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터너 증후군에서 FISH (Fluorescence in Situ Hybridization)법을 이용한 숨겨진 Y 염색체의 존재 유무 및표적 염색체의 기원 규명

Hidden Y Chromosome and Marker Chromosome Identification by FISH (Fluorescence in Situ Hybridization) in Turner Syndrome

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주제분류산부인과학

초록

목적 : 본 연구에서는 핵형 검사상 터너 증후군과 표적 염색체를 보인 터너 증후군 환자에서 분자 유전학적 검사 방법인 FISH을 이용하여 표적 염색체의 기원 및 숨겨진 Y 염색체의 존재 유무를 밝힘으로써 이의 임상적 유용성을 검토하였다. 연구 방법 : 연구 대상은 저신장과 성적 유치증으로 연세대학교 의과대학 부속 신촌세브란스병원을 방문하여 세포 유전학 검사로 핵형 분석 결과 터너 증후군과 기원을 알 수 없는 표적 염색체를 함유한 터너 증후군 25명을 대상으로 FISH법을 시행하였다. 결과 : 총 25명 중 9명은 45,X, 7명은 45,X/46,XX인 모자이시즘이었고 나머지 9명은 45,X/46,X,+mar인 모자이시즘이였다. 분자 유전학적 방법인 FISH 를 이용하여 9명 모두에서 표적 염색체의 기원을 알 수 있었고 Y 염색체에서 유래된 경우가 9명 중 5명으로 SRY 유전자를 발견할 수 있었다. 나머지 16명을 대상으로 FISH를 시행하였으나 숨겨진 Y 염색체는 발견하지 못했다. 결론 : 터너 증후군에서 표적 염색체의 기원을 밝히는 것은 환자에게 정확한 진료와 치료면에서도 성선제거술 등 적극적 치료를 가능케 하는 지침이 될 수 있어 빠르고 민감도가 높은 FISH법을 이용한 검사가 임상적으로 매우 유용하다고 사료된다.

Abstract

Objective : To assess the effectiveness of hidden Y chromosome and marker chromosome identification by FISH (Fluorescence in Situ Hybridization) in Turner syndrome. Methods : Data was collected retrospectively from 25 patients with or without marker chromosome confirmed Turner syndrome by chromosomal study in Department of Obstetrics and Gynecology, Yonsei University Medical Center. FISH was performed on all patients for hidden Y chromosome and marker chromosome identification. Results : FISH showed the origin of marker chromosome in 9 patients whose karyotypes were 45,X/ 46,X+mar, 5 patients were positive for SRY gene. Of 16 patients whose karyotypes were 45,X or 45,X/46,XX, there was no hidden Y chromosome indentification by FISH. Conclusion : FISH for marker chromosome identification in Turner syndrome is a rapid and effective procedure. But to enable widespread use of hidden Y chromosome identification by FISH in Turner syndrome, further studies involving many cases are warranted.

참고문헌 (22)

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