在遗传性疾病遗传检测中具有不确定的意义的变异的发生率和分类
Elaine Chen1, Flavia M Facio1, Kerry W Aradhya1
1Invitae Corporation, San Francisco, California.
JAMA network open
|October 25, 2023
概括
不确定意义的变异 (VUSs) 在遗传测试中很常见. 这项研究分析了160万个人,发现VUS的发病率因人口和年龄而异,大多数VUS被重新归类为良性.
科学领域:
- 基因组医学是基因组医学.
- 临床遗传学 临床遗传学
- 生物信息学是一种生物信息学.
背景情况:
- 不确定意义的变异 (VUSs) 在临床遗传测试中存在挑战,阻碍了诊断和患者管理.
- 需要进行全面的评估,以了解VUS并减少诊断不确定性.
研究的目的:
- 描述VUS来源,基因分布和人口属性.
- 评估证据类型对VUS重新分类的影响.
主要方法:
- 对1689,845名接受遗传性疾病诊断基因检测的人进行了队列研究.
- 从2014年9月到2022年9月的生殖基因DNA变体数据的分析.
- 根据人口统计,基因组和变异属性对VUS率的分层.
主要成果:
- 41.0%的人至少有一次VUS; 31.7%的人只有VUS结果.
- 在非欧洲人群中,中年/老年人群中,以及不完全穿透的疾病中,VUS的发病率更高.
- 在重新分类的VUS中,80.2%最终是良性的;临床证据是重新分类的关键.
结论:
- 这项研究强调了需要改进误解变异解释方法和更多多样化的基因组数据.
- 增强的临床和实验证据对于准确的变种分类至关重要.
- 这些发现为了解VUS和指导患者护理策略提供了基础.
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