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基于Panel的新一代测序与临床发现相结合在中国患者先天性晶状体异位诊断中的应用

Combination of Panel-based Next-Generation Sequencing and Clinical Findings in Congenital Ectopia Lentis Diagnosed in Chinese Patients.

作者信息

Chen Tian-Hui, Chen Ze-Xu, Zhang Min, Chen Jia-Hui, Deng Michael, Zheng Jia-Lei, Lan Li-Na, Jiang Yong-Xiang

机构信息

From the Department of Ophthalmology and Vision Science, Eye and ENT Hospital of Fudan University and Key Laboratory of Myopia of State Health Ministry, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, China.

From the Department of Ophthalmology and Vision Science, Eye and ENT Hospital of Fudan University and Key Laboratory of Myopia of State Health Ministry, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, China.

出版信息

Am J Ophthalmol. 2022 May;237:278-289. doi: 10.1016/j.ajo.2021.11.014. Epub 2021 Nov 21.

Abstract

PURPOSE

To evaluate the diagnostic yield of congenital ectopia lentis (EL) in a Chinese cohort by combining panel-based next-generation sequencing with clinical findings.

DESIGN

A cohort study.

METHODS

In total, 175 patients with congenital EL and their available family members (n = 338) were enrolled. All patients with congenital EL underwent genetic testing. Genotype-phenotype analyses were conducted to assess the biometric and structural ocular manifestations of congenital EL.

RESULTS

In total, 175 patients with congenital EL and 338 of their relatives were included in this study. In these patients, 92.57% (162 of 175) of disease-related variants were detected in FBN1 (83.43%), CPAMD8 (1.71%), COL4A5 (0.57%), ADAMTSL4 (3.43%), LTBP2 (1.71%), and CBS (2.29%). Based on genetic and clinical findings, the primary diagnostic rate was increased to 40.57% from 19.43% with the exception of the 91 diagnoses of potential Marfan syndrome, with a new diagnostic strategy for congenital EL, thus having been developed. Within this group of patients harboring FBN1 mutations, 16.44% (19 of 141) probands were diagnosed with EL syndrome and 2.13% (3 of 141) were diagnosed with Marfan syndrome.

CONCLUSIONS

The results of this cohort study expand the genomic landscape associated with congenital EL in Chinese cohorts. FBN1 mutations represent the most common cause of congenital EL in this population, and we have developed a new diagnostic strategy for congenital EL subtypes via the use of a well-designed panel-based next-generation sequencing that can be used to efficiently and precisely diagnose patients with congenital EL in a cost-effective manner.

摘要

目的

通过将基于基因panel的二代测序与临床发现相结合,评估中国队列中先天性晶状体异位(EL)的诊断率。

设计

队列研究。

方法

共纳入175例先天性EL患者及其可获得的家庭成员(n = 338)。所有先天性EL患者均接受基因检测。进行基因型-表型分析以评估先天性EL的生物测量和眼部结构表现。

结果

本研究共纳入175例先天性EL患者及其338名亲属。在这些患者中,92.57%(175例中的162例)的疾病相关变异在FBN1(83.43%)、CPAMD8(1.71%)、COL4A5(0.57%)、ADAMTSL4(3.43%)、LTBP2(1.71%)和CBS(2.29%)中被检测到。基于基因和临床发现,除91例潜在马凡综合征诊断外,主要诊断率从19.43%提高到40.57%,从而开发了一种针对先天性EL的新诊断策略。在这组携带FBN1突变的患者中,16.44%(141例中的19例)先证者被诊断为EL综合征,2.13%(141例中的3例)被诊断为马凡综合征。

结论

本队列研究结果扩展了中国队列中与先天性EL相关的基因组格局。FBN1突变是该人群先天性EL的最常见原因,并且我们通过使用精心设计的基于基因panel的二代测序开发了一种针对先天性EL亚型的新诊断策略,该策略可用于以具有成本效益的方式高效、准确地诊断先天性EL患者。

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