遗传性癌症易感性:新鲜冷冻乳腺/卵巢肿瘤与血液的多基因panel 测序比较。

Hereditary cancer predispositions: Comparison of multigene panel sequencing on fresh-frozen breast/ovarian tumor versus blood.

机构信息

Department of Genetics, Institut Curie, Paris, France.

Paris Sciences Lettres Research University, Paris, France.

出版信息

Clin Genet. 2023 Jul;104(1):107-113. doi: 10.1111/cge.14327. Epub 2023 Mar 27.

Abstract

In breast or ovarian cancer (BC/OC) patients with evocative personal and/or family history, multigene panel sequencing is performed on blood to diagnose hereditary predispositions. Additionally, BRCA1/BRCA2 testing can be performed on tumor sample for therapeutic purpose. The accuracy of multigene panel tumor analysis on BC/OC to detect predisposing germline pathogenic variants (gPV) has not been precisely assessed. By comparing sequencing data from blood and fresh-frozen tumor we show that tumor genomic instability causes pitfalls to consider when performing tumor testing to detect gPV. Even if loss of heterozygosity increases germline signal in most cases, somatic copy number variants (CNV) can mask germline CNV and collapse point gPV variant allele frequency (VAF). Moreover, VAF does not allow an accurate distinction between germline and somatic pathogenic variants.

摘要

在有明显个人和/或家族病史的乳腺癌或卵巢癌(BC/OC)患者中,通过血液进行多基因panel 测序以诊断遗传易感性。此外,还可以对肿瘤样本进行 BRCA1/BRCA2 检测,以达到治疗目的。BC/OC 多基因panel 肿瘤分析检测致病变异(gPV)的准确性尚未得到精确评估。通过比较血液和新鲜冷冻肿瘤的测序数据,我们发现肿瘤基因组不稳定性会导致在进行肿瘤检测以检测 gPV 时需要考虑的陷阱。即使杂合性缺失(LOH)会增加大多数情况下的种系信号,但体细胞拷贝数变异(CNV)会掩盖种系 CNV,并使点突变 gPV 变异等位基因频率(VAF)下降。此外,VAF 无法准确区分种系和体细胞致病性变异。

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