特殊脆弱性。我们证明了对MFRN2损失的脆弱性是由其模拟物的表达决定的,SLC25A37(也称为MFRN1),位于染色体8p上。根据它们作为线粒体铁转运蛋白的功能,MFRN1/2旁系同源蛋白缺乏严重损害线粒体呼吸,诱导铁-硫簇蛋白的全球消耗,导致DNA损伤和细胞死亡.MFRN2在缺乏MFRN1的肿瘤中的消耗导致生长受损,甚至在临床前小鼠异种移植实验中肿瘤根除,突出其治疗潜力。
    结论:我们的数据揭示了MFRN2作为8p染色体缺失癌症的治疗靶标,并将MFNR1作为MFRN2定向治疗的补充生物标志物。
    BACKGROUND: Somatic copy number alterations are a hallmark of cancer that offer unique opportunities for therapeutic exploitation. Here, we focused on the identification of specific vulnerabilities for tumors harboring chromosome 8p deletions.
    METHODS: We developed and applied an integrative analysis of The Cancer Genome Atlas (TCGA), the Cancer Dependency Map (DepMap), and the Cancer Cell Line Encyclopedia to identify chromosome 8p-specific vulnerabilities. We employ orthogonal gene targeting strategies, both in vitro and in vivo, including short hairpin RNA-mediated gene knockdown and CRISPR/Cas9-mediated gene knockout to validate vulnerabilities.
    RESULTS: We identified SLC25A28 (also known as MFRN2), as a specific vulnerability for tumors harboring chromosome 8p deletions. We demonstrate that vulnerability towards MFRN2 loss is dictated by the expression of its paralog, SLC25A37 (also known as MFRN1), which resides on chromosome 8p. In line with their function as mitochondrial iron transporters, MFRN1/2 paralog protein deficiency profoundly impaired mitochondrial respiration, induced global depletion of iron-sulfur cluster proteins, and resulted in DNA-damage and cell death. MFRN2 depletion in MFRN1-deficient tumors led to impaired growth and even tumor eradication in preclinical mouse xenograft experiments, highlighting its therapeutic potential.
    CONCLUSIONS: Our data reveal MFRN2 as a therapeutic target of chromosome 8p deleted cancers and nominate MFNR1 as the complimentary biomarker for MFRN2-directed therapies.
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  • 文章类型: Journal Article
    MYC失调在IDH突变神经胶质瘤的发生和进展中至关重要,主要由拷贝数改变驱动,调节元件改变,或表观遗传变化。我们的初步分析发现了相对MYC过表达的实例,而近端MYC网络(PMN)没有改变,促使对潜在的新致癌机制进行更深入的研究。从癌症基因组图谱中分析236“IDH-突变型1p/19q非共缺失”低级别胶质瘤的全面基因组学概况,我们确定了PMN内的体细胞基因组改变。在没有PMN改变但MYC过表达的肿瘤中,鉴定了与MYC过表达相关的基因。我们的分析得出,86/236的星形细胞瘤没有表现出PMN改变,显示相对MYC过表达的21/86的子集。在这个子集内,我们发现42个基因与MYC的相对表达呈负相关,所有在19q进一步的分析在19q13.43确定了一个最小的共同区域,包括15个基因。使用独立的scRNAseq数据重新证实了这15种基因与相对MYC过表达的负相关。Further,与WT病例相比,微缺失星形细胞瘤亚群显示出明显更高的基因组不稳定性,但与PMN命中病例相比,不稳定性较低。这种新发现的19q微缺失代表了星形细胞瘤中MYC失调的潜在新机制。鉴于IDH突变型神经胶质瘤中19q丢失的重要性,我们的发现对于理解胶质细胞生成具有重要意义.
    MYC dysregulation is pivotal in the onset and progression of IDH-mutant gliomas, mostly driven by copy-number alterations, regulatory element alterations, or epigenetic changes. Our pilot analysis uncovered instances of relative MYC overexpression without alterations in the proximal MYC network (PMN), prompting a deeper investigation into potential novel oncogenic mechanisms. Analysing comprehensive genomics profiles of 236 \"IDH-mutant 1p/19q non-co-deleted\" lower-grade gliomas from The Cancer Genome Atlas, we identified somatic genomic alterations within the PMN. In tumours without PMN-alterations but with MYC-overexpression, genes correlated with MYC-overexpression were identified. Our analyses yielded that 86/236 of astrocytomas exhibited no PMN-alterations, a subset of 21/86 displaying relative MYC overexpression. Within this subset, we discovered 42 genes inversely correlated with relative MYC expression, all on 19q. Further analysis pinpointed a minimal common region at 19q13.43, encompassing 15 genes. The inverse correlations of these 15 genes with relative MYC overexpression were re-confirmed using independent scRNAseq data. Further, the micro-deleted astrocytoma subset displayed significantly higher genomic instability compared to WT cases, but lower instability compared to PMN-hit cases. This newly identified 19q micro-deletion represents a potential novel mechanism underlying MYC dysregulation in astrocytomas. Given the prominence of 19q loss in IDH-mutant gliomas, our findings bear significant implications for understanding gliomagenesis.
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  • 文章类型: Journal Article
    NF1微缺失综合征,占NF1患者的5-11%,由NF1区域中的缺失引起,并且其通常以严重表型为特征。虽然70%的NF1微缺失患者表现出相同的1.4MbI型缺失,一些患者可能表现出额外的临床特征。因此,几种致病机制的贡献,除了缺失区间内某些基因的单倍体不足,是预期的,需要定义。我们通过qPCR研究了1型NF1缺失患者中缺失侧翼基因的表达改变,与健康的捐赠者相比,可能有助于NF1微缺失综合征的临床特征。此外,1.4Mb缺失导致17q11.2区域的3D染色质结构发生变化。具体来说,这种缺失改变了断点侧翼区域的DNA-DNA相互作用,正如我们的4C-seq分析所证明的那样。这种改变可能导致对缺失侧翼基因表达的位置效应。有趣的是,4C-seq分析显示,在微缺失患者中,在RHOT1启动子和SLC6A4基因之间建立了相互作用,显示表达增加。我们对推定的修饰基因进行了NGS,并确定了RAS途径中的两种“可能致病”罕见变异,可能有助于偶然的表型特征。这项研究为理解NF1微缺失综合征的发病机理提供了新的见解,并提出了一种新的病理机制,除了位于缺失内的基因的单倍体不足外,还有助于表达表型。这是一种关键的方法,可以应用于解开微缺失综合征,改善精准医学,预后和患者随访。
    NF1 microdeletion syndrome, accounting for 5-11% of NF1 patients, is caused by a deletion in the NF1 region and it is generally characterized by a severe phenotype. Although 70% of NF1 microdeletion patients presents the same 1.4 Mb type-I deletion, some patients may show additional clinical features. Therefore, the contribution of several pathogenic mechanisms, besides haploinsufficiency of some genes within the deletion interval, is expected and needs to be defined. We investigated an altered expression of deletion flanking genes by qPCR in patients with type-1 NF1 deletion, compared to healthy donors, possibly contributing to the clinical traits of NF1 microdeletion syndrome. In addition, the 1.4-Mb deletion leads to changes in the 3D chromatin structure in the 17q11.2 region. Specifically, this deletion alters DNA-DNA interactions in the regions flanking the breakpoints, as demonstrated by our 4C-seq analysis. This alteration likely causes position effect on the expression of deletion flanking genes.Interestingly, 4C-seq analysis revealed that in microdeletion patients, an interaction was established between the RHOT1 promoter and the SLC6A4 gene, which showed increased expression. We performed NGS on putative modifier genes, and identified two \"likely pathogenic\" rare variants in RAS pathway, possibly contributing to incidental phenotypic features.This study provides new insights into understanding the pathogenesis of NF1 microdeletion syndrome and suggests a novel pathomechanism that contributes to the expression phenotype in addition to haploinsufficiency of genes located within the deletion.This is a pivotal approach that can be applied to unravel microdeletion syndromes, improving precision medicine, prognosis and patients\' follow-up.
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  • 文章类型: Journal Article
    背景:男性不育已成为全球性的健康问题,遗传因素是其中一个重要原因。Y染色体微缺失是导致男性不育的主要遗传因素。本研究的目的是探讨海南男性不育与Y染色体微缺失的相关性。中国唯一的热带岛屿省。
    方法:本研究对海南897名不育男性进行精液分析。根据世界卫生组织标准,生殖医学部的专业人员对精液分析进行了测量,海南医科大学第一附属医院,在那里收集样本。通过在外周血DNA上进行多重聚合酶链反应检测六个STS标记,证实了Y染色体AZF微缺失。生殖激素的水平,包括FSH,LH,PRL,T,和E2,使用酶联免疫吸附测定(ELISA)进行定量。
    结果:海南不育男性Y染色体微缺失发生率为7.13%。少精子症组Y染色体微缺失发生率为6.69%(34/508),无精子症组Y染色体微缺失发生率为7.71%(30/389)。在无精子症组中观察到AZF亚区各种类型的缺失,而在少精子症组没有检测到AZFb缺失。在所有微缺失患者中,AZFc区的缺失率为68.75%(64个中的44个),其次是AZFa区的缺失率为6.25%(64个中的4个),AZFb区的缺失率为4.69%(64个中的3个)。无精子症患者的AZFa区域缺失率明显高于少精子症患者(0.51%vs.0.39%,p<0.001)。相比之下,在少精子症患者中,AZFc区的缺失率明显更高(3.08%vs.6.30%,p<0.001)。此外,在所有患者中,AZFb+c次区域关联缺失的比例最高(0.89%,8/897),其次是AZFa+b+c缺失(0.56%,5/897),并且仅发生在无精子症患者中。激素分析显示FSH(21.63±2.01U/Lvs.10.15±0.96U/L,p=0.001),LH(8.96±0.90U/Lvs.4.58±0.42U/L,p<0.001)和PRL(263.45±21.84mIU/Lvs.170.76±17.10mIU/L,p=0.002)在无精子症患者中微缺失显着增加。尽管如此,P、E2水平两组间差异无统计学意义。
    结论:海南省男性不育患者AZF微缺失发生率可达7.13%,AZFc亚区的缺失最高。虽然Y染色体微缺失率在不同的区域或群体中是不同的,Y染色体的上述区域可能在调节精子发生中起着不可或缺的作用。Y染色体微缺失分析在男性不育的临床评估和诊断中起着至关重要的作用。
    BACKGROUND: Male infertility has become a global health problem, and genetic factors are one of the essential causes. Y chromosome microdeletion is the leading genetic factor cause of male infertility. The objective of this study is to investigate the correlation between male infertility and Y chromosome microdeletions in Hainan, the sole tropical island province of China.
    METHODS: We analyzed the semen of 897 infertile men from Hainan in this study. Semen analysis was measured according to WHO criteria by professionals at the Department of Reproductive Medicine, the First Affiliated Hospital of Hainan Medical University, where samples were collected. Y chromosome AZF microdeletions were confirmed by detecting six STS markers using multiple polymerase chain reactions on peripheral blood DNA. The levels of reproductive hormones, including FSH, LH, PRL, T, and E2, were quantified using the enzyme-linked immunosorbent assay (ELISA).
    RESULTS: The incidence of Y chromosome microdeletion in Hainan infertile men was 7.13%. The occurrence rate of Y chromosome microdeletion was 6.69% (34/508) in the oligozoospermia group and 7.71% (30/389) in the azoospermia group. The deletion of various types in the AZF subregion was observed in the group with azoospermia, whereas no AZFb deletion was detected in the oligozoospermia group. Among all patients with microdeletions, the deletion rate of the AZFc region was the higher at 68.75% (44 out of 64), followed by a deletion rate of 6.25% (4 out of 64) for the AZFa region and a deletion rate of 4.69% (3 out of 64) for the AZFb region. The deletion rate of the AZFa region was significantly higher in patients with azoospermia than in patients with oligozoospermia (0.51% vs. 0.39%, p < 0.001). In comparison, the deletion rate of the AZFc region was significantly higher in patients with oligozoospermia (3.08% vs. 6.30%, p < 0.001). Additionally, the AZFb + c subregion association deletion was observed in the highest proportion among all patients (0.89%, 8/897), followed by AZFa + b + c deletion (0.56%, 5/897), and exclusively occurred in patients with azoospermia. Hormone analysis revealed FSH (21.63 ± 2.01 U/L vs. 10.15 ± 0.96 U/L, p = 0.001), LH (8.96 ± 0.90 U/L vs. 4.58 ± 0.42 U/L, p < 0.001) and PRL (263.45 ± 21.84 mIU/L vs. 170.76 ± 17.10 mIU/L, p = 0.002) were significantly increased in azoospermia patients with microdeletions. Still, P and E2 levels were not significantly different between the two groups.
    CONCLUSIONS: The incidence of AZF microdeletion can reach 7.13% in infertile men in Hainan province, and the deletion of the AZFc subregion is the highest. Although the Y chromosome microdeletion rate is distinct in different regions or populations, the regions mentioned above of the Y chromosome may serve an indispensable role in regulating spermatogenesis. The analysis of Y chromosome microdeletion plays a crucial role in the clinical assessment and diagnosis of male infertility.
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