在多基因小组和基因组测试中报告的VUS景观:改变的时候到了
Heidi L Rehm1, Joseph T Alaimo2, Swaroop Aradhya3
1Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA; Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA; Pathology, Harvard Medical School, Boston, MA.
诊断基因测试显示,外体和基因组测序 (ES/GS) 产生不确定的意义 (VUS) 的变异比多基因面板 (MGP) 更少. 需要制定战略来降低VUS的发病率,并改善临床解释.
科学领域:
- 遗传学 是一个遗传学.
- 临床诊断 临床诊断 临床诊断
背景情况:
- 不确定意义的变异 (VUS) 在遗传测试中很常见.
- VUS可能导致误解,增加成本和临床医生的负担.
研究的目的:
- 在使用多基因组 (MGP) 和外基因组/基因组测序 (ES/GS) 的诊断基因测试中调查VUS的发病率.
- 探索减少不确定的遗传测试结果影响的方法.
主要方法:
- 分析了来自19个北美临床实验室的150多万个测序测试结果 (2020-2021).
- 在MGP和ES/GS之间比较VUS率.
- 评估了小组规模和三组分析对VUS费率的影响.
主要成果:
- 在ES/GS中,VUS的发病率比MGP (32.6%) 低 (22.5%).
- MGP VUS率与面板大小相关.
- 三组分析降低了VUS率 (18.9%与27.6%相比),而基因组测序 (GS) 与外基因组测序 (ES) 没有显著差异.
结论:
- 在MGP测试中高VUS率需要审查报告实践.
- 拟议的方法旨在减少报告的VUS,并优化临床医生专注于重大发现.
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