继承性癌症遗传检测后变异重新分类的发生率
Jacqueline Mersch1, Nichole Brown1, Sara Pirzadeh-Miller1
1University of Texas Southwestern Medical Center, Dallas.
JAMA
|September 29, 2018
概括
在遗传性癌症基因检测中,变异重新分类至关重要. 大约24.9%的不确定的变异被重新分类,突出显示了基因测试解释的动态性质.
科学领域:
- 遗传学
- 癌症学
- 临床诊断
背景情况:
- 变种重新分类是遗传性癌症遗传检测的一个关键方面.
- 关于变种重新分类的流行率和模式的数据有限.
- 准确的变种分类对于患者管理和遗传咨询至关重要.
研究的目的:
- 在遗传性癌症遗传检测中量化变异重新分类的频率和类型.
- 评估变种重新分类后修改报告的时间.
- 了解重新分类对临床决策的影响.
主要方法:
- 在2006年至2018年间在商业实验室接受基因检测的145万个人的回顾性队列研究.
- 对初始测试报告和随后因变种重新分类而修改的报告进行分析.
- 将变种分为良性,可能良性,意义不明的变种,可能致病性或致病性类别.
主要成果:
- 总体而言,6. 4%的独特变体被重新分类.
- 病原性或良性变体的重新分类是罕见的 (分别为0. 7%和0. 2%).
- 7. 7% 的不确定的独特变异被重新分类,其中大多数被降级 (91.2%) 和更少的比例被升级 (8.7%).
- 考虑到所有报告的VUS,有24.9%被重新分类,降级的中位时间为1.17年,升级的中位时间为1.86年.
结论:
- 随着时间的推移,很大一部分 (24.9%) 的不确定的变体被重新分类,包括降级和升级.
- 这些发现强调了遗传性癌症遗传学中变异性解释的演变性质.
- 需要进一步的研究来评估这些重新分类的概括性和临床影响.
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