Purpose: Cytogenetic investigations are useful for etiologic determinations of mental retardation, developmental delay, multiple congenital anomalies, and pregnancy complications; however, the causes remain elusive in a majority of cases despite high-resolution cytogenetic studies and multiple fluorescence in situ hybridization examinations. Array-based comparative genomic hybridization has the ability to examine the genome at a higher resolution and may yield an increased detection of genetic abnormalities. The purpose of this study was to assess the use of array-based comparative genomic hybridization in a clinical genetics setting. Methods: DNA from 1176 patients was analyzed using a bacterial artificial chromosome array-based comparative genomic hybridization platform. All abnormal cases were confirmed by fluorescence in situ hybridization and parental studies were completed when possible. Results: Of the 1176 patients included in this survey, 163 showed a genomic imbalance identified by array-based comparative genomic hybridization. Of these 163 cases, 116 had a clinically relevant genetic abnormality. A total of 9.8% (116 of 1176 cases) were determined to exhibit a causative genomic imbalance. Twenty-five of the 116 abnormal cases had a previously identified cytogenetic abnormality yielding an increased detection rate of 7.9% (91 of 1146) in cases with normal or no cytogenetics. Conclusion: Array-based comparative genomic hybridization increases the overall abnormality detection rate, thus improving the diagnostic potential of clinical cytogenetics investigations. Genet Med 2008:10(4):262-266.
Key Words: aCGH, cytogenetics, clinical geneticsMental retardation (MR) and developmental delay (DD) affect a substantial number of children with an estimated frequency of approximately 3%. 1 Cytogenetic investigations are useful for the diagnosis and management of constitutional disorders, including MR, DD, multiple congenital anomalies (MCA), and pregnancy complications because many conditions are associated with unbalanced chromosomal abnormalities. The approaches to identify chromosomal aberrations include traditional high-resolution karyotyping, targeted fluorescence in situ hybridization (FISH) and, more recently, array-based comparative genomic hybridization (aCGH). 2 High-resolution G-banding (650 band level or higher) identifies chromosome alterations in some cases and is still considered the standard initial test because it will detect a variety of balanced chromosomal rearrangements in addition to unbalanced chromosome alterations with resultant deletions and duplications. 3,4 However, the resolution of G-band analysis is limited to approximately 4 Mb and in many cases FISH studies are used to examine specific regions of the genome at a higher resolution. Individual DNA probes specific for chromosome regions associated with microdeletions and a panel of subtelomeric FISH probes are often used to identify submicroscopic interstitial and terminal deletions. Estimates of the number of anomalies detected by su...