全基因组测序的临床解释和影响
Frederick E Dewey1, Megan E Grove1, Cuiping Pan2
1Stanford Center for Inherited Cardiovascular Disease, Stanford, California2Stanford Cardiovascular Institute, Stanford, California3Division of Cardiovascular Medicine, Stanford University, Stanford, California4Stanford Center for Genomics and Personalized.
JAMA
|March 13, 2014
概括
全基因组测序 (WGS) 显示不完全覆盖疾病基因和低变异检测可重复性,影响临床效用. 虽然WGS可以找到可操作的遗传变异,但这些局限性需要对其在医学中的使用进行仔细考虑.
科学领域:
- 基因组学就是基因组学.
- 临床医学 临床医学
- 生物信息学是一种生物信息学.
背景情况:
- 全基因组测序 (WGS) 在临床环境中越来越多地使用.
- 预计WGS将识别出临床上显著的遗传发现,无论测序的原因如何.
研究的目的:
- 评估来自WGS的临床相关遗传变异的覆盖范围和一致性.
- 在WGS数据中量化遗传性疾病风险和药物基因组发现.
- 评估由WGS发现引起的临床行动.
主要方法:
- 对12名接受WGS.的成年参与者的探索性研究.
- 多学科团队审查了遗传发现.
- 医生建议基于WGS结果进行临床随访.
主要成果:
- 10-19%的遗传性疾病基因对变异发现的覆盖率不足.
- 对于单核酸变体 (99-100%) 的基因型一致性很高,但对于小插入/删除变体 (53-59%) 却很低.
- 每位参与者发现2-6个疾病风险发现,包括BRCA1变异;每位参与者考虑对1-3个测试/转诊进行临床随访.
结论:
- 在WGS中,遗传性疾病基因的覆盖范围不完全,高影响变异的复制性低.
- 关于WGS.的临床报告发现存在不确定性.
- WGS可以识别可操作的变异,但其临床作用需要仔细考虑当前的局限性.
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