基因组测序作为罕见疾病的通用诊断策略
Gaby Schobers1,2, Ronny Derks1, Amber den Ouden1
1Department of Human Genetics, Radboudumc, Nijmegen, Netherlands.
Genome medicine
|February 14, 2024
概括
基因组测序 (GS) 可以有效诊断遗传和先天性疾病,可能取代多个遗传测试工作流程. 对于大多数罕见疾病诊断来说,GS-first策略是可行的,提高了效率并减少了假阴性.
科学领域:
- 基因组学和遗传学 基因组学和遗传学
- 医学诊断 医学诊断 医学诊断
- 生物信息学是一种生物信息学.
背景情况:
- 遗传实验室目前在诊断遗传和先天性疾病方面采用了多种不同的工作流程,包括型和外体序列测序.
- 一个统一的,高通量的工作流可以显著提高诊断效率.
- 这项研究调查了基因组测序 (GS) 的潜力,以取代现有的生殖基因诊断在罕见疾病的生殖基因诊断工作流.
研究的目的:
- 评估基因组测序 (GS) 的诊断有效性,以取代传统的遗传测试工作流程.
- 在罕见疾病的临床诊断环境中确定"GS-first战略"的可行性.
- 为了评估各种变种类型的检测率,使用短读GS.
主要方法:
- 在1000个已知临床相关变异的1271个病例中进行了短读基因组测序 (GS).
- 分类变体为小 (SNVs,indels <50 bp),大 (CNVs,STRs) 和其他 (SVs,动脉突变).
- 模拟了2022年24,570名个人的GS-first诊断场景,评估诊断疗效和假阴性率.
主要成果:
- 总体变种检测率为95%,小变种为96%,大变种为93%,其他变种为87%.
- 10个工作流中的7个工作流显示了GS的替代潜力,真正的积极率在79%到100%之间.
- 预计GS-first策略在84.9%的临床转诊中是可行的,覆盖71%的所有个人,估计假阴性率为0.3%.
结论:
- 基因组测序 (GS) 显示出捕获临床相关的生殖系变异的巨大潜力.
- 在基因诊断实验室内,对于大多数临床指标来说",GS-first策略"是可行的.
- 实施GS作为主要诊断测试可以简化罕见病诊断,提高实验室效率.
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