Clinical application of KASP-based RHCE genotyping in RhD-positive patients
10.13303/j.cjbt.issn.1004-549x.2026.05.004
- VernacularTitle:采用KASP技术进行RhD阳性患者RHCE基因分型的临床应用研究
- Author:
Xiaoyu LIAN
1
;
Mengdan LI
2
;
Xiaoyu GUAN
2
;
Li TIAN
1
;
Chenying WANG
1
;
Di WU
2
;
Tianqiong LUO
2
;
Xiaolin DU
1
;
Xin JI
1
;
Haixia XU
1
;
Jue WANG
1
;
Ling LI
2
;
Zhong LIU
1
Author Information
1. Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu 610052, China; Key Laboratory of Transfusion Adverse Reactions, Chinese Academy of Medical Sciences, Chengdu 610052, China
2. Department of Blood Transfusion, The Third People's Hospital of Chengdu (Affiliated Hospital of Southwest Jiaotong University), School of Medicine, Southwest Jiaotong University, Chengdu 610031, China
- Publication Type:Journal Article
- Keywords:
RHCE;
genotyping;
kompetitive allele-specific PCR;
blood group antigens
- From:
Chinese Journal of Blood Transfusion
2026;39(5):596-602
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To develop a RHCE genotyping assay based on kompetitive allele-specific PCR (KASP) and assess its clinical accuracy for RhCE blood group determination. Methods: KASP primers were designed to interrogate three RHCE loci: the 109 bp insertion/deletion in intron 2, c. 307T>C, and c. 676C>G. A total of 1 194 RhD-positive inpatients from Chengdu were typed by both KASP genotyping and manual tube serology. Discordant samples (n=10) were retested by both methods and further resolved by Sanger sequencing. An additional 377 cases were tested for the c. 48C>G locus to evaluate the predictive accuracy of individual loci and combined locus testing for RhC antigen. Results: Genotyping concordance with serology was 100.0% for both the c. 676C>G locus (RhE/Rhe) and the c. 307T>C locus (Rhc). For RhC prediction using the 109 bp insertion, overall accuracy was 99.7% (1 191/1 194); the 3 discordant cases were confirmed by Sanger sequencing to be false negatives attributable to 109 bp deletion in intron 2. Testing the c. 48C>G allele for RhC prediction yielded 7 false positives, with an accuracy of 98.1% (370/377). RhC antigen status was determined by combining the 109 bp insertion and the c. 48C allele. After excluding 10 samples with inconsistent results between the two loci, the accuracy reached 100% in the remaining 367 samples. When both loci were applied in combination, accuracy reached 100% in the 367 cases with concordant results. Among the 1 194 patients, CCee (45.8%) and CcEe (31.7%) were the most common RhCE phenotypes. The e antigen had the highest positivity rate (92.2%), and the Ce haplotype was the most frequent (66.9%). Conclusion: The KASP-based RHCE genotyping method achieves high accuracy for clinical RhCE typing. Combining the 109 bp insertion/deletion with the c. 48C allele significantly improves RhC antigen prediction compared with either locus alone. This method was applied to RhCE genotyping of 1 194 RhD-positive inpatients in Chengdu, providing local RhCE phenotype and haplotype distribution data to support RhCE-matched transfusion practice.
