gene mutation

基因突变
  • 文章类型: Letter
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  • 文章类型: Case Reports
    膀胱横纹肌肉瘤是一种罕见的肿瘤性疾病,其特征是由于缺乏标准化指南和大规模临床研究,在治疗方面存在挑战。在这种情况下,患者被测试TP53突变,其可以提供新的诊断和治疗选择。
    这里,我们报道了一名34岁的男性,他接受了膀胱肿瘤切除术,病理检查后诊断为膀胱横纹肌肉瘤,TP53突变。该患者接受了6轮化疗。然而,第一次手术后11个月盆腔肿瘤复发。所以,患者接受盆腔肿瘤切除术。手术干预后仅3个月,该患者经历了腹部大量转移,并最终在第二次手术后六个月死于疾病。病程为22个月。
    膀胱横纹肌肉瘤是一种预后极差的疾病。基因检测在诊断和治疗中具有重要价值。也许针对TP53的靶向治疗对于此类罕见疾病具有潜在的价值。
    UNASSIGNED: Rhabdomyosarcoma of the bladder is an infrequent neoplastic condition characterized by a pronounced malignant situation with challenges in treatment due to the lack of standardized guidelines and large-scale of clinical studies. The patient in this case is tested TP53 mutation that may provide new diagnostic and therapeutic options.
    UNASSIGNED: Here, we reported a 34-year-old male who received bladder tumor resection, and diagnosed as bladder rhabdomyosarcoma with TP53 mutation after the pathology test. This patient underwent 6 rounds of chemotherapy. However, the pelvic tumor recurred 11 months after the first surgery. So, the patient accepted the pelvic tumor resection. Only 3 months after the surgical intervention, the patient underwent abdominal massive metastasis and ultimately succumbed to the illness six months following the second surgery. The course of the illness was 22 months.
    UNASSIGNED: Bladder rhabdomyosarcoma is a disease with an extremely poor prognosis. Genetic testing holds significant value in the diagnosis and treatment. Perhaps targeted therapy against TP53 is potential valuable for such rare diseases.
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  • 文章类型: Journal Article
    血友病B(Hb)是一种由FIX基因缺陷引起的遗传性出血性疾病,导致严重的凝血功能障碍。本研究设计了8对覆盖FIX基因8个外显子的引物,采用PCR和DNA测序技术检测31例HB患者的FIX基因突变。在Blast上使用Chromas软件将测序结果与正常序列进行比较以鉴定突变位点。研究结果表明,在中国人群中,CpG二核苷酸区是突变热点,第192核苷酸(F192)是二核苷酸多态性位点。致病突变包括点突变,删除,插入,和影响氨基酸或剪接位点的突变。对于只有多态位点的情况,需要进一步的外显子测序.这项研究为全球HB数据库增加了新的突变数据,支持对FIX基因突变种族差异的研究,并有助于国内HB统计。该结果有助于理解FIX基因在凝血中的作用,阐明HB发病机制,并为未来的基因治疗提供基础。
    Hemophilia B (HB) is an inherited bleeding disorder caused by defects in the FⅨ gene, leading to severe coagulation dysfunction. This study designed eight pairs of primers covering eight exons of the FⅨ gene and used PCR and DNA sequencing to detect FⅨ gene mutations in 31 HB patients. Sequencing results were compared with normal sequences using Chromas software on Blast to identify mutation sites. Findings revealed the CpG dinucleotide region as a mutation hotspot and the 192nd nucleotide (FⅨ192) as a dinucleotide polymorphism site in the Chinese population. Pathogenic mutations included point mutations, deletions, insertions, and mutations affecting amino acids or splicing sites. For cases with only polymorphic sites, further exon sequencing is needed. This study adds new mutation data to the global HB database, supports research on racial differences in FⅨ gene mutations, and contributes to domestic HB statistics. The results aid in understanding the FⅨ gene\'s role in coagulation, elucidating HB pathogenesis, and providing a basis for future gene therapy.
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  • 文章类型: Letter
    1q跳跃易位(JT)很少见,其在骨髓性恶性肿瘤中的分子谱尚不为人所知。这项研究评估了在约翰霍普金斯医院(n=11,908)和MD安德森癌症中心接受遗传分析的血液恶性标本中1q-JT队列(0.38%)的基因突变。1q-JT在11个基因中频繁突变,其中大多数与预后较差有关。BCOR突变与其他突变显著共同发生。患者倾向于在DNA修复中发生突变,剪接体,和表观遗传修饰途径,尽管在这些途径中使用的基因不是随机分布的。多-,尽管重叠,途径中断往往表现为两个基因集的突变。一个基因集由SF3B1(剪接体)和TET2(表观遗传修饰)组成,而另一个由STAG2(DNA修复)组成,SRSF2,U2AF(剪接体),ASXL1,KMT2D(表观遗传修饰),BCOR,和GATA2(转录因子)。类似“中间”JT的重排可能代表发生1q-JT的早期迹象。治疗(低甲基化剂)和近端染色体短臂的独特结构可能有助于髓样恶性肿瘤中1q-JT的形成。确定JT后的中位总生存期为10个月(95%置信区间,5-15个月)。我们的队列代表了迄今为止分析的1q-JT事件前后来自多中心的最大数量的骨髓性恶性肿瘤。总的来说,这项研究确定了髓系恶性肿瘤中与1q-JT相关的特定分子谱.1q-JT可作为髓系恶性肿瘤预后不良的生物标志物,这对于制定明智的临床决策和治疗策略可能很重要。
    1q jumping translocation (JT) is rare and its molecular profiles in myeloid malignancies are not well-known. This study evaluated gene mutations in 1q-JT cohorts (0.38%) from hematological malignant specimens that underwent genetic analysis at the Johns Hopkins Hospital (n = 11,908) and the MD Anderson Cancer Center. 1q-JT had frequent mutations in eleven genes, most of which are associated with worse prognosis. BCOR mutations significantly co-occurred with others. Patients tended to have mutations in DNA-repair, spliceosome, and epigenetic modification pathways, though genes utilized within each of these pathways were not randomly distributed. Multi-, albeit overlapping, pathway interruptions tended to manifest in mutations of two gene sets. One gene set consisted of SF3B1 (spliceosome) and TET2 (epigenetic modification), while the other consisted of STAG2 (DNA repair), SRSF2, U2AF (spliceosome), ASXL1, KMT2D (epigenetic modification), BCOR, and GATA2 (transcription factors). An \"intermediate\" JT-like rearrangement may represent an early sign of occurring 1q-JT. Treatments (hypomethylating agents) and unique structures of the short arms of acrocentric chromosomes may contribute to 1q-JT formation in myeloid malignancies. The median overall survival after identification of a JT was 10 months (95% confidence interval, 5-15 months). Our cohort represents the largest number of myeloid malignancies from multi-centers with before and after the 1q-JT event analyzed to date. Overall, this study identified specific molecular profiles that are associated with 1q-JT in myeloid malignancies. 1q-JT could serve as a poor prognosis biomarker in myeloid malignancies, which could be important in making well-informed clinical decisions and treatment strategies.
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  • 文章类型: Journal Article
    髓系肉瘤(MS)发生在急性髓系白血病(AML)患者中。在极少数情况下,MS可以代表骨髓增殖性肿瘤(MPN)患者的一种母细胞转化形式,骨髓增生异常肿瘤(MDS),或MDS/MPN。MS中最常见的染色体改变是t(8;21)或inv(16),报告了其他改动。患有纤维化的Janus激酶2(JAK2)阳性MDS中的MS病例极为罕见。这里,我们描述了这样一个案例。据我们所知,这是一例JAK2V617F突变阳性MDS病例的首例报告,该病例与累及左侧第七肋后部的MS同时发生.先前在髓内AML细胞遗传学和髓外疾病发生之间没有明确的关联。有趣的是,该患者的髓内MDS和髓外肿块样本呈现相同的JAK2V617F突变.在阿扎胞苷和维奈托克的治疗方案之后,患者达到完全缓解。胸部CT扫描显示第七后肋骨肿块消失。该病例为该疾病的潜在未来治疗提供了有价值的信息。
    Myeloid sarcoma (MS) occurs in patients with acute myeloid leukemia (AML). In rare cases, MS can represent a form of blast transformation in patients with myeloproliferative neoplasms (MPN), myelodysplastic neoplasms (MDS), or MDS/MPN. The most frequent chromosomal alterations in MS are t(8;21) or inv(16), with other alterations being reported. Cases of MS in Janus kinase 2 (JAK2)-positive MDS with fibrosis are exceedingly rare. Here, we describe such a case. To the best of our knowledge, this is the first report of a JAK2 V617F mutation-positive MDS case occurring concurrently with MS involving the posterior aspect of the left seventh rib. No clear association has been previously demonstrated between the intramedullary AML cytogenetics and extramedullary disease occurrence. Interestingly, samples from the intramedullary MDS and extramedullary mass in this patient presented the same JAK2 V617F mutation. Following a treatment regimen of azacitidine and venetoclax, the patient achieved complete remission. The chest CT scan showed that the seventh posterior rib mass disappeared. This case provides valuable information for the potential future treatment of this disease.
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  • 文章类型: Journal Article
    探讨4例Bartter综合征3型(BS3型)患者的临床特点。
    临床数据,遗传分析,回顾性总结了4例3型Bartter综合征的结果。
    基因测序分析表明,所有儿童都在CLCNKB基因中携带复合杂合突变,并被诊断为BS3型。检测到所有类型的突变,包括两个错义突变,一个无意义的突变,一个小片段缺失突变,两个大缺失突变和一个剪接位点突变。剪接位点突变c.100+1(IVS2)C>T是新的。2例携带大的缺失突变。患者表现为典型的BS,表现为适度。最常见的体征是生长迟缓。没有羊水过多或早产。所有病例均接受氯化钾补充和吲哚美辛治疗。在长期随访中,临床症状和生长迟缓明显改善。未观察到肾钙质沉着或肾功能障碍。
    3型BS的临床表现主要表现为cBS。生长迟缓是常见的征兆。BS3型远期预后良好。在CLCNKB基因中存在各种类型的突变。大量删除是最常见的。
    UNASSIGNED: To investigate the characteristics of 4 Chinese patients with Bartter syndrome type 3 (BS Type 3).
    UNASSIGNED: The clinical data, genetic analysis, and outcome of four cases with Bartter syndrome type 3 were retrospectively summarised.
    UNASSIGNED: Gene sequencing analysis showed that all children carried a compound heterozygous mutation in the CLCNKB gene and were diagnosed with BS type 3. All types of mutations were detected, including two missense mutations, one nonsense mutation, one small fragment deletion mutation, two large deletion mutations and one splice-site mutation. The splice-site mutation c.100 + 1 (IVS2) C > T was novel. Two cases carried large deletion mutations. The patients presented as classic BS with modest manifestations. The most common sign was growth retardation. There was no polyhydramnios or preterm delivery. All cases were treated with potassium chloride supplementation and indomethacin. During long-term follow-up, clinical symptoms and growth retardation improved significantly. Nephrocalcinosis or renal dysfunction was not observed.
    UNASSIGNED: The clinical manifestations of BS type 3 are mostly presented as cBS. Growth retardation is a common sign. BS type 3 had a good long-term prognosis. There were various types of mutations in the CLCNKB gene. Large deletions were the most common.
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  • 文章类型: Journal Article
    Weiss-Kruszka综合征(WSKA)是由ZNF462的致病变异引起的,代表一种罕见的常染色体显性遗传先天性异常综合征。它的特点是全球发育迟缓,低张力,喂养困难,和颅面异常,记录在不到30名患者中。ZNF462位于染色体9p31.2,是一种转录因子,在胚胎发育和染色质重塑过程中具有重要作用。这里,我们报告了三名WSKA患者,通过全外显子组测序(WES)分析,我们在三名患者中发现了两个新的变异,其中两个是兄弟姐妹。这些变体(c.3078dup,ZNF462基因中的p.Val1027Cysfs5和c.4792A>Tp.Lys1598*)可能导致单倍体不足。我们的患者有助于进一步描绘表型,WSKA的基因型和潜在的治疗管理策略。由于我们报告了第二名患有自身免疫性疾病的WSKA患者,因此需要进一步的临床和功能研究来阐明这种染色质重塑障碍与自身免疫性问题发展之间的关联。在未来,鼓励合作努力为WSKA开发标签,考虑到基因的功能和相关的患者表型。这项新技术有可能为这种疾病提供有价值的见解。
    Weiss-Kruszka Syndrome (WSKA) is caused by pathogenic variants in ZNF462 representing a rare autosomal dominant congenital anomaly syndrome. It is characterized by global developmental delay, hypotonia, feeding difficulties, and craniofacial abnormalities, documented in fewer than 30 patients. ZNF462, located on chromosome 9p31.2, is a transcription factor and has an important role during embryonic development and chromatin remodelling. Here, we report three new patients with WSKA, Through whole exome sequencing (WES) analysis, we identified two novel variants in three patients, two of whom are siblings. These variants (c.3078dup, p.Val1027Cysfs5 and c.4792A > T p.Lys1598*) in the ZNF462 gene are likely resulting in haploinsufficiency. Our patients help to further delineate the phenotype, genotype and potential therapeutic management strategies for WSKA. Since we report a second WSKA patient with an autoimmune disease further clinical and functional studies are needed to elucidate the association between this chromatin remodelling disorder and the development of autoimmune problems. In the future, collaborative efforts are encouraged to develop an episignature for WSKA, given the gene\'s function and associated patient phenotypes. This new technology has the potential to provide valuable insights into the disorder.
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  • 文章类型: Case Reports
    卡尼复合体是一种罕见的常染色体显性综合征,已被证明与PRKAR1A突变引起的失活有关。我们揭示了一个新的PRKAR1A基因突变在中国患者卡尼复杂,并回顾了文献,以提高对卡尼复杂的理解。
    一名23岁的中国男性患者,有心脏粘液瘤家族史,因中心性肥胖和色素沉着过度入院。体格检查显示最大血压为150/93mmHg,一个腰围102cm,70kg的重量,身高170cm,BMI为24.22kg/m2。此外,嘴唇粘膜上有斑点的皮肤色素沉着,腹部紫色条纹,两条腿皮肤薄,和可见的静脉。血液检查发现皮质醇血症,促肾上腺皮质激素(ACTH)水平降低,低剂量和高剂量地塞米松抑制试验未能抑制皮质醇。磁共振成像(MRI)扫描显示多个肾上腺小结节和腹膜后神经源性肿瘤。遗传检测显示PRKAR1A第5外显子存在新的杂合突变(c.500_502+8delAAGGTAAGGGC)。该患者于2020年接受了右肾上腺和腹膜后肿瘤切除术。右肾上腺切除术后病理示肾上腺皮质结节增生。腹膜后肿瘤切除术的病理显示梭形细胞肿瘤富含色素和细胞。根据2001年的StratakisCA指南,该患者被诊断为卡尼复合体。经过长期随访,病人病情稳定,减肥,腰围减少,显著降低皮质醇水平,血脂正常.
    该病例报道了一名中国患者的卡尼情结,临床特征为非ACTH依赖性库欣综合征,家族性复发性心脏粘液瘤,假结肠黑素性神经鞘瘤(PMS)和皮肤和粘膜色素沉着。发现了PRKAR1A突变的新亚型,这可能会影响PRKAR1A蛋白的特性,并有助于Carney复合物的发展。
    UNASSIGNED: Carney complex is a rare autosomal dominant syndrome that has been shown to be associated with inactivation due to PRKAR1A mutations. We revealed a novel PRKAR1A gene mutation in Chinese patient with Carney complex and review the literature to enhance understanding of Carney complex.
    UNASSIGNED: A 23-year-old Chinese male patient with a family history cardiac myxoma was admitted to our Department of Endocrinology because of central obesity and hyperpigmentation. Physical examination revealed a maximum blood pressure of 150/93mmHg, a waist circumference of 102cm, a weight of 70kg, a height of 170cm, and a BMI of 24.22kg/m2. Additionally, there was spotty skin pigmentation on the lip mucosa, purple striae on the abdomen, thin skin on both legs, and visible veins. Blood examination revealed hypercortisolemia, decreased adrenocorticotropic hormone (ACTH) levels and failure to suppress cortisol with low and high-dose dexamethasone suppression tests. Magnetic resonance imaging (MRI) scan revealed multiple small adrenal nodules and Retroperitoneal neurogenic tumor. Genetic testing showed a novel heterozygous mutation in exon 5 of PRKAR1A (c.500_502 + 8delAAGGTAAGGGC). The patient underwent resection of the right adrenal gland and retroperitoneal neoplasms in 2020. Postoperative pathology following the right adrenal gland resection showed nodular hyperplasia of the adrenal cortex. The pathology from the retroperitoneal tumor resection revealed spindle cell tumors rich in pigment and cells. The patient was diagnosed as Carney complex according to Stratakis CA in 2001 guidelines. After long-term follow-up, the patient\'s condition was stable, with weight loss, waist circumference reduction, significantly lower cortisol levels, and normal blood lipids.
    UNASSIGNED: This case reported a Carney complex in a Chinese patient, characterized clinically by non-ACTH-dependent Cushing\'s syndrome, familial recurrent cardiac myxomas, psammomatous melanotic schwannoma (PMS) and skin and mucosal pigmentation. A novel subtype of PRKAR1A mutation was discovered, which may affect the characteristics of the PRKAR1A protein and contribute to the development of Carney complex.
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  • 文章类型: Journal Article
    SnijdersBlok-Campeau综合征(SNIBCPS)是一种罕见的遗传性疾病,以面部异常为特征,低张力,大头畸形,CHD3基因突变引起的全球发育迟缓(GDD)。关于SNIBCPS的信息有限,对其致病基因CHD3的研究很少。
    我们利用了全外显子组测序,体外小基因剪接分析,并构建蛋白质模型以验证可疑致病突变。此外,使用关键字\"SnijdersBlok-Campeau综合征搜索PubMed数据库,“CHD3”或“SNIBCPS”总结SNIBCPS患儿的基因突变和临床表型特征。
    我们确定了一个非移码变体c.3592_c.3606delGCCAAGAAGATG,剪接位点变异体c.1708-1G>T,和两个错觉变体,C.2954G>C(第Arg985Pro)和c.3371C>T(p。A1124V),在具有SNIBCPS的CHD3变体中。重要的是,c.3592_c.3606delGCCAAGAGAAAGATG,c.1708-1G>T,和c.3371C>T(p。A1124V)位点未被报道,这项研究中的儿童也有单眉的表型特征,手掌横向折痕,气管支气管,和伊藤低黑素病(HI)。c.1708-1G>T经典剪接突变导致mRNA的异常剪切,形成最终影响基因功能的截短蛋白。
    我们的发现扩大了SNIBCPS患儿的遗传变异和临床特征的范围。CHD3的剪接分析是了解剪接细胞发病机制的重要方法。
    UNASSIGNED: Snijders Blok-Campeau syndrome (SNIBCPS) is a rare genetic disorder characterized by facial abnormalities, hypotonia, macrocephaly, and global developmental delay (GDD) caused by mutations in CHD3 gene. There is limited information on SNIBCPS and few studies on its pathogenic gene CHD3.
    UNASSIGNED: We utilized whole-exome sequencing, in vitro minigene splicing assay analysis, and construction of protein models to validate the suspected pathogenic mutation. In addition, the PubMed database was searched using the keywords \"Snijders Blok-Campeau syndrome,\" \"CHD3,\" or \"SNIBCPS\" to summarize the gene mutations and clinical phenotypic characteristics of children with SNIBCPS.
    UNASSIGNED: We identified a non-frameshift variant c.3592_c.3606delGCCAAGAGAAAGATG, a splice site variant c.1708-1G>T, and two missense variants, c. 2954G>C (p.Arg985Pro) and c.3371C>T (p.A1124V), in CHD3 variants with SNIBCPS. Importantly, the c.3592_c.3606delGCCAAGAGAAAGATG, c.1708-1G>T, and c.3371C > T (p.A1124V) loci were not reported, and the children in this study also had phenotypic features of unibrow, transverse palmar creases, tracheal bronchus, and hypomelanosis of Ito (HI). The c.1708-1G>T classical splicing mutation leads to abnormal shearing of mRNA, forming a truncated protein that ultimately affects gene function.
    UNASSIGNED: Our findings have expanded the spectrum of genetic variants and clinical features in children with SNIBCPS. Splicing analysis of CHD3 is an important method to understand the pathogenesis of spliced cells.
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  • 文章类型: Journal Article
    在组织病理学领域,关于使用人工智能(AI)技术对整个幻灯片图像(WSI)进行分类的许多研究已经报道。我们已经研究了神经胶质瘤的疾病进展评估。成人型弥漫性胶质瘤,一种脑肿瘤,被分类为星形细胞瘤,少突胶质细胞瘤,和胶质母细胞瘤.星形细胞瘤和少突胶质细胞瘤也被称为低级别胶质瘤(LGG),胶质母细胞瘤也称为多形性胶质母细胞瘤(GBM)。LGG患者经常具有异柠檬酸脱氢酶(IDH)突变。据报道,有IDH突变的患者比没有IDH突变的患者预后更好。因此,IDH突变是神经胶质瘤分类的重要指标。这就是为什么我们专注于IDH1突变。在本文中,我们旨在使用WSI和神经胶质瘤患者的临床数据对IDH1突变的存在与否进行分类.WSI模型和临床数据模型之间的集成学习用于对IDH1突变的存在或不存在进行分类。通过使用幻灯片级别标签,我们结合了来自苏木精和曙红(H&E)染色的WSI的基于贴片的成像信息,以及使用深度图像特征提取和机器学习分类器预测546例患者中IDH1基因突变的临床数据。我们实验了不同的深度学习(DL)模型,包括基于注意力的多实例学习(ABMIL)模型以及临床变量的梯度增强机(LightGBM)。Further,我们使用超参数优化来找到分类精度方面的最佳整体模型。我们获得了WSI的最高曲线下面积(AUC)为0.823,0.782的临床数据,使用MaxViT和LightGBM组合的集合结果为0.852,分别。我们的实验结果表明,通过使用临床数据和图像可以提高AI模型的整体准确性。
    In the field of histopathology, many studies on the classification of whole slide images (WSIs) using artificial intelligence (AI) technology have been reported. We have studied the disease progression assessment of glioma. Adult-type diffuse gliomas, a type of brain tumor, are classified into astrocytoma, oligodendroglioma, and glioblastoma. Astrocytoma and oligodendroglioma are also called low grade glioma (LGG), and glioblastoma is also called glioblastoma multiforme (GBM). LGG patients frequently have isocitrate dehydrogenase (IDH) mutations. Patients with IDH mutations have been reported to have a better prognosis than patients without IDH mutations. Therefore, IDH mutations are an essential indicator for the classification of glioma. That is why we focused on the IDH1 mutation. In this paper, we aimed to classify the presence or absence of the IDH1 mutation using WSIs and clinical data of glioma patients. Ensemble learning between the WSIs model and the clinical data model is used to classify the presence or absence of IDH1 mutation. By using slide level labels, we combined patch-based imaging information from hematoxylin and eosin (H & E) stained WSIs, along with clinical data using deep image feature extraction and machine learning classifier for predicting IDH1 gene mutation prediction versus wild-type across cohort of 546 patients. We experimented with different deep learning (DL) models including attention-based multiple instance learning (ABMIL) models on imaging data along with gradient boosting machine (LightGBM) for the clinical variables. Further, we used hyperparameter optimization to find the best overall model in terms of classification accuracy. We obtained the highest area under the curve (AUC) of 0.823 for WSIs, 0.782 for clinical data, and 0.852 for ensemble results using MaxViT and LightGBM combination, respectively. Our experimental results indicate that the overall accuracy of the AI models can be improved by using both clinical data and images.
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