Pfundt Rolph, Kwiatkowski Kat, Roter Alan, Shukla Anju, Thorland Eric, Hockett Richard, DuPont Barbara, Fung Eric T, Chaubey Alka
Radboud University Medical Center, Nijmegen, The Netherlands.
Affymetrix, Inc., Santa Clara, California, USA.
Genet Med. 2016 Feb;18(2):168-73. doi: 10.1038/gim.2015.51. Epub 2015 Apr 16.
The prevalence of developmental disabilities in the United States is reported to be 13.87% across all racial, ethnic, and socioeconomic groups. Microarrays have been recommended as first-tier tests for these patients. This study reports the diagnostic yield and potential actionability of findings using a high-density chromosomal microarray (CMA).
The diagnostic yield of CytoScan Dx Assay in 960 patients was assessed with the Riggs criteria of actionability to evaluate predicted clinical utility.
Eighty-six percent of the subjects were assessed using a microarray as part of historical routine patient care (RPC). The rate of pathogenic findings was similar between RPC (13.3%) and the CytoScan Dx Assay (13.8%). Among the 138 patients who did not receive microarray as RPC, the diagnostic yield for CytoScan Dx Assay was 23.9% as compared with 14.5%, indicating a 9.4% improvement when using higher-resolution methods. Thirty-five percent of patients with abnormal findings had predicted clinical management implications.
This is the first study to assess the clinical performance of CytoScan Dx Assay. The assay's diagnostic yields are similar to those found in other studies of CMAs. Thirty-five percent of patients with abnormal findings are predicted to have clinical management implications that may improve health outcomes.
据报道,在美国所有种族、族裔和社会经济群体中,发育障碍的患病率为13.87%。微阵列已被推荐作为这些患者的一线检测方法。本研究报告了使用高密度染色体微阵列(CMA)的诊断率及发现结果的潜在可操作性。
采用里格斯可操作性标准评估CytoScan Dx检测法在960例患者中的诊断率,以评估预测的临床实用性。
86%的受试者使用微阵列作为历史常规患者护理(RPC)的一部分进行评估。RPC组(13.3%)和CytoScan Dx检测法组(13.8%)的致病发现率相似。在138例未将微阵列作为RPC接受检测的患者中,CytoScan Dx检测法的诊断率为23.9%,而RPC组为14.5%,这表明使用更高分辨率方法时诊断率提高了9.4%。35%的异常发现患者预计会对临床管理产生影响。
这是第一项评估CytoScan Dx检测法临床性能的研究。该检测法的诊断率与其他CMA研究中的结果相似。预计35%的异常发现患者会对临床管理产生影响,这可能改善健康结局。