天津医药 ›› 2021, Vol. 49 ›› Issue (6): 561-569.doi: 10.11958/20210386

• 建议与共识 •    下一篇

关于遗传基因检测中基因变异临床意义分级的建议 #br#

天津市医学会医学遗传学分会,天津市医学会遗传咨询分会
  

  1. 天津市儿童医院(天津大学儿童医院),天津市儿科
    研究所,天津市儿童出生缺陷防治重点实验室


  • 收稿日期:2021-02-15 修回日期:2021-04-20 出版日期:2021-06-15 发布日期:2021-06-15
  • 通讯作者: 李光 E-mail:lig@tmu.edu.cn
  • 基金资助:
    国家重点研发计划;国家重点研发计划;国家自然科学基金;京津冀专项项目;天津市卫生行业重点攻关项目;天津市重大疾病防治科技重大专项;天津市重大疾病防治科技重大专项;天津市卫生健康科技项目;天津市卫生健康科技项目

Recommendations on the clinical significance grading of genetic variation in clinical gene testing

Medical Genetics Branch of Tianjin Medical Association, Genetic Counseling Branch of Tianjin Medical Association #br#   

  • Received:2021-02-15 Revised:2021-04-20 Published:2021-06-15 Online:2021-06-15

摘要: 目前基因检测报告主要对基因变异的致病性及临床含义进行描述,实验室人员撰写报告时往往把焦点放 在变异本身的性质,而临床医生的关注点主要在案例的临床情况。这种关注点的差异时常造成临床医生对检测报 告的误解。本建议提出基因变异的临床分级方案,即在基因检测报告中不仅应对基因变异的致病性进行分类,还应 增加临床意义的分级。推荐将基因变异的临床指导意义分为5个级别:具有明确的临床指导意义、具有潜在的临床 指导意义、临床指导意义不明确、具有意外发现的临床指导意义和没有明显的临床指导意义。本方案强调了临床表 型的准确性、全面性,以及实验室-临床沟通的重要性,并且提倡表型描述的标准化,这将有助于临床医生与实验室 人员之间的相互理解,有利于基因检测报告的解读和遗传咨询。

关键词: 基因检测, 遗传变异, 遗传咨询, 致病性分类, 临床意义, 结果解读

Abstract: Presently, clinical genetic testing reports for genetic patients mainly describe the pathogenicity of gene variations and their clinical implications. When writing reports, laboratory staff often focus on the nature of variation itself. However, clinicians have to face the referred cases, so their focus is mainly on the clinical situation of cases. This situation often causes clinicians to misunderstand test reports. The paper proposes a five-tier categorization system of the sequence variation findings based on their clinical significance. That is, the genetic test report should not only classify the pathogenicity of gene variants, but also include the classification of clinical significance. This protocol recommended that the clinical significance of gene mutation be divided into five levels: variants with strong clinical significance, variants with potential clinical significance, variants of unknown clinical significance, unexpected secondary findings and variants with no important clinical significance. This protocol emphasizes the importance of accuracy and comprehensiveness of clinical phenotypes and the importance of laboratory-clinical communication. The standardization of phenotype description is advocated. These recommendations will promote the mutual understanding for the clinicians and laboratory staff, and will be helpful for the interpretation of the testing reports and genetic counseling.

Key words: genetic testing, genetic variation, genetic counseling, pathogenicity classification, clinical significance, result interpretation