Autism & Developmental Medicine Institute, Geisinger, Danville, PA, USA.
ARUP Laboratories, Salt Lake City, UT, USA.
Genet Med. 2020 Feb;22(2):245-257. doi: 10.1038/s41436-019-0686-8. Epub 2019 Nov 6.
Copy-number analysis to detect disease-causing losses and gains across the genome is recommended for the evaluation of individuals with neurodevelopmental disorders and/or multiple congenital anomalies, as well as for fetuses with ultrasound abnormalities. In the decade that this analysis has been in widespread clinical use, tremendous strides have been made in understanding the effects of copy-number variants (CNVs) in both affected individuals and the general population. However, continued broad implementation of array and next-generation sequencing-based technologies will expand the types of CNVs encountered in the clinical setting, as well as our understanding of their impact on human health.
To assist clinical laboratories in the classification and reporting of CNVs, irrespective of the technology used to identify them, the American College of Medical Genetics and Genomics has developed the following professional standards in collaboration with the National Institutes of Health (NIH)-funded Clinical Genome Resource (ClinGen) project.
This update introduces a quantitative, evidence-based scoring framework; encourages the implementation of the five-tier classification system widely used in sequence variant classification; and recommends "uncoupling" the evidence-based classification of a variant from its potential implications for a particular individual.
These professional standards will guide the evaluation of constitutional CNVs and encourage consistency and transparency across clinical laboratories.
为了评估患有神经发育障碍和/或多发先天畸形的个体,以及有超声异常的胎儿,推荐进行拷贝数分析,以检测基因组中的致病缺失和获得。自该分析在广泛的临床应用以来的十年中,我们在理解拷贝数变异(CNVs)对受影响个体和一般人群的影响方面取得了巨大进展。然而,广泛应用基于阵列和新一代测序的技术将扩展临床环境中遇到的 CNV 类型,并加深我们对其对人类健康影响的理解。
为了协助临床实验室对 CNVs 进行分类和报告,无论用于识别它们的技术如何,美国医学遗传学与基因组学学院都与美国国立卫生研究院(NIH)资助的临床基因组资源(ClinGen)项目合作制定了以下专业标准。
本更新引入了一个定量的、基于证据的评分框架;鼓励广泛应用于序列变异分类的五级分类系统的实施;并建议将变异的基于证据的分类与其对特定个体的潜在影响“解耦”。
这些专业标准将指导对先天性 CNVs 的评估,并鼓励临床实验室之间的一致性和透明度。