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在一家三甲医院中,使用靶向大规模平行测序panel 来诊断遗传性内分泌疾病。

Targeted massively parallel sequencing panel to diagnose genetic endocrine disorders in a tertiary hospital.

机构信息

Laboratório de Sequenciamento em Larga Escala (SELA), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.

Laboratório de Sequenciamento em Larga Escala (SELA), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.

出版信息

Clinics (Sao Paulo). 2022 Oct 23;77:100132. doi: 10.1016/j.clinsp.2022.100132. eCollection 2022.

Abstract

OBJECTIVES

To analyze the efficiency of a multigenic targeted massively parallel sequencing panel related to endocrine disorders for molecular diagnosis of patients assisted in a tertiary hospital involved in the training of medical faculty.

MATERIAL AND METHODS

Retrospective analysis of the clinical diagnosis and genotype obtained from 272 patients in the Endocrine unit of a tertiary hospital was performed using a custom panel designed with 653 genes, most of them already associated with the phenotype (OMIM) and some candidate genes that englobes developmental, metabolic and adrenal diseases. The enriched DNA libraries were sequenced in NextSeq 500. Variants found were then classified according to ACMG/AMP criteria, with Varsome and InterVar.

RESULTS

Three runs were performed; the mean coverage depth of the targeted regions in panel sequencing data was 249×, with at least 96.3% of the sequenced bases being covered more than 20-fold. The authors identified 66 LP/P variants (24%) and 27 VUS (10%). Considering the solved cases, 49 have developmental diseases, 12 have metabolic and 5 have adrenal diseases.

CONCLUSION

The application of a multigenic panel aids the training of medical faculty in an academic hospital by showing the picture of the molecular pathways behind each disorder. This may be particularly helpful in developmental disease cases. A precise genetic etiology provides an improvement in understanding the disease, guides decisions about prevention or treatment, and allows genetic counseling.

摘要

目的

分析与内分泌疾病相关的多基因靶向大规模平行测序panel 的效率,为在参与医学教师培训的三级医院就诊的患者进行分子诊断。

材料和方法

使用针对 653 个基因设计的定制panel,对三级医院内分泌科的 272 名患者的临床诊断和基因型进行回顾性分析,这些基因大多数与表型(OMIM)相关,还有一些候选基因与发育、代谢和肾上腺疾病有关。富集的 DNA 文库在 NextSeq 500 上进行测序。然后根据 ACMG/AMP 标准,使用 Varsome 和 InterVar 对发现的变体进行分类。

结果

进行了三次运行;panel 测序数据中靶向区域的平均覆盖深度为 249×,至少 96.3%的测序碱基覆盖超过 20 倍。作者确定了 66 个 LP/P 变体(24%)和 27 个 VUS(10%)。考虑到已解决的病例,49 例为发育性疾病,12 例为代谢性疾病,5 例为肾上腺疾病。

结论

多基因panel 的应用通过展示每种疾病背后的分子途径图,有助于学术医院的医学教师培训。这在发育性疾病病例中可能特别有帮助。精确的遗传病因学可以提高对疾病的认识,指导预防或治疗决策,并提供遗传咨询。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d30/9593712/d40b7c60e017/gr1.jpg

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