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目的比较孕早期经宫颈不同部位获取的胎儿细胞量,以确定更佳的取材部位。方法收集孕5～10周人工流产妇女的经宫颈内口和宫颈外口冲洗液,分别称为内口冲洗组和外口冲洗组,每组各60例。提取冲洗液中的 DNA,对 Y 染色体的 SRY 基因进行扩增和定量。对人流后的绒毛采用直接法分析染色体核型确定流产胎儿性别。结果 (1)经宫颈内口冲洗组,实时定量 PCR 检测出71.4％(15/21)已知男胎的 SRY 基因,5.13％(2/39)已知女胎的 SRY 基因,总性别正确预测率为86.7％;经宫颈外口冲洗组,实时定量 PCR 检测出37％(10/27)已知男胎的 SRY 基因,6.25％(2/32)已知女胎的 SRY 基因,总性别正确预测率为67.8％。经宫颈内口冲洗组的总性别正确预测率和男胎阳性率均高于经宫颈外口冲洗组,差异有统计学意义(P<0.05)。(2)实时定量 PCR 检测经宫颈内口冲洗组 DNA 抽提液 SRY 基因的拷贝数为1487.2±430.5,高于经宫颈外口冲洗组702.4±365.7拷贝,差异有统计学意义(P<0.05)。结论经宫颈获取胎儿细胞为孕早期无创性产前诊断提供了一个可能途径,经宫颈内口水平能比外口得到更多的胎儿细胞,但应采取更加安全有效的取材方法。
Objective To compare the amount of fetal cells obtained from different parts of the cervix during the first trimester of pregnancy in order to determine the better location of the fetus. Methods The cervical intracranial and cervix external irrigation fluid were collected from 5 to 10 weeks pregnant women who were induced by artificial abortion. They were called internal irrigation group and external irrigation group, 60 cases in each group. The DNA in the washings was extracted and the YYR SRY gene was amplified and quantified. Direct analysis of chorionic karyotypes after abortion was used to determine abortion fetal sex. Results (1) The SRY gene of 71.4% (15/21) male fetuses and SRY gene of 5.13% (2/39) female fetuses were detected by real-time PCR. The total gender was correctly predicted (86.7%). SRY gene in 37% (10/27) male fetuses and 6.25% (2/32) female fetuses were detected by real-time quantitative PCR. The total sex was correct The forecast rate is 67.8%. The correct rate of positive predictive value of total gender and the positive rate of male fetus in the endoscopic wash group were significantly higher than those of the cervix external wash group, the difference was statistically significant (P <0.05). (2) Real-time PCR showed that the copy number of SRY gene was 1487.2 ± 430.5, which was higher than that of 702.4 ± 365.7 copies in the cervix external wash group (P <0.05) . Conclusions Transcervical acquisition of fetal cells provides a possible avenue for noninvasive prenatal diagnosis of early pregnancy. More fetal cells can be obtained at the level of the internal os of the cervix than that of the external os, but safer and more effective methods should be taken.