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联合遗传筛查和传统生化筛查以优化新生儿筛查系统。

Combined genetic screening and traditional biochemical screening to optimize newborn screening systems.

机构信息

Genetic Medicine Center, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China.

Genetic Medicine Center, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China.

出版信息

Clin Chim Acta. 2022 Mar 1;528:44-51. doi: 10.1016/j.cca.2022.01.015. Epub 2022 Jan 24.

DOI:10.1016/j.cca.2022.01.015
PMID:35085585
Abstract

Newborn screening can detect around 40 different diseases based on biochemical indicators and has resulted in the improved quality of life for children suffering from genetic diseases. However, NBS is limited as it does not cover all genetic diseases in newborns and has high rates of false positives and negatives. Genetic screening can be used to address the shortcomings of traditional biochemical screening, however, the comprehensive clinical value of genetic screening is yet to be systematically studied. In this study, we used two different genetic screening methods to examine 200 cases of NBS. We found that genetic screening can be used to identify a broader spectrum of diseases and is not limited to traditional biochemical screening diseases; it can identify positive cases of disease and can eliminate false positives caused by multiple factors such as pathogenic variants carrier or the mode of childbirth. Genetic screening has shortened the time to diagnosis and reduced the costs of testing. Furthermore, we found that the biochemical detection results were limited when patients simultaneously carried multiple pathogenic mutations. Our research provisionally demonstrates the necessity, feasibility and significance of clinical genetic screening in newborns and provides a solid basis for future clinical developments.

摘要

新生儿筛查可以基于生化指标检测出大约 40 种不同的疾病,从而提高了患有遗传疾病的儿童的生活质量。然而,新生儿筛查存在局限性,因为它不能涵盖所有新生儿的遗传疾病,且存在较高的假阳性和假阴性率。遗传筛查可以弥补传统生化筛查的不足,然而,遗传筛查的综合临床价值仍有待系统研究。在这项研究中,我们使用两种不同的遗传筛查方法对 200 例 NBS 进行了检测。我们发现,遗传筛查可以识别更广泛的疾病谱,且不受传统生化筛查疾病的限制;它可以识别疾病的阳性病例,并可以消除多种因素(如致病性变异携带者或分娩方式)导致的假阳性。遗传筛查缩短了诊断时间,降低了检测成本。此外,我们发现当患者同时携带多种致病性突变时,生化检测结果是有限的。我们的研究初步证明了新生儿临床遗传筛查的必要性、可行性和意义,为未来的临床发展提供了坚实的基础。

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