在德克萨斯州 KidsCanSeq 儿童癌症研究的不同人群中比较种系外显子组测序与基因组测序的诊断率。

IF 5.3 2区 医学 Q1 ONCOLOGY
Lauren R Desrosiers-Battu, Tao Wang, Jacquelyn Reuther, George Miles, Hongzheng Dai, Eunji Jo, Heidi Russell, Robin Raesz-Martinez, Alva Recinos, Stephanie Gutierrez, Amy Thomas, Emily Berenson, Jessica Corredor, Kimberly Nugent, Rachel Wyatt Castillo, Rebecca Althaus, Rebecca Littlejohn, Shawn Gessay, Gail Tomlinson, Jonathan Gill, Juan Carlos Bernini, Kelly Vallance, Timothy Griffin, Sarah Scollon, Frank Y Lin, Christine Eng, Shashikant Kulkarni, Susan G Hilsenbeck, Angshumoy Roy, Amy L McGuire, D Williams Parsons, Sharon E Plon
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引用次数: 0

摘要

目的:评估临床种系基因组检测在不同儿科癌症人群中的相对诊断率:KidsCanSeq研究在得克萨斯州的六个地点招募了儿科癌症患者。种系分析包括外显子组测序和以治疗为重点的儿科癌症基因面板。研究结果按参与者的人口统计学特征、致病或可能致病变异(P/LP)的存在以及癌症易感基因(CPGs)中意义不确定的变异(VUS)进行分类。儿科可采取行动的 CPGs 被定义为在儿童期有癌症监测建议的 CPGs:578名参与者中有103人(17.8%)的至少一个平台报告了癌症P/LP变异,其中76人是显性癌症基因(13.1%),自我描述的种族或西班牙裔没有明显差异。不过,亚裔和非裔美国人的 VUS 比例更高(P = .0029)。外显子组的诊断率为 16.6%,面板组为 8.5%(P < .0001),42 名参与者的种系结果一致。纯外显子组结果包括 54 名参与者 30 个不同 CPG 中的 P/LP 变异,而纯面板结果包括 7 名参与者 CPG 中的拷贝数或结构性 P/LP 变异。仅限于儿科可操作 CPG 的诊断率没有明显差异(P = .6171):结论:在不同的儿科癌症人群中,约有18%的人有种系诊断结果,其中50%的P/LP变异仅由一个平台报告,原因是CPG不在靶向面板上,拷贝数变异(CNV)/重排不在外显子组报告中。尽管在这一多样化人群中诊断率相似,但在亚裔和非裔美国人中观察到 VUS 结果增加。鉴于 CNVs/重排在该人群中的临床意义,检测对于优化儿科癌症人群的种系分析至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparing the Diagnostic Yield of Germline Exome Versus Panel Sequencing in the Diverse Population of the Texas KidsCanSeq Pediatric Cancer Study.

Purpose: To evaluate the relative diagnostic yield of clinical germline genomic tests in a diverse pediatric cancer population.

Patients and methods: The KidsCanSeq study enrolled pediatric cancer patients across six sites in Texas. Germline analysis included both exome sequencing and a therapy-focused pediatric cancer gene panel. The results were categorized by participants demographics, the presence of pathogenic or likely pathogenic (P/LP) variants, and variants of uncertain significance (VUS) in cancer predisposition genes (CPGs). Pediatric actionable CPGs were defined as those with cancer surveillance recommendations during childhood.

Results: Cancer P/LP variants were reported by at least one platform in 103 of 578 (17.8%) participants of which 76 were dominant cancer genes (13.1%) with no significant differences by self-described race or Hispanic ethnicity. However, the proportion of participants with VUS was greater in Asian and African American participants (P = .0029). Diagnostic yield was 16.6% for exome versus 8.5% for panel (P < .0001) with 42 participants with concordant germline results. Exome-only results included P/LP variants in 30 different CPGs in 54 participants, whereas panel-only results included seven participants with a copy number or structural P/LP variants in CPGs. There was no significant difference in diagnostic yield limited to pediatric actionable CPGs (P = .6171).

Conclusion: Approximately 18% of a diverse pediatric cancer population had germline diagnostic findings with 50% of P/LP variants reported by only one platform because of CPGs not on the targeted panel and copy number variants (CNVs)/rearrangements not reported by exome. Although diagnostic yields were similar in this diverse population, increases in VUS results were observed in Asian and African American populations. Given the clinical significance of CNVs/rearrangements in this cohort, detection is critical to optimize germline analysis of pediatric cancer populations.

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