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贝叶斯分析为具有体外剪接结果意义不明确的临床特征的 BRCA1 c.135-1G>T(IVS3-1)和 BRCA2 c.7977-1G>C(IVS17-1)变异体的致病性提供了证据。

Bayes analysis provides evidence of pathogenicity for the BRCA1 c.135-1G>T (IVS3-1) and BRCA2 c.7977-1G>C (IVS17-1) variants displaying in vitro splicing results of equivocal clinical significance.

机构信息

Queensland Institute of Medical Research, Brisbane, Australia.

出版信息

Hum Mutat. 2010 Feb;31(2):E1141-5. doi: 10.1002/humu.21181.

Abstract

Although in vitro splicing assays can provide useful information about the clinical interpretation of sequence variants in high-risk cancer genes such as BRCA1 and BRCA2, results can sometimes be difficult to interpret. The BRCA1 c.135-1G>T (IVS3-1G>T) variant has been shown to give rise to an in-frame deletion of exon 5 (BRCA1 c.135_212del) that is predicted to encode 26 amino acids. BRCA2 c.7977-1G>C (IVS17-1G>C) was shown to increase the expression of two naturally occurring transcripts that contain frameshifts (BRCA2, c.7977_8311del (exon 18 deletion); BRCA2, c.7806_8331del (exon 17&18 deletion)). In this study we conducted multifactorial likelihood analysis to evaluate the clinical significance of these two variants, including assessing variant segregation in families by Bayes analysis, and breast tumor pathology features suggestive of positive mutation status. Multifactorial analysis provided strong evidence for causality for both of these variants. The Bayes scores from a single family with BRCA1 c.135-1G>T was 9528:1, and incorporation of pathology features gave an overall likelihood of causality of 28108:1. The Bayes scores from five informative families with BRCA2 c.7977-1G>C was 47401:1, and the combined Bayes-pathology odds of causality was 29389:1. Multifactorial likelihood analysis indicates that the BRCA1 c.135-1G>T and BRCA2 c.7977-1G>C variants are disease-associated mutations which should be managed clinically in the same fashion as classical truncating mutations.

摘要

虽然体外剪接分析可以为 BRCA1 和 BRCA2 等高危癌症基因中序列变异的临床解释提供有用信息,但结果有时可能难以解释。BRCA1 c.135-1G>T(IVS3-1G>T)变体已被证明会导致外显子 5 的框内缺失(BRCA1 c.135_212del),预计会编码 26 个氨基酸。BRCA2 c.7977-1G>C(IVS17-1G>C)被证明会增加两个自然发生的转录本的表达,这些转录本包含移码(BRCA2,c.7977_8311del(外显子 18 缺失);BRCA2,c.7806_8331del(外显子 17&18 缺失))。在这项研究中,我们进行了多因素似然分析,以评估这两个变体的临床意义,包括通过贝叶斯分析评估家族中的变体分离,以及提示阳性突变状态的乳腺肿瘤病理学特征。多因素分析为这两个变体的因果关系提供了强有力的证据。一个具有 BRCA1 c.135-1G>T 的家族的贝叶斯得分是 9528:1,纳入病理学特征后,因果关系的总似然率为 28108:1。五个具有 BRCA2 c.7977-1G>C 的信息丰富家族的贝叶斯得分是 47401:1,贝叶斯-病理学因果关系的综合比值比为 29389:1。多因素似然分析表明,BRCA1 c.135-1G>T 和 BRCA2 c.7977-1G>C 变体是与疾病相关的突变,应采用与经典截断突变相同的方式进行临床管理。

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