Clinical, Cytogenetic and Molecular Cytogenetic Outcomes of Cell-Free DNA Testing for Rare Chromosomal Anomalies
- PMID: 36553656
- PMCID: PMC9777917
- DOI: 10.3390/genes13122389
Clinical, Cytogenetic and Molecular Cytogenetic Outcomes of Cell-Free DNA Testing for Rare Chromosomal Anomalies
Abstract
The scope of cell-free DNA (cfDNA) testing was expanded to the genome, which allowed screening for rare chromosome anomalies (RCAs). Since the efficiency of the test for RCAs remains below the common aneuploidies, there is a debate on the usage of expanded tests. This study focuses on the confirmatory and follow-up data of cases with positive cfDNA testing for RCAs and cases with screen-negative results in a series of 912 consecutive cases that underwent invasive testing following cfDNA testing. Chorion villus sampling (CVS), amniocentesis (AS), fetal blood sampling, and term placenta samples were investigated using classical cytogenetic and molecular cytogenetic techniques. Out of 593 screen-positive results, 504 (85%) were for common aneuploidies, 40 (6.7%) for rare autosomal trisomies (RATs), and 49 (8.3%) for structural chromosome anomalies (SAs). Of the screen-positives for RATs, 20 cases were evaluated only in fetal tissue, and confined placental mosaicism (CPM) could not be excluded. Among cases with definitive results (n = 20), the rates of true positives, placental mosaics, and false positives were 35%, 45%, and 10%, respectively. Among screen-positives for SAs, 32.7% were true positives. The confirmation rate was higher for duplications than deletions (58.3% vs. 29.4%). The rate of chromosomal abnormality was 10.9% in the group of 256 screen-negatives with pathological ultrasound findings. This study provides further data to assess the efficiency of expanded cfDNA testing for RATs and SAs. The test efficiency for cfDNA seems to be higher for duplications than for deletions, which is evidence of the role of expert ultrasound in identifying pregnancies at increased risk for chromosome anomalies, even in pregnancies with screen-negatives. Furthermore, we discussed the efficiency of CVS vs. AC in screen-positives for RATs.
Keywords: NIPT; cell-free DNA; mosaicism; positive predictive values; rare chromosomal anomalies.
Conflict of interest statement
The authors declare that they have no conflict of interest. None of the authors are affiliated with any commercial company providing cfDNA tests in Turkey.
Similar articles
-
Rare autosomal trisomies: comparison of detection through cell-free DNA analysis and direct chromosome preparation of chorionic villus samples.Ultrasound Obstet Gynecol. 2019 Oct;54(4):458-467. doi: 10.1002/uog.20383. Epub 2019 Sep 3. Ultrasound Obstet Gynecol. 2019. PMID: 31237735
-
Cytogenetic outcomes following a failed cell-free DNA screen: a population-based retrospective cohort study of 35,146 singleton pregnancies.Am J Obstet Gynecol. 2023 Aug;229(2):168.e1-168.e8. doi: 10.1016/j.ajog.2023.01.007. Epub 2023 Jan 7. Am J Obstet Gynecol. 2023. PMID: 36627072
-
Performance of a cell-free DNA prenatal screening test, choice of prenatal procedure, and chromosome conditions identified during pregnancy after low-risk cell-free DNA screening.Prenat Diagn. 2023 Feb;43(2):213-225. doi: 10.1002/pd.6307. Epub 2023 Jan 21. Prenat Diagn. 2023. PMID: 36617980
-
Non-invasive prenatal testing for fetal chromosomal abnormalities by low-coverage whole-genome sequencing of maternal plasma DNA: review of 1982 consecutive cases in a single center.Ultrasound Obstet Gynecol. 2014 Mar;43(3):254-64. doi: 10.1002/uog.13277. Epub 2014 Feb 10. Ultrasound Obstet Gynecol. 2014. PMID: 24339153 Review.
-
Diagnostic testing after positive results on cell free DNA screening: CVS or Amnio?Prenat Diagn. 2021 Sep;41(10):1249-1254. doi: 10.1002/pd.6021. Epub 2021 Aug 25. Prenat Diagn. 2021. PMID: 34386984 Review.
Cited by
-
Genome-Wide, Non-Invasive Prenatal Testing for rare chromosomal abnormalities: A systematic review and meta-analysis of diagnostic test accuracy.PLoS One. 2024 Nov 5;19(11):e0308008. doi: 10.1371/journal.pone.0308008. eCollection 2024. PLoS One. 2024. PMID: 39499701 Free PMC article.
References
-
- Hill M., Wright D., Daley R., Lewis C., McKay F., Mason S., Lench N., Howarth A., Boustred C., Lo K., et al. Evaluation of non-invasive prenatal testing (NIPT) for aneuploidy in an NHS setting: A reliable accurate prenatal non-invasive diagnosis (RAPID) protocol. BMC Pregnancy Childbirth. 2014;14:229. doi: 10.1186/1471-2393-14-229. - DOI - PMC - PubMed
-
- Dondorp W., Wert G.d., Bombard Y., Bianchi D.W., Bergmann C., Borry P., Chitty L.S., Fellmann F., Forzano F., Hall A., et al. Non-invasive prenatal testing for aneuploidy and beyond: Challenges of responsible innovation in prenatal screening. Summary and recommendations. Eur. J. Hum. Genet. 2015;23:1438–1450. doi: 10.1038/ejhg.2015.57. - DOI - PMC - PubMed
-
- Kozlowski P., Burkhardt T., Gembruch U., Gonser M., Kähler C., Kagan K.-O., von Kaisenberg C., Klaritsch P., Merz E., Steiner H., et al. DEGUM, ÖGUM, SGUM and FMF Germany Recommendations for the Implementation of First-Trimester Screening, Detailed Ultrasound, Cell-Free DNA Screening and Diagnostic Procedures. Ultraschall Med. 2019;40:176–193. doi: 10.1055/a-0631-8898. - DOI - PubMed
-
- Gadsbøll K., Petersen O.B., Gatinois V., Strange H., Jacobsson B., Wapner R., Vermeesch J.R., NIPT-map Study Group. Vogel I. Current use of noninvasive prenatal testing in Europe, Australia and the USA: A graphical presentation. Acta Obstet. Gynecol. Scand. 2020;99:722–730. doi: 10.1111/aogs.13841. - DOI - PubMed
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Research Materials