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中国儿童脑性瘫痪队列中通过外显子组测序鉴定的基因谱

Genetic Spectrum Identified by Exome Sequencing in a Chinese Pediatric Cerebral Palsy Cohort.

作者信息

Mei Hongfang, Yang Lin, Xiao Tiantian, Wang Sujuan, Wu Bingbing, Wang Huijun, Lu Yulan, Dong Xinran, Yang Hong, Zhou Wenhao

机构信息

Department of Neonatology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China.

Department of Pediatric Endocrinology and Inherited Metabolic Diseases, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China.

出版信息

J Pediatr. 2022 Mar;242:206-212.e6. doi: 10.1016/j.jpeds.2021.11.019. Epub 2021 Nov 14.

Abstract

OBJECTIVE

To explore the genetic spectrum of cerebral palsy (CP) in a Chinese pediatric cohort.

STUDY DESIGN

This was a retrospective observational study of patients with CP from the Children's Hospital of Fudan University between June 2015 and December 2019. Their clinical data and exome sequencing data were collected and analyzed.

RESULTS

A total of 217 patients with CP were enrolled, and genetic variants were identified in 78 subjects (35.9%): 65 patients with single-nucleotide variants (SNVs), 12 patients with copy number variants, and 1 patient with both an SNV and a copy number variant. The genetic diagnosis rates were significantly greater in patients without clinical risk factors than in patients with clinical risk factors (χ = 21.705, P = .000) and were significantly greater in patients with a family history than in those without a family history (χ = 4.493, P = .034). Variants in genes related to neurologic disorders were the most commonly detected variants, affecting 41 patients (62.1%, 41/66). Among the patients with SNVs detected, the top 12 genes were found to cover 62.1% (41/66) of cases, and 39.4% (26/66) of patients with SNVs had medically actionable genetic findings.

CONCLUSIONS

The overall genetic diagnostic rate in this study was 35.9%, and patients without any clinical risk factors or with a family history were more likely to have genetic risk factors. The top 12 genes detected in this study as well as genes related to neurologic disorders or other medically actionable disorders should be noted in the analysis of genetic testing results in patients with CP.

摘要

目的

探索中国儿科队列中脑瘫(CP)的基因谱。

研究设计

这是一项对2015年6月至2019年12月期间复旦大学附属儿科医院CP患者的回顾性观察研究。收集并分析了他们的临床数据和外显子测序数据。

结果

共纳入217例CP患者,78例(35.9%)鉴定出基因变异:65例单核苷酸变异(SNV)患者,12例拷贝数变异患者,1例同时存在SNV和拷贝数变异。无临床风险因素患者的基因诊断率显著高于有临床风险因素患者(χ = 21.705,P = .000),有家族史患者的基因诊断率显著高于无家族史患者(χ = 4.493,P = .034)。与神经障碍相关基因的变异是最常检测到的变异,影响41例患者(62.1%,41/66)。在检测到SNV的患者中,前12个基因涵盖62.1%(41/66)的病例,39.4%(26/66)的SNV患者有医学上可采取行动的基因发现。

结论

本研究中总体基因诊断率为35.9%,无任何临床风险因素或有家族史的患者更可能有基因风险因素。在分析CP患者的基因检测结果时,应注意本研究中检测到的前12个基因以及与神经障碍或其他医学上可采取行动的疾病相关的基因。

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