Department of Clinical Genetics, United Laboratories, Tartu University Hospital, Tartu, Estonia.
Department of Clinical Genetics, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia.
Clin Genet. 2018 Jan;93(1):78-83. doi: 10.1111/cge.13031. Epub 2017 Aug 21.
In addition to whole exomes, large gene panels of clinically associated genes are used as high-throughput sequencing tests in many clinical centers, but their clinical utility has been much less investigated.
Here we report the results of the 501 first unselected cases for whom TruSight One panel (Illumina Inc., San Diego, California) was sequenced as a clinical diagnostic test for a variety of indications in our department. The analysis was restricted to virtual subpanels based on referral forms, where doctors were asked to list candidate genes or select one from predefined larger panels.
A probable or definite pathogenic finding was reported in 26.3% of cases. In 238 samples for whom 1 to 9 genes were requested for analysis, the diagnostic yield was significantly higher compared to other 263 cases for whom larger subpanels were requested (31.5% vs 21.7%, respectively, P = .016). Detected mutations included single nucleotide variants, small insertions and deletions, and larger copy number variants. Out of 157 reported mutations, 67 were previously undescribed.
The clinical utility of large gene panel sequencing in the context of other genetic diagnostic tests is discussed in detail.
除了全外显子组测序外,许多临床中心还将包含大量临床相关基因的大型基因面板用作高通量测序检测,但对其临床应用的研究要少得多。
本研究报告了我们科室对 501 例未经选择的患者进行 TruSight One 基因panel(Illumina Inc.,圣地亚哥,加利福尼亚州)测序的结果,这些患者的各种适应证均作为临床诊断检测。分析仅限于基于转诊表的虚拟子panel,医生会被要求列出候选基因或从预先定义的较大面板中选择一个。
报告了 26.3%的疑似或明确致病性发现。在 238 例要求分析 1 至 9 个基因的样本中,诊断率明显高于其他 263 例要求分析更大子panel的样本(分别为 31.5%和 21.7%,P=0.016)。检测到的突变包括单核苷酸变异、小插入和缺失以及较大的拷贝数变异。在报告的 157 个突变中,有 67 个是以前未描述的。
详细讨论了大型基因面板测序在其他遗传诊断检测背景下的临床应用。