乳腺癌前植入遗传检测中罕见和常见变异的临床影响
Todd Lencz1,2,3, Upasana Bhattacharyya1,2, Liraz Klausner4
1Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA.
medRxiv : the preprint server for health sciences
|November 24, 2025
概括
对于中度乳腺癌风险变体的植入前遗传测试 (PGT-M) 可能会产生不准确的结果,当不考虑多基因风险得分 (PRS) 时. 在胚胎选择中需要对PGT-M和PRS进行仔细评估.
科学领域:
- 生殖遗传学 生殖遗传学
- 基因组风险评估 基因组风险评估
- 在瘤学瘤学.
背景情况:
- 诊所越来越多地使用单一性疾病 (PGT-M) 的植入前遗传测试,用于中度乳腺癌 (BC) 风险变异.
- 与此同时,多基因风险评分 (PRS) 正在用于植入前胚胎查.
研究的目的:
- 用PRS评估胚胎选择中的潜在错误,而不考虑单一载体的身份.
- 评估中等透度变体的PGT-M是否可能受到未经评估的升高PRS的缺陷.
主要方法:
- 使用模拟和正式的数学建模.
- 分析的重点是单一基因变异 (BRCA1,BRCA2,PALB2) 和PRS之间的相互作用.
- 在不同的PRS场景下,对运营商和非运营商之间的风险分布进行了比较.
主要成果:
- 对于高透率变体 (BRCA1,BRCA2,PALB2),风险分布与非载体不同,不论PRS.
- 对于中度透基因的标准PGT-M可以错误地绕过最低风险的胚胎大约5%的时间,由于PRS升高.
结论:
- 适度透变异的PGT-M与PRS之间的相互作用使胚胎选择复杂化.
- 在仅用于中度透变异的PGT-M或在植入前遗传测试中完全依赖PRS时,建议谨慎使用.
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