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Ji X, Li J, Huang Y, Sung PL, Yuan Y, Liu Q, Chen Y, Ju J, Zhou Y, Huang S, Chen F, Han Y, Yuan W, Fan C, Zhao Q, Wu H, Feng S, Liu W, Li Z, Chen J, Chen M, Yao H, Zeng L, Ma T, Fan S, Zhang J, Yuen KY, Cheng SH, Chik IWS, Liu NT, Zhu J, Lin S, Cao J, Tong S, Shan Z, Li W, Hekmat MR, Garshasbi M, Suela J, Torres Y, Cigudosa JC, Ruiz FJP, Rodríguez L, García M, Bernik J, Traven E, Reš U, Tul N, Tseng CF, Zhao D, Sun L, Pan Q, Shen L, Dai M, Wang Y, Wang J, Yang H, Yin Y, Duan T, Zhu B, Choolani M, Jin X, Chen Y, Mao M. Identifying occult maternal malignancies from 1.93 million pregnant women undergoing noninvasive prenatal screening tests. Genet Med 2019; 21:2293-2302. [PMID: 30976098 DOI: 10.1038/s41436-019-0510-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 03/25/2019] [Indexed: 12/28/2022] Open
Abstract
PURPOSE Multiple chromosomal aneuploidies may be associated with maternal malignancies and can cause failure of noninvasive prenatal screening (NIPS) tests. However, multiple chromosomal aneuploidies show poor specificity and selectivity for diagnosing maternal malignancies. METHODS This multicenter retrospective analysis evaluated 639 pregnant women who tested positive for multiple chromosomal aneuploidies on initial NIPS test between January 2016 and December 2017. Women were assessed using genome profiling of copy-number variations, which was translated to cancer risk using a novel bioinformatics algorithm called the cancer detection pipeline (CDP). Sensitivity, specificity, and positive predictive value (PPV) of diagnosing maternal malignancies were compared for multiple chromosomal aneuploidies, the CDP model, and the combination of CDP and plasma tumor markers. RESULTS Of the 639 subjects, 41 maternal malignant cancer cases were diagnosed. Multiple chromosomal aneuploidies predicted maternal malignancies with a PPV of 7.6%. Application of the CDP algorithm to women with multiple chromosomal aneuploidies allowed 34 of the 41 (83%) cancer cases to be identified, while excluding 422 of 501 (84.2%) of the false positive cases. Combining the CDP with plasma tumor marker testing gave PPV of 75.0%. CONCLUSION The CDP algorithm can diagnose occult maternal malignancies with a reasonable PPV in multiple chromosomal aneuploidies-positive pregnant women in NIPS tests. This performance can be further improved by incorporating findings for plasma tumor markers.
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Affiliation(s)
- Xing Ji
- Center for Clinical Genetics, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, China.,Department of Genetics, Shanghai Institute for Pediatric Research, Shanghai, China
| | - Jia Li
- BGI Genomics, BGI-Shenzhen, Shenzhen, Guangdong, China
| | - Yonghua Huang
- Department of Obstetrics and Gynecology, Jiangmen Central Hospital, Affiliated Jiangmen Hospital of Sun Yat-Sen University, Jiangmen, Guangdong, China
| | - Pi-Lin Sung
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Obstetrics and Gynecology, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yuying Yuan
- BGI Genomics, BGI-Shenzhen, Shenzhen, Guangdong, China
| | - Qiang Liu
- BGI Genomics, BGI-Shenzhen, Shenzhen, Guangdong, China
| | - Yan Chen
- BGI Genomics, BGI-Shenzhen, Shenzhen, Guangdong, China
| | - Jia Ju
- BGI Genomics, BGI-Shenzhen, Shenzhen, Guangdong, China
| | - Yafeng Zhou
- BGI Genomics, BGI-Shenzhen, Shenzhen, Guangdong, China
| | - Shujia Huang
- BGI Genomics, BGI-Shenzhen, Shenzhen, Guangdong, China
| | - Fang Chen
- BGI Genomics, BGI-Shenzhen, Shenzhen, Guangdong, China
| | - Yuan Han
- BGI-Wuhan, BGI-Shenzhen, Wuhan, Guangdong, China
| | - Wen Yuan
- BGI-Wuhan, BGI-Shenzhen, Wuhan, Guangdong, China
| | - Cheng Fan
- BGI Genomics, BGI-Shenzhen, Shenzhen, Guangdong, China
| | - Qiang Zhao
- Department of Obstetrics and Gynecology, Jiangmen Central Hospital, Affiliated Jiangmen Hospital of Sun Yat-Sen University, Jiangmen, Guangdong, China
| | - Haitao Wu
- Reproductive Medicine Center, Jiangmen Central Hospital, Affiliated Jiangmen Hospital of Sun Yat-Sen University, Jiangmen, Guangdong, China
| | - Suihua Feng
- Department of Obstetrics and Gynecology, Jiangmen Central Hospital, Affiliated Jiangmen Hospital of Sun Yat-Sen University, Jiangmen, Guangdong, China
| | - Weiqiang Liu
- Key Laboratory for Major Obstetric Diseases of Guangdong, Key Laboratory for Reproduction and Genetics of Guangdong Higher Education Institutes, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Zhihua Li
- Department of Prenatal Diagnosis and Fetal Medicine, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jingsi Chen
- Department of Prenatal Diagnosis and Fetal Medicine, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Min Chen
- Department of Prenatal Diagnosis and Fetal Medicine, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Hong Yao
- Prenatal Diagnosis Center, Southwest Hospital, Chongqing, China
| | - Li Zeng
- Department of Obstetrics and Gynecology, Bazhong Central Hospital, Bazhong, Sichuan, China
| | - Tao Ma
- Department of Obstetrics and Gynecology, Sichuan Provincial People's Hospital, Chengdu, Sichuan, China
| | - Shushu Fan
- Genetic Diagnosis Center and Reproductive Center, Yue Bei People's Hospital, Shaoguan, Guangdong, China
| | - Jinman Zhang
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, Yunnan, China.,Genetic Diagnosis Center, First People's Hospital of Yunnan, Kunming, Yunnan, China
| | | | | | | | | | - Jianyu Zhu
- BGI Genomics, BGI-Shenzhen, Shenzhen, Guangdong, China
| | | | | | | | | | - Wenyan Li
- BGI Genomics, BGI-Shenzhen, Shenzhen, Guangdong, China
| | | | - Masoud Garshasbi
- Department of Medical Genetics, DeNA laboratory, Tehran, Iran.,Department of Medical Genetics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | | | | | | | - F J Pérez Ruiz
- Servicio de Ginecología y Obstetricia, Hospital General San Jorge, Huesca, Spain
| | - Laura Rodríguez
- Laboratorio de Genética Molecular AbaCid, Hospitales HM, Madrid, Spain
| | - Mónica García
- Laboratorio de Genética Molecular AbaCid, Hospitales HM, Madrid, Spain
| | | | | | - Uršula Reš
- Dravlje Health Center-IVF, Ljubljana, Slovenia
| | - Nataša Tul
- Division of Obstetrics and Gynecology, Department of Perinatology, University Medical Centre, Ljubljana, Slovenia
| | | | - Depeng Zhao
- Department of Prenatal Diagnosis and Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Luming Sun
- Department of Prenatal Diagnosis and Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Qiong Pan
- Laboratory of Clinical Genetics, Huai'an Maternity and Child Health Care Hospital of Jiangsu Province, Yangzhou University, Huai'an, Jiangsu, China
| | - Li Shen
- Department of Pathology, Shanghai Pu Nan Hospital, Shanghai, China
| | - Mengyao Dai
- Center for Clinical Genetics, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, China.,Department of Genetics, Shanghai Institute for Pediatric Research, Shanghai, China
| | - Yuying Wang
- BGI Genomics, BGI-Shenzhen, Shenzhen, Guangdong, China
| | - Jian Wang
- BGI Genomics, BGI-Shenzhen, Shenzhen, Guangdong, China.,James D. Watson Institute of Genome Sciences, Hangzhou, Zhejiang, China
| | - Huanming Yang
- BGI Genomics, BGI-Shenzhen, Shenzhen, Guangdong, China.,James D. Watson Institute of Genome Sciences, Hangzhou, Zhejiang, China
| | - Ye Yin
- BGI Genomics, BGI-Shenzhen, Shenzhen, Guangdong, China.,Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | - Tao Duan
- Department of Prenatal Diagnosis and Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Baosheng Zhu
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, Yunnan, China.,Genetic Diagnosis Center, First People's Hospital of Yunnan, Kunming, Yunnan, China
| | - Mahesh Choolani
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Xin Jin
- BGI Genomics, BGI-Shenzhen, Shenzhen, Guangdong, China. .,School of Medicine, South China University of Technology, Guangzhou, Guangdong, China. .,BGI-Guangzhou Medical Laboratory, BGI-Shenzhen, Guangzhou, Guangdong, China.
| | - Yingwei Chen
- Center for Clinical Genetics, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, China.
| | - Mao Mao
- BGI Genomics, BGI-Shenzhen, Shenzhen, Guangdong, China.
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