乳腺癌在植入前基因检测中罕见和常见变异的临床影响
Todd Lencz1,2,3, Upasana Bhattacharyya4,5, Liraz Klausner6
1Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA. tlencz@northwell.edu.
NPJ genomic medicine
|January 7, 2026
概括
对于乳腺癌风险的植入前遗传测试需要仔细考虑. 标准检测可能会错过较低风险的胚胎,当多基因风险得分较高时,特别是适度透基因.
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对乳腺癌 (BC) 风险变异的单一性疾病 (PGT-M) 的植入前遗传测试.
- 多基因风险评分 (PRS) 也在植入前胚胎查中使用.
研究的目的:
- 使用PRS评估胚胎选择中的潜在错误,而不考虑单一的状态.
- 评估中等透度变体的PGT-M是否可能由于未评估的升高PRS而存在错误.
主要方法:
- 使用了模拟和正式的数学方法.
- 分析的重点是高透率变异 (BRCA1,BRCA2,PALB2) 和中等透率变异.
主要成果:
- 高透性变异 (BRCA1,BRCA2,PALB2) 显示了与非载体不同的风险分布,不论PRS.
- 对于中度透基因,标准PGT-M错误地未能在约5%的病例中选择最低风险的胚胎,原因是PRS升高.
结论:
- 使用PRS进行胚胎选择可能会产生错误的结果,如果不考虑单一的载体身份.
- 对于中等透度变体的PGT-M可能有缺陷,如果没有评估PRS的升高.
- 在适度透变异或在植入前遗传测试中使用PGT-M时建议谨慎使用PRS.
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