panel testing

  • 文章类型: Systematic Review
    目的:眼部疾病的基因检测选择不断增加,包括视神经萎缩,眼前节发育不全,白内障,角膜营养不良,眼球震颤,和青光眼。基因面板的内容和覆盖范围可能有所不同,正如我们和其他人对遗传性视网膜疾病(IRD)的评估。
    目的:描述遗传性眼病表型的基因小组检测方案及其差异。这篇评论对于做出诊断决策很重要。
    方法:获得许可,认证遗传咨询师(RP)使用ConcertGenetics和搜索词视神经萎缩,角膜营养不良,白内障,青光眼,眼前节发育不全,小眼症/无眼症,和眼球震颤,以确定由CLIA认证的商业基因检测实验室执行的可用检测选项。其他合著者就用于感兴趣的适应症的遗传小组进行了调查。然后,除了自己的网站外,还使用ConcertGenetics对眼科小组进行了比较。
    结果:包括并总结了来自每个临床类别的小组。这种比较突出了小组之间的差异和相似性,以便临床医生可以做出明智的决定。
    结论:获得基因检测的机会正在增加。基因检测的诊断率正在增加。每个面板都不同,所以表型或表征临床特征可能有助于预测特定的基因型,以及关于基因型的预测试假设,应该塑造面板的选择。
    The options for genetic testing continue to grow for ocular conditions, including optic atrophy, anterior segment dysgenesis, cataracts, corneal dystrophy, nystagmus, and glaucoma. Gene panels can vary in content and coverage, as we and others have evaluated in inherited retinal disease (IRD).
    To describe gene panel testing options for inherited eye disease phenotypes and their differences. This review is important for making diagnostic decisions.
    A licensed, certified genetic counselor (RP) used Concert Genetics and the search terms optic atrophy, corneal dystrophy, cataract, glaucoma, anterior segment dysgenesis, microphthalmia/anophthalmia, and nystagmus to identify available testing options performed by CLIA-certified commercial genetic testing laboratories. Other co-authors were surveyed with respect to genetic panels used for the indications of interest. Ophthalmic panels were then compared using Concert Genetics in addition to their own websites.
    Panels from each clinical category were included and summarized. This comparison highlighted the differences and similarities between panels so that clinicians can make informed decisions.
    Access to genetic testing is increasing. The diagnostic yield of genetic testing is increasing. Each panel is different, so phenotyping or characterizing clinical characteristics that may help predict a specific genotype, as well as pre-test hypotheses regarding a genotype, should shape the choice of panels.
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  • 文章类型: Journal Article
    背景:由于基因测序技术的进步,最近对驱动遗传性乳腺癌和卵巢癌(HBOC)的遗传机制的了解有所增加。HBOC风险的基因检测现在涉及多基因小组检测,其中包括特征良好的高外显率基因(例如BRCA1和BRCA2),以及中等和低外显率基因。某些中等和低外显率基因与有限的数据相关,以告知癌症风险估计和临床管理建议。这为患者创造了新的遗传和临床不确定性来源。
    目的:本综述的目的是评估与HBOC风险的多基因小组测试相关的心理和健康行为结果。搜索是与信息专家(玛格丽特公主癌症中心)合作开发的,并在以下数据库中进行:MEDLINE,EMBASE,EMCare,PsycINFO,Epub在出版之前。
    结果:与BRCA1/2文献类似,具有致病性变异(PV)的个体报告了更高水平的与测试相关的担忧和癌症特异性困扰,以及与具有不确定意义(VUS)或阴性结果的个体相比,受影响和未受影响的个体对预防性手术的摄取更高。一项研究表明,具有中等外显率基因的PV的个体报告了更高的癌症担忧率,与高外显率PV的女性相比,基因检测问题和癌症相关的痛苦。基于基因外显率的癌症筛查和预防结果分析仅限于两项研究,矛盾的发现。
    结论:本综述的研究结果强调需要研究与小组测试相关的心理和健康行为结果,以包括基于变异致病性和基因外显率的组间差异。未来评估基因外显率对患者报告和临床结果的影响的研究将需要大样本进行这些分析,因为发现有限数量的测试个体具有PV。
    BACKGROUND: Knowledge of the genetic mechanisms driving hereditary breast and ovarian cancer (HBOC) has recently expanded due to advances in gene sequencing technologies. Genetic testing for HBOC risk now involves multi-gene panel testing, which includes well characterized high-penetrance genes (e.g. BRCA1 and BRCA2), as well as moderate- and low-penetrance genes. Certain moderate and low penetrance genes are associated with limited data to inform cancer risk estimates and clinical management recommendations, which create new sources of genetic and clinical uncertainty for patients.
    OBJECTIVE: The aim of this review is to evaluate the psychological and health behaviour outcomes associated with multi-gene panel testing for HBOC risk. The search was developed in collaboration with an Information Specialist (Princess Margaret Cancer Centre) and conducted in the following databases: MEDLINE, EMBASE, EMCare, PsycINFO, Epub Ahead of Publication.
    RESULTS: Similar to the BRCA1/2 literature, individuals with a pathogenic variant (PV) reported higher levels of testing-related concerns and cancer-specific distress, as well as higher uptake of prophylactic surgery in both affected and unaffected individuals compared to those with variant of uncertain significance (VUS) or negative result. A single study demonstrated that individuals with a PV in a moderate penetrance gene reported higher rates of cancer worry, genetic testing concerns and cancer-related distress when compared to women with high penetrance PV. Analysis of cancer screening and prevention outcomes based upon gene penetrance were limited to two studies, with conflicting findings.
    CONCLUSIONS: The findings in this review emphasize the need for studies examining psychological and health behavior outcomes associated with panel testing to include between group differences based upon both variant pathogenicity and gene penetrance. Future studies evaluating the impact of gene penetrance on patient-reported and clinical outcomes will require large samples to be powered for these analyses given that a limited number of tested individuals are found to have a PV.
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  • 文章类型: Journal Article
    Minimal residual disease (MRD) testing in acute myeloid leukemia is increasingly being used to assess treatment response and stratify the risk of relapse for individual patients. Molecular methods for MRD testing began with PCR-based assays for individual recurrent mutations. To date, there is robust evidence for testing NPM1, CBFB-MYH11, and RUNX1/RUNXT1 mutations using this approach, though the best timing and threshold level for each mutation varies. More recent approaches have been with PCR-based multigene panels, occasionally combined with flow cytometric techniques, and next-generation sequencing techniques. This review outlines the various techniques used in molecular approaches to MRD, the evidence behind individual mutation testing, and the novel approaches for evaluating multigene MRD so that clinicians can understand and incorporate these evaluations into their practice.
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