在患有GDD/iD的儿童中,外基因组测序和染色体微阵列的诊断和临床实用性:元分析
Maliwan Tengsujaritkul1, Orawan Louthrenoo1, Narueporn Likhitweerawong1
1Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Annals of medicine
|December 31, 2025
概括
整体外基因组测序 (WES) 为全球发育迟缓/智力障碍 (GDD/ID) 提供了比染色体微组 (CMA) 更高的诊断产量. 推WES作为一线基因测试,用于儿童无法解释的GDD/ID.
科学领域:
- 遗传学 是一个遗传学.
- 神经发育障碍 神经发育障碍
- 诊断实用工具 诊断实用工具 诊断实用工具
背景情况:
- 全球发育迟缓/智力障碍 (GDD/ID) 是一种常见的神经发育障碍,具有显著的遗传贡献.
- 染色体微阵列 (CMA) 一直是标准的遗传测试,但新的方法显示出希望.
- 全外体测序 (WES) 和全基因组测序 (WGS) 正在成为诊断GDD/ID的强大工具.
研究的目的:
- 为了比较WES和CMA在患有GDD/ID的儿童的诊断效用.
- 评估WES和CMA在确定GDD/ID的遗传原因方面的有效性.
- 为临床实践提供关于GDD/ID最佳遗传测试策略的信息.
主要方法:
- 在主要数据库 (PubMed,Scopus,EMBASE,Cochrane图书馆) 进行了全面的文献搜索.
- 分析了102项涉及55,752名患有GDD/ID的儿童的研究.
- 使用元分析和元回归来汇集诊断产量并确定影响因素.
主要成果:
- 整体外基因组测序 (WES) 与CMA (0.19) 相比,显示出明显更高的综合诊断产量 (0.37).
- 在同样样本 (OR=2.27) 和不同样本 (OR=1.65) 的比较中,WES显示出更高的诊断率.
- 在隔离的GDD/ID和具有并发症的GDD/ID之间,没有发现诊断实用性的显著差异.
结论:
- 整体外体序列 (WES) 与CMA相比,对于不明原因的GDD/ID提供了优越的诊断和临床实用性.
- 应将WES视为GDD/ID遗传评估的第一线调查.
- 这一发现支持将WES纳入神经发育障碍的标准诊断方案.
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