在林奇综合征中预测MLH1和MSH2突变
Judith Balmaña1, David H Stockwell, Ewout W Steyerberg
1Population Sciences Division, Dana-Farber Cancer Institute, and Division of Gastroenterology, Boston, Mass 02115, USA.
JAMA
|September 28, 2006
概括
在风险患者中,MLH1/MSH2基因的林奇综合征突变很常见. 该PREMM(1,2) 模型使用个人和家庭癌症史准确预测突变概率,帮助基因测试策略.
科学领域:
- 遗传学 遗传学 是一个
- 在瘤学瘤学.
- 临床预测建模临床预测建模
背景情况:
- 林奇综合征是一种遗传性癌症倾向,主要是由MLH1和MSH2不匹配修复基因的突变引起的.
- 识别患有林奇综合征的个体对于早期发现和预防相关癌症至关重要.
研究的目的:
- 为了确定MLH1/MSH2突变在接受基因测试的大队伍中的患病率.
- 开发和验证一种临床预测模型 (PREMM(1,2) 用于估计MLH1/MSH2突变的概率.
主要方法:
- 从1914年接受MLH1/MSH2遗传测试的试验者的个人和家庭病史数据的分析.
- 开发一个多变量逻辑回归模型 (PREMM(1,2) 使用898个人的队列,在1016名患者中进行前性验证.
- 该PREMM(1,2) 模型被集成到一个基于网络的工具中,包含癌症和腺瘤史.
主要成果:
- 在MLH1/MSH2中的致病突变在发育队列的14.5%和验证队列的15.3%中被发现.
- 突变的关键预测因素包括个人结直肠或子宫内膜癌史和这些癌症的家族史.
- PREMM(1,2) 模型表现出良好的预测性能,接收器运行特征曲线下的面积为0.80.
结论:
- 个人和家庭病史是MHL1/MSH2突变状况的可靠预测因素,这些突变状况可预测Lynch综合征的风险.
- 普雷姆 (PREMM) 1,2模型为临床医生提供了一个实用的工具,以客观地评估突变可能性并指导分子测试策略.
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