Shearer A Eliot, Smith Richard J H
Department of Otolaryngology-Head and Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
Department of Otolaryngology-Head and Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA Interdepartmental PhD Program in Genetics, University of Iowa, Iowa City, Iowa, USA Department of Molecular Physiology & Biophysics, University of Iowa College of Medicine, Iowa City, Iowa, USA
Otolaryngol Head Neck Surg. 2015 Aug;153(2):175-82. doi: 10.1177/0194599815591156. Epub 2015 Jun 17.
To evaluate the use of new genetic sequencing techniques for comprehensive genetic testing for hearing loss.
Articles were identified from PubMed and Google Scholar databases using pertinent search terms.
Literature search identified 30 studies as candidates that met search criteria. Three studies were excluded, and 8 studies were found to be case reports. Twenty studies were included for review analysis, including 7 studies that evaluated controls and 16 studies that evaluated patients with unknown causes of hearing loss; 3 studies evaluated both controls and patients.
In the 20 studies included in the review analysis, 426 control samples and 603 patients with unknown causes of hearing loss underwent comprehensive genetic diagnosis for hearing loss using massively parallel sequencing. Control analysis showed a sensitivity and specificity >99%, sufficient for clinical use of these tests. The overall diagnostic rate was 41% (range, 10%-83%) and varied based on several factors, including inheritance and prescreening prior to comprehensive testing. There were significant differences in platforms available with regard to the number and type of genes included and whether copy number variations were examined. Based on these results, comprehensive genetic testing should form the cornerstone of a tiered approach to clinical evaluation of patients with hearing loss along with history, physical examination, and audiometry and can determine further testing that may be required, if any.
Comprehensive genetic testing has become the new standard of care for genetic testing for patients with sensorineural hearing loss.
评估使用新的基因测序技术进行听力损失综合基因检测的情况。
使用相关检索词从PubMed和谷歌学术数据库中识别文章。
文献检索确定了30项符合检索标准的候选研究。排除3项研究,发现8项研究为病例报告。纳入20项研究进行综述分析,其中7项研究评估了对照,16项研究评估了病因不明的听力损失患者;3项研究同时评估了对照和患者。
在纳入综述分析的20项研究中,426份对照样本和603例病因不明的听力损失患者使用大规模平行测序技术进行了听力损失的综合基因诊断。对照分析显示敏感性和特异性>99%,足以用于这些检测的临床应用。总体诊断率为41%(范围为10%-83%),并因多种因素而异,包括遗传方式和综合检测前的预筛查。在可用平台方面,所包含基因的数量和类型以及是否检测拷贝数变异存在显著差异。基于这些结果,综合基因检测应成为对听力损失患者进行临床评估的分层方法的基石,同时结合病史、体格检查和听力测定,并可确定是否可能需要进一步检测。
综合基因检测已成为感音神经性听力损失患者基因检测的新护理标准。