Added value of buccal cell FISH analysis in the diagnosis and management of Turner syndrome

Autor: N Bourcigaux, A. Khodawardi, Jean-Pierre Siffroi, A. Graff, Sophie Christin-Maitre, Camille Vatier, M.C. Villy, A. Borgel, B. Donadille, H. Morel
Přispěvatelé: Sorbonne Université (SU), Service d'Endocrinologie, diabétologie et endocrinologie de la reproduction [CHU Saint-Antoine], CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), UF de Génétique chromosomique [CHU Trousseau], Maladies génétiques d'expression pédiatrique [CHU Trousseau] (Inserm U933), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Trousseau [APHP], Couvet, Sandrine
Jazyk: angličtina
Rok vydání: 2020
Předmět:
MESH: Mouth Mucosa
[SDV]Life Sciences [q-bio]
Buccal swab
blood karyotype
Turner Syndrome
[SDV.GEN] Life Sciences [q-bio]/Genetics
Cohort Studies
0302 clinical medicine
Turner syndrome
Medicine
X/46
Prospective Studies
MESH: Cohort Studies
Ovarian Neoplasms
030219 obstetrics & reproductive medicine
medicine.diagnostic_test
Mosaicism
Rehabilitation
Obstetrics and Gynecology
[SDV] Life Sciences [q-bio]
MESH: Ovarian Neoplasms
buccal cells FISH
Cohort
Female
MESH: Mosaicism
Cohort study
Adult
medicine.medical_specialty
MESH: Turner Syndrome
Urinary system
Gonadoblastoma
030209 endocrinology & metabolism
[SDV.GEN.GH] Life Sciences [q-bio]/Genetics/Human genetics
03 medical and health sciences
Internal medicine
Humans
[SDV.GEN]Life Sciences [q-bio]/Genetics
MESH: Humans
business.industry
Mouth Mucosa
Turner’s syndrome
MESH: Adult
Buccal administration
medicine.disease
MESH: Prospective Studies
Reproductive Medicine
[SDV.GEN.GH]Life Sciences [q-bio]/Genetics/Human genetics
Skin biopsy
business
MESH: Female
X monosomy
XX mosaicism
Zdroj: Human Reproduction
Human Reproduction, 2020, 35 (10), pp.2391-2398. ⟨10.1093/humrep/deaa197⟩
ISSN: 0268-1161
1460-2350
Popis: STUDY QUESTION Is there an added diagnosis value of buccal cell FISH analysis compared with blood lymphocyte chromosomal investigations in patients with Turner syndrome (TS)? SUMMARY ANSWER Buccal cell FISH analysis, a non-invasive technique, modified the chromosomal results obtained with the blood karyotype in 17 patients (12%) of our cohort. WHAT IS KNOWN ALREADY Few studies have evaluated buccal cell FISH analysis and compared them with blood karyotype in patients with TS. STUDY DESIGN, SIZE, DURATION A prospective, monocentric cohort study was conducted in a rare diseases centre (CMERC) between July 2017 and August 2019. PARTICIPANTS/MATERIALS, SETTING, METHODS In total, 142 adult patients with TS, and at least 5% 45,X cells in a previous blood karyotype, were recruited. All the patients’ files were included in the CEMARA database. This national database has been declared to the French data protection agency (CNIL approval number 1187326). In compliance with French law, consent regarding non-opposition to collect and use the data was obtained from each patient. A FISH analysis on a buccal smear was performed. MAIN RESULTS AND THE ROLE OF CHANCE The percentage of 45,X cells was identical between the two tissues in only 32.4% of cases. The discrepancy was higher than 41% for 12% of the cohort. The percentage of 45,X cells was higher in blood in 53 (37.3%) patients, and higher in buccal cells in 43 (30.3%) of cases. In 17 (12%) cases, the blood karyotype had to be reconsidered in regard to the buccal cell analysis. LIMITATIONS, REASONS FOR CAUTION It would have been interesting to evaluate karyotypes in cells from other tissues such as cells from skin biopsy or from the urinary tract and even from blood vessels or gonads in case of surgery and to compare them with each patient’s phenotype. However, most of the time, these tissues are not available. WIDER IMPLICATIONS OF THE FINDINGS Although blood lymphocyte karyotype remains the gold standard for the diagnosis of TS, buccal cell FISH analysis is an efficient tool to evaluate the global chromosomal constitution in these patients, thus allowing them to have better care and follow-up. For instance, identifying a Y chromosome can prevent the occurrence of a gonadoblastoma, as gonadectomy should be discussed. On the other hand, finding normal XX cells in a patient with a previous diagnosis of homogenous 45,X TS, may be psychologically helpful and relevant for gynaecological care. STUDY FUNDING/COMPETING INTEREST(S) No specific funding was sought for the study. The authors declare no competing interests. TRIAL REGISTRATION NUMBER N/A
N/A.
Databáze: OpenAIRE