"洞"外体序列:表型化的重要性,以填补整个外体序列的空白
R Colin McNamara1, Sidney Zven1, David E Horvat2
1Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, Maryland.
Pediatric neurology
|January 3, 2024
概括
整个外体序列测序 (WES) 可以错过明显症状的患者的遗传诊断. 依赖患者病史和体检对于选择正确的基因检测至关重要,以避免诊断延迟.
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
- 医学研究 医学研究
背景情况:
- 整体外基因组测序 (WES) 是诊断具有多种症状的遗传疾病的常见工具.
- 负WES结果并不排除遗传原因.
- 临床评估,包括患者病史和体检,对于指导遗传测试选择至关重要.
研究的目的:
- 要突出整体外体序列测序 (WES) 的局限性.
- 强调临床评估在遗传诊断中的重要性.
- 为复杂病例提出一个改进的诊断算法.
主要方法:
- 一系列病例报告了三名具有可识别表型的患者.
- 患者出现了包括雷特综合征,神经病变/缺氧/色素视网膜炎和马赛克细分父单亲异构14在内的疾病.
- 所有患者都接受了整体外体测序 (WES) 测序,结果没有诊断.
主要成果:
- 尽管有不同的表型,但由于不适当的初始遗传检测,患者经历了诊断延迟.
- 该研究发现,仅依靠WES进行诊断存在局限性.
- 临床表现是确定潜在的遗传诊断的关键,这些诊断被WES遗漏了.
结论:
- 整体外体测序 (WES) 有局限性,即使有明显的临床症状,也可以产生非诊断结果.
- 精确选择基因检测,以患者病史和体检为指导,对于及时诊断至关重要.
- 对于具有不确定的临床表现的患者,建议采用结构化诊断方法,以优化遗传检测策略.
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