SRY基因检测在儿童性发育疾病诊断中的应用

SRY gene-testing in the diagnosis of disorders of sex development among children

摘要:

目的：应用SRY基因直接测序检测技术和外周血染色体核型分析技术对外生殖器模糊的幼儿及青春期儿童进行检查以明确诊断。方法：采用常规G显带方法分析20例外生殖器模糊的患儿染色体核型，用PCR技术扩增其SRY基因，进行基因测序，分析是否存在SRY基因及SRY基因是否存在突变情况。结果：20例患儿中SRY基因阳性的有17例，阴性3例。直接测序结果显示所有SRY基因阳性患者该基因均未发生突变。染色体核型分析中检出4例特殊核型为：46, XY, del (Y) (q12)/45, X、46, XY, add (Y) (p11)、46, XY, r (9)及46, XY, 9 qh+。结论：SRY基因检测有助于明确儿童性发育疾病的分型，具有快速检测的优越性，与常规G显带相结合分析有助于儿童性发育疾病的初步诊断。

Abstract:

OBJECTIVE: To investigate the value of direct sequencing of sex-determining region Y (SRY) gene, as well as peripheral blood karyotype analysis, in the diagnosis of disorders of sex development (DSD) among children and adolescents with ambiguous genitalia. METHODS: The karyotypes of 20 children and adolescents with ambiguous genitalia were determined by conventional G-banding analysis. PCR amplification was used to detect SRY gene in these patients, and direct sequencing was used to judge whether there was SRY gene mutation. RESULTS: Of the 20 cases, 17 were positive for SRY gene, and 3 were negative for SRY gene. Direct sequencing revealed no SRY gene mutation in the positive cases, however karyotype analysis found 4 special karyotypes in these patients: 46, XY, del(Y) (q12)/45, X; 46, XY, add(Y) (p11); 46, XY, r(9); 46, XY, 9qh+. CONCLUSIONS: SRY gene detection can help determine the type of DSD among children and has the advantage of quick detection. Used together with G-banding analysis, it is helpful for primary diagnosis of DSD among children.