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- 저자 : 정재현 ( Je Hyun Jung ) (검색결과 1 건)
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모체혈액내 태아 유핵적혈구의 분리후PCR과 FISH에 의한 Y 염색체 검출의 임상적 유용성
정재현 ( Jae Hyun Chung ),지관자 ( Kwan Ja Ji ),양순하 ( Soon Ha Yang ),오정미 ( Jung Mi Oh ),노정래 ( Cheong Rae Roh ),문영규 ( Young Kyu Moon ),김승욱 ( Syng Wook Kim ),이제호 ( Je Ho Lee ) 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.12
Background: Fetal cells in maternal circulation offer a potential source of fetal material for non-invasive prenatal diagnosis. The presence of fetal cells in maternal blood can be confirmed by detecting Y-chromosome of male fetus by polymerase chain reaction(PCR) or fluorescence in situ hybridization(FISH). The current investigations, however, have not yet reached the accuracy for clinical application in detecting Y-chromosome by PCR or FISH because of tiny number of fetal cells in maternal blood. Therefore, if PCR and FISH were applied simultaneously on the same materials for detecting Y-chromosome, the diagnostic accuracy would be improved. Objective: The purpose of this study was to determine the clinical applicability of combined use of PCR and FISH in the detection of Y-chromosome from isolated fetal cells in maternal blood. Study Design: Peripheral blood was obtained from 43 pregnant women at 11~20 weeks `gestation. Fetal nucleated red blood cells(nRBCs) were discriminated by centrifugation under triple density gradient and by magnetic-activated cell sorter using CD 45 monoclonal antibody. The samples were resorted using CD 71 and GPA monoclonal antibodies. The PCR and FISH were performed simultaneously for the detection of Y-chromosome in each sample. Results: The diagnostic indices of PCR in the detection of Y-chromosome from fetal nRBC in maternal blood were sensitivity 70%(14/20), specificity 83%(19/23), positive predictive value 78%(14/18), and negative predictive value 76%(19/25). Those of FISH were 85%(17/20), 87%(20/23), 85%(17/20), and 87%(20/23), respectively. When PCR and FISH were concomittently applied for detecting Y-chromosome, sensitivity was 65%(13/20), specificity was 96%(22/23), positive predictive value was 93%(13/14), and negative predictive value was 76%(22/29). When PCR detected Y-chromosome and FISH did not or vice versa, it was interpreted as male. In that case, the sensitivity was 90%(18/20), the specificity was 74%(17/23), the positive predictive value was 75%(18/24), and the negative predictive value was 89%(17/19). Conclusions: When PCR and FISH were applied simultaneously, the specificity and positive predictive value in the detection of Y-chromosome from fetal cells in maternal blood were improved. However, the overall diagnostic indicies were not enough for clinical application as prenatal diagnostic technique.
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