A prospective evaluation of whole-exome sequencing as a first-tier molecular test in infants with suspected monogenic disorders

A prospective evaluation of whole-exome sequencing as a first-tier molecular test in infants with suspected monogenic disorders
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DOI:
10.1038/gim.2016.1
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发表时间:
2016-11-01
影响因子:
8.8
通讯作者:
White, Susan M.
White, Susan M.
中科院分区:
医学1区
文献类型:
--
作者:
Stark, Zornitza;Tan, Tiong Y.;White, Susan M.

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Purpose: To prospectively evaluate the diagnostic and clinical utility of singleton whole-exome sequencing (WES) as a first-tier test in infants with suspected mopogenic disease.Methods: Singleton WES was performed as a first-tier sequencing test in infants recruited from a single pediatric tertiary center. This occurred in parallel with standard investigations, including single-or multigene panel sequencing when clinically indicated. The diagnosis rate, clinical utility, and impact on management of singleton WES were evaluated.Results: Of 80 enrolled infants, 46 received a molecular genetic-diagnosis through singleton WES (57.5%) compared with 11 (13.75%) who underwent standard investigations in the same patient group. Clinical management changed following exome diagnosis in 15 of 46 diagnosed participants (32.6%). Twelve relatives received a genetic diagnosis following cascade testing, and 28 couples were identified as being at high risk of recurrence in future pregnancies.Conclusions: This prospective study provides strong evidence for increased diagnostic and clinical utility of singleton WES as a first tier sequencing test for infants with a suspected monogenic disorder. Singleton WES outperformed standard care in terms of diagnosis rate and the benefits of a diagnosis, namely, impact on management of the child and Clarification of reproductive risks for the-extended family in, a timely manner.