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Brady L, Ballantyne M, Duck J, Fisker T, Kleefman R, Li C, Nfonsam L, Schultz LA, Tarnopolsky M, McCready E. Further characterization of the 9q31 microdeletion phenotype; delineation of a common region of overlap containing ZNF462. Mol Genet Genomic Med 2023; 11:e2116. [PMID: 36461789 PMCID: PMC10009906 DOI: 10.1002/mgg3.2116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 11/03/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Loss of function variants and whole gene deletions of ZNF462 has been associated with a novel phenotype of developmental delay/intellectual disability and distinctive facial features. Over two dozen cases have been reported to date and the condition is now known as Weiss-Kruszka syndrome (OMIM# 618619). There are several older reports in the literature and DECIPER detailing individuals with interstitial deletions of 9q31 involving the ZNF462 gene. Many of the characteristic facial features described in these microdeletion cases are similar to those who have been diagnosed with Weiss-Kruszka syndrome. METHODS We describe three additional patients with overlapping 9q31 deletions and compare the phenotypes of the microdeletion cases reported in the literature to Weiss-Kruszka syndrome. RESULTS Phenotypic overlap was observed between patients with 9q31 deletions and Weiss-Kruszka syndrome. Several additional features were noted in 9q31 deletion patients, including hearing loss, small head circumference, palate abnormalities and short stature. CONCLUSIONS The common region of overlap of microdeletion cases implicates ZNF462 as the main driver of the recognizable 9q31 microdeletion phenotype. The observation of additional features in patients with 9q31 microdeletions that are not reported in Weiss-Kruszka syndrome further suggests that other genes from the 9q31 region likely act synergistically with ZNF462 to affect phenotypic expression.
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Affiliation(s)
- Lauren Brady
- Hamilton Health Sciences Centre, Hamilton, Ontario, Canada.,Division of Neuromuscular & Neurometabolic Disorders, Department of Paediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Mark Ballantyne
- Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences Centre, Hamilton, Ontario, Canada
| | - John Duck
- Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences Centre, Hamilton, Ontario, Canada
| | - Thomas Fisker
- Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences Centre, Hamilton, Ontario, Canada
| | - Ryan Kleefman
- Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences Centre, Hamilton, Ontario, Canada
| | - Chumei Li
- Hamilton Health Sciences Centre, Hamilton, Ontario, Canada.,Division of Genetics, Department of Paediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Landry Nfonsam
- Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences Centre, Hamilton, Ontario, Canada.,Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Lee-Anne Schultz
- Hamilton Health Sciences Centre, Hamilton, Ontario, Canada.,Division of Genetics, Department of Paediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Mark Tarnopolsky
- Hamilton Health Sciences Centre, Hamilton, Ontario, Canada.,Division of Neuromuscular & Neurometabolic Disorders, Department of Paediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Elizabeth McCready
- Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences Centre, Hamilton, Ontario, Canada.,Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
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Carter MT, Srour M, Au PYB, Buhas D, Dyack S, Eaton A, Inbar-Feigenberg M, Howley H, Kawamura A, Lewis SME, McCready E, Nelson TN, Vallance H. Genetic and metabolic investigations for neurodevelopmental disorders: position statement of the Canadian College of Medical Geneticists (CCMG). J Med Genet 2023; 60:523-532. [PMID: 36822643 DOI: 10.1136/jmg-2022-108962] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 01/27/2023] [Indexed: 02/25/2023]
Abstract
PURPOSE AND SCOPE The aim of this position statement is to provide recommendations for clinicians regarding the use of genetic and metabolic investigations for patients with neurodevelopmental disorders (NDDs), specifically, patients with global developmental delay (GDD), intellectual disability (ID) and/or autism spectrum disorder (ASD). This document also provides guidance for primary care and non-genetics specialists caring for these patients while awaiting consultation with a clinical geneticist or metabolic specialist. METHODS OF STATEMENT DEVELOPMENT A multidisciplinary group reviewed existing literature and guidelines on the use of genetic and metabolic investigations for the diagnosis of NDDs and synthesised the evidence to make recommendations relevant to the Canadian context. The statement was circulated for comment to the Canadian College of Medical Geneticists (CCMG) membership-at-large and to the Canadian Pediatric Society (Mental Health and Developmental Disabilities Committee); following incorporation of feedback, it was approved by the CCMG Board of Directors on 1 September 2022. RESULTS AND CONCLUSIONS Chromosomal microarray is recommended as a first-tier test for patients with GDD, ID or ASD. Fragile X testing should also be done as a first-tier test when there are suggestive clinical features or family history. Metabolic investigations should be done if there are clinical features suggestive of an inherited metabolic disease, while the patient awaits consultation with a metabolic physician. Exome sequencing or a comprehensive gene panel is recommended as a second-tier test for patients with GDD or ID. Genetic testing is not recommended for patients with NDDs in the absence of GDD, ID or ASD, unless accompanied by clinical features suggestive of a syndromic aetiology or inherited metabolic disease.
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Affiliation(s)
| | - Myriam Srour
- Division of Neurology, McGill University Health Centre, Montreal, Québec, Canada
- Department of Pediatrics, McGill University, Montréal, QC, Canada
| | - Ping-Yee Billie Au
- Department of Medical Genetics, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Daniela Buhas
- Division of Medical Genetics, Department of Specialized Medicine, McGill University Health Centre, McGill University, Montreal, Québec, Canada
- Department of Human Genetics, McGill University, Montreal, QC, Canada
| | - Sarah Dyack
- Division of Medical Genetics, IWK Health Centre, Halifax, Nova Scotia, Canada
- Department of Pediatrics, Dalhousie University, Halifax, NS, Canada
| | - Alison Eaton
- Department of Medical Genetics, Stollery Children's Hospital, Edmonton, Alberta, Canada
- Department of Medical Genetics, University of Alberta, Edmonton, AB, Canada
| | - Michal Inbar-Feigenberg
- Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Heather Howley
- Office of Research Services, CHEO Research Institute, Ottawa, Ontario, Canada
| | - Anne Kawamura
- Division of Developmental Pediatrics, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Department of Paediatrics, University of Toronto, Toronto, ON, Canada
- Mental Health and Developmental Disability Committee, Canadian Pediatric Society, Ottawa, ON, Canada
- Canadian Paediatric Society, Toronto, Ontario, Canada
| | - Suzanne M E Lewis
- Department of Medical Genetics, BC Children's and Women's Hospital, Vancouver, British Columbia, Canada
| | - Elizabeth McCready
- Department of Pathology and Molecular Medicine, McMaster University, McMaster University, Hamilton, ON, Canada, Hamilton, Ontario, Canada
- Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences Centre, Hamilton, ON, Canada
| | - Tanya N Nelson
- Department of Pathology and Laboratory Medicine, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Hilary Vallance
- Department of Pathology and Laboratory Medicine, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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Schenkel LC, Mathew J, Hirte H, Provias J, Paré G, Chong M, Grafodatskaya D, McCready E. Evaluation of DNA Methylation Array for Glioma Tumor Profiling and Description of a Novel Epi-Signature to Distinguish IDH1/IDH2 Mutant and Wild-Type Tumors. Genes (Basel) 2022; 13:2075. [PMID: 36360312 PMCID: PMC9690723 DOI: 10.3390/genes13112075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/17/2022] [Accepted: 10/27/2022] [Indexed: 09/15/2023] Open
Abstract
UNLABELLED Molecular biomarkers, such as IDH1/IDH2 mutations and 1p19q co-deletion, are included in the histopathological and clinical criteria currently used to diagnose and classify gliomas. IDH1/IDH2 mutation is a common feature of gliomas and is associated with a glioma-CpG island methylator phenotype (CIMP). Aberrant genomic methylation patterns can also be used to extrapolate information about copy number variation in a tumor. This project's goal was to assess the feasibility of DNA methylation array for the simultaneous detection of glioma biomarkers as a more effective testing strategy compared to existing single analyte tests. METHODS Whole-genome methylation array (WGMA) testing was performed using 48 glioma DNA samples to detect methylation aberrations and chromosomal gains and losses. The analyzed samples include 39 tumors in the discovery cohort and 9 tumors in the replication cohort. Methylation profiles for each sample were correlated with IDH1 p.R132G mutation, immunohistochemistry (IHC), and previous 1p19q clinical testing to assess the sensitivity and specificity of the WGMA assay for the detection of these variants. RESULTS We developed a DNA methylation signature to specifically distinguish a IDH1/IDH2 mutant tumor from normal samples. This signature is composed of 11 CpG sites that were significantly hypermethylated in the IDH1/IDH2 mutant group. Copy number analysis using WGMA data was able to identify five of five positive samples for 1p19q co-deletion and was concordant for all negative samples. CONCLUSIONS The DNA methylation signature presented here has the potential to refine the utility of WGMA to predict IDH1/IDH2 mutation status of gliomas, thus improving diagnostic yield and efficiency of laboratory testing compared to single analyte IDH1/IDH2 or 1p19q tests.
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Affiliation(s)
- Laila C. Schenkel
- Faculty of Health Sciences, Department of Pathology and Molecular Medicine, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
| | - Joseph Mathew
- Faculty of Health Sciences, Department of Pathology and Molecular Medicine, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
| | - Hal Hirte
- Faculty of Health Sciences, Department of Oncology, McMaster University, 699 Concession Street, Hamilton, ON L8V 5C2, Canada
| | - John Provias
- Faculty of Health Sciences, Department of Pathology and Molecular Medicine, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
- Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences and St. Joseph’s Healthcare Hamilton, 50 Charlton Avenue East, Hamilton, ON L8N 4A6, Canada
| | - Guillaume Paré
- Faculty of Health Sciences, Department of Pathology and Molecular Medicine, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
- Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences and St. Joseph’s Healthcare Hamilton, 50 Charlton Avenue East, Hamilton, ON L8N 4A6, Canada
- Population Health Research Institute, 237 Barton Street East, Hamilton, ON L8L 2X2, Canada
- Faculty of Health Sciences, Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Michael Chong
- Faculty of Health Sciences, Department of Pathology and Molecular Medicine, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
- Population Health Research Institute, 237 Barton Street East, Hamilton, ON L8L 2X2, Canada
- Faculty of Health Sciences, Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Daria Grafodatskaya
- Faculty of Health Sciences, Department of Pathology and Molecular Medicine, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
- Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences and St. Joseph’s Healthcare Hamilton, 50 Charlton Avenue East, Hamilton, ON L8N 4A6, Canada
| | - Elizabeth McCready
- Faculty of Health Sciences, Department of Pathology and Molecular Medicine, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
- Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences and St. Joseph’s Healthcare Hamilton, 50 Charlton Avenue East, Hamilton, ON L8N 4A6, Canada
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4
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Grafodatskaya D, O'Rielly DD, Bedard K, Butcher DT, Howlett CJ, Lytwyn A, McCready E, Parboosingh J, Spriggs EL, Vaags AK, Stockley TL. Practice guidelines for BRCA1/2 tumour testing in ovarian cancer. J Med Genet 2022; 59:727-736. [PMID: 35393334 PMCID: PMC9340048 DOI: 10.1136/jmedgenet-2021-108238] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 02/24/2022] [Indexed: 12/26/2022]
Abstract
The purpose of this document is to provide pre-analytical, analytical and post-analytical considerations and recommendations to Canadian clinical laboratories developing, validating and offering next-generation sequencing (NGS)-based BRCA1 and BRCA2 (BRCA1/2) tumour testing in ovarian cancers. This document was drafted by the members of the Canadian College of Medical Geneticists (CCMG) somatic BRCA Ad Hoc Working Group, and representatives from the Canadian Association of Pathologists. The document was circulated to the CCMG members for comment. Following incorporation of feedback, this document has been approved by the CCMG board of directors. The CCMG is a Canadian organisation responsible for certifying medical geneticists and clinical laboratory geneticists, and for establishing professional and ethical standards for clinical genetics services in Canada. The current CCMG Practice Guidelines were developed as a resource for clinical laboratories in Canada; however, they are not inclusive of all information laboratories should consider in the validation and use of NGS for BRCA1/2 tumour testing in ovarian cancers.
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Affiliation(s)
- Daria Grafodatskaya
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada.,Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Darren D O'Rielly
- Division of BioMedical Sciences, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada.,Centre for Translational Genomes & Division of Genetics, Eastern Regional Health Authority, St. John's, Newfoundland, Canada
| | - Karine Bedard
- Département de Pathologie et Biologie cellulaire, Université de Montréal, Montreal, Québec, Canada.,Laboratoire de Diagnostic Moléculaire, Centre hospitalier de l'Université de Montréal, Montreal, Québec, Canada
| | - Darci T Butcher
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada.,Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Christopher J Howlett
- Department of Pathology and Laboratory Medicine, Schulich School of Medicine & Dentistry, Wester University, London, Ontario, Canada
| | - Alice Lytwyn
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada.,Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Elizabeth McCready
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada.,Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Jillian Parboosingh
- Department of Medical Genetics, Alberta Children's Hospital Research Institute for Child and Maternal Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Genetics and Genomics, Alberta Precision Laboratories, Calgary, Alberta, Canada
| | - Elizabeth L Spriggs
- Genomics, Diagnostic Services, Shared Health Manitoba, Winnipeg, Manitoba, Canada.,Department of Biochemistry and Medical Genetics, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Andrea K Vaags
- Laboratory Medicine and Genetics, Trillium Health Partners, Mississauga, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Tracy L Stockley
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada .,Department of Clinical Laboratory Genetics, Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada
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Whitney R, Nair A, McCready E, Keller AE, Adil IS, Aziz AS, Borys O, Siu K, Shah C, Meaney BF, Jones K, RamachandranNair R. The spectrum of epilepsy in children with 15q13.3 microdeletion syndrome. Seizure 2021; 92:221-229. [PMID: 34601452 DOI: 10.1016/j.seizure.2021.09.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/02/2021] [Accepted: 09/23/2021] [Indexed: 12/31/2022] Open
Abstract
PURPOSE To further define the epilepsy phenotype in a cohort of children with 15q13.3 microdeletion syndrome. METHODS We retrospectively reviewed the phenotypic spectrum of all children aged < 18 years with epilepsy and 15q13.3 microdeletion syndrome. RESULTS Thirteen children were included, 69% were female. The median age of children in the cohort was 12 years (age range: 3 years-15 years). Median age at seizure onset was 4 years. Eleven children (85%) had intellectual disability. Nine of 13 children (69%) had a history of typical absence seizures with median age of onset at 5 years (2 had absence status epilepticus). Thirty-one percent (4/13) had focal with impaired awareness non-motor onset seizures. ILAE recognized absence epilepsy syndromes were diagnosed in 6/13 (46%). The remainder were classified as having genetic generalized epilepsies with overlap clinical features, combined or focal epilepsies. Electroencephalogram in the cohort showed generalized (85%) and focal epileptiform discharges (62%) and posterior dominant rhythm slowing (33%). One child had electrical status epilepticus of sleep. Neuroimaging was performed in 5 children (38%) and revealed abnormal findings in 3. Seizures were drug resistant in a third of the cohort. Valproate resulted in seizure freedom in 5 (42%). Oxcarbazepine caused clinical worsening in one child with combined seizure types. Two children tried cannabidiol and one tried the ketogenic diet; neither was effective. CONCLUSIONS The epilepsy phenotype in children with 15q13.3 microdeletion syndrome is defined by childhood onset absence seizures, and may have atypical features such as, early onset absences, persistence into adolescence, status epilepticus, intellectual disability and treatment resistance. Focal seizures and focal EEG findings may be observed and should be treated cautiously, given the possibility of combined seizure types. Valproate appeared effective, although other treatments must be explored further.
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Affiliation(s)
- Robyn Whitney
- Division of Neurology, Department of Paediatrics, McMaster University, Hamilton, ON, Canada.
| | - Arjun Nair
- Division of Neurology, Department of Paediatrics, McMaster University, Hamilton, ON, Canada
| | - Elizabeth McCready
- Division of Clinical Pathology, Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
| | - Anne E Keller
- Division of Neurology, Department of Paediatrics, McMaster University, Hamilton, ON, Canada
| | - Ishita Siddiq Adil
- Pediatric Neurology Clinic, Oakville, ON, Canada; Division of Neurology, Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - Aly Shah Aziz
- Division of Neurology, Department of Paediatrics, McMaster University, Hamilton, ON, Canada; Pediatric Neurology Clinic, Oakville, ON, Canada
| | - Oksana Borys
- Division of Neurology, Department of Paediatrics, McMaster University, Hamilton, ON, Canada; Pediatric Neurology Clinic, Oakville, ON, Canada
| | - Kaitlyn Siu
- Division of Neurology, Department of Paediatrics, McMaster University, Hamilton, ON, Canada
| | - Chintan Shah
- Division of Neurology, Department of Paediatrics, McMaster University, Hamilton, ON, Canada
| | - Brandon F Meaney
- Division of Neurology, Department of Paediatrics, McMaster University, Hamilton, ON, Canada
| | - Kevin Jones
- Division of Neurology, Department of Paediatrics, McMaster University, Hamilton, ON, Canada
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Selvarajah S, Plante S, Speevak M, Vaags A, Hamelinck D, Butcher M, McCready E, Grafodatskaya D, Blais N, Tran-Thanh D, Weng X, Nassabein R, Greer W, Walton RN, Lo B, Demetrick D, Santos S, Sadikovic B, Zhang X, Zhang T, Spence T, Stockley T, Feilotter H, Joubert P. A Pan-Canadian Validation Study for the Detection of EGFR T790M Mutation Using Circulating Tumor DNA From Peripheral Blood. JTO Clin Res Rep 2021; 2:100212. [PMID: 34590051 PMCID: PMC8474449 DOI: 10.1016/j.jtocrr.2021.100212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/23/2021] [Accepted: 07/08/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Genotyping circulating tumor DNA (ctDNA) is a promising noninvasive clinical tool to identify the EGFR T790M resistance mutation in patients with advanced NSCLC with resistance to EGFR inhibitors. To facilitate standardization and clinical adoption of ctDNA testing across Canada, we developed a 2-phase multicenter study to standardize T790M mutation detection using plasma ctDNA testing. METHODS In phase 1, commercial reference standards were distributed to participating clinical laboratories, to use their existing platforms for mutation detection. Baseline performance characteristics were established using known and blinded engineered plasma samples spiked with predetermined concentrations of T790M, L858R, and exon 19 deletion variants. In phase II, peripheral blood collected from local patients with known EGFR activating mutations and progressing on treatment were assayed for the presence of EGFR variants and concordance with a clinically validated test at the reference laboratory. RESULTS All laboratories in phase 1 detected the variants at 0.5 % and 5.0 % allele frequencies, with no false positives. In phase 2, the concordance with the reference laboratory for detection of both the primary and resistance mutation was high, with next-generation sequencing and droplet digital polymerase chain reaction exhibiting the best overall concordance. Data also suggested that the ability to detect mutations at clinically relevant limits of detection is generally not platform-specific, but rather impacted by laboratory-specific practices. CONCLUSIONS Discrepancies among sending laboratories using the same assay suggest that laboratory-specific practices may impact performance. In addition, a negative or inconclusive ctDNA test should be followed by tumor testing when possible.
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Affiliation(s)
- Shamini Selvarajah
- Department of Laboratory Medicine and Genetics, Trillium Health Partners, Mississauga, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Sophie Plante
- Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Québec, Quebec, Canada
| | - Marsha Speevak
- Department of Laboratory Medicine and Genetics, Trillium Health Partners, Mississauga, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Andrea Vaags
- Department of Laboratory Medicine and Genetics, Trillium Health Partners, Mississauga, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Darren Hamelinck
- Department of Laboratory Medicine and Genetics, Trillium Health Partners, Mississauga, Ontario, Canada
| | - Martin Butcher
- Department of Oncology, McMaster University, Hamilton, Ontario, Canada
| | - Elizabeth McCready
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
- Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Daria Grafodatskaya
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
- Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Normand Blais
- Centre Hospitalier de l’Université de Montréal, Montréal, Quebec, Canada
| | - Danh Tran-Thanh
- Centre Hospitalier de l’Université de Montréal, Montréal, Quebec, Canada
| | - Xiaoduan Weng
- Centre Hospitalier de l’Université de Montréal, Montréal, Quebec, Canada
| | - Rami Nassabein
- Centre Hospitalier de l’Université de Montréal, Montréal, Quebec, Canada
| | - Wenda Greer
- Queen Elizabeth II Health Sciences Center, Department of Pathology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Bryan Lo
- Department of Pathology and Laboratory Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Doug Demetrick
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Oncology, University of Calgary, Calgary, Alberta, Canada
- Department of Biochemistry and Molecular Biology, University of Calgary, Calgary, Alberta, Canada
- Department of Medical Genetics, University of Calgary, Calgary, Alberta, Canada
| | - Stephanie Santos
- Molecular Genetics Laboratory, Molecular Diagnostics Division, London Health Sciences Centre, London, Ontario, Canada
| | - Bekim Sadikovic
- Molecular Genetics Laboratory, Molecular Diagnostics Division, London Health Sciences Centre, London, Ontario, Canada
- Department of Pathology and Laboratory Medicine, Western University, London, Ontario, Canada
- Verspeeten Clinical Genome Centre, London Health Sciences Centre, London, Ontario, Canada
| | - Xiao Zhang
- Laboratory Genetics, Kingston Health Sciences Center, Kingston, Ontario, Canada
| | - Tong Zhang
- Department of Clinical Laboratory Genetics, University Health Network, Toronto, Ontario, Canada
| | - Tara Spence
- Department of Pathology and Molecular Medicine, Queen’s University, Kingston, Ontario, Canada
| | - Tracy Stockley
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
- Department of Clinical Laboratory Genetics, University Health Network, Toronto, Ontario, Canada
| | - Harriet Feilotter
- Laboratory Genetics, Kingston Health Sciences Center, Kingston, Ontario, Canada
- Department of Pathology and Molecular Medicine, Queen’s University, Kingston, Ontario, Canada
| | - Philippe Joubert
- Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Québec, Quebec, Canada
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7
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Ashfield T, McCready E, Shago M, Wang H, Sinclair-Bourque E, Cappa E, Piche Marolt A, Chun K. Practice patterns of prenatal and perinatal testing in Canadian cytogenetics laboratories. Prenat Diagn 2021; 41:843-854. [PMID: 33882154 DOI: 10.1002/pd.5951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 02/04/2021] [Accepted: 03/22/2021] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To survey patterns of practice in Canadian cytogenetics laboratories and evaluate whether newer technologies have influenced testing algorithms for the detection of common aneuploidies and other genomic imbalances in the prenatal and perinatal settings. METHODS Cytogenetics laboratories across Canada were invited to participate in two patterns-of-practice surveys: one in 2016 and one in 2019. They were asked to identify the prenatal and perinatal specimen types tested at their facility and which testing methods were used for initial testing and for follow-up. RESULTS All clinical laboratories performing prenatal testing offer rapid aneuploidy detection (RAD). Most laboratories also offer microarray analysis. A positive result is either followed up by karyotyping or no further testing is performed. For prenatal samples, a negative result may be followed up by microarray or karyotyping and is dependent on the reason for referral. For perinatal samples, availability of microarray to follow up a negative result is increasing. CONCLUSIONS Since 2016, the availability of RAD as a first-line test in Canadian cytogenetics laboratories remains consistent, while microarray has become the preferred follow-up testing method over traditional karyotyping following a normal RAD result. Despite a universal healthcare system, disparities in prenatal and perinatal cytogenetic testing algorithms are apparent.
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Affiliation(s)
- Tamara Ashfield
- Institute for Quality Management in Healthcare, Toronto, Canada
| | - Elizabeth McCready
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Canada.,Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences, Hamilton, Canada
| | - Mary Shago
- Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
| | - Hong Wang
- Genetics Program, North York General Hospital, Toronto, Canada
| | | | - Eva Cappa
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital - Joseph & Wolf Lebovic Health Complex, Toronto, Canada
| | | | - Kathy Chun
- Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
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8
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McCready E, Butcher D, Woodside C, Kord D, Sur ML, Lytwyn A, Bell K, Nfonsam L, Choi C, Grafodatskaya D. 33. Tumor testing of DNA repair genes in high grade serous ovarian cancer (HGSOC); a potential tool for personalized therapy. Cancer Genet 2020. [DOI: 10.1016/j.cancergen.2020.04.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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9
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Odedra D, MacEachern K, Elit L, Mohamed S, McCready E, DeFrance B, Wang Y. Twin pregnancy with metastatic complete molar pregnancy and coexisting live fetus. Radiol Case Rep 2019; 15:195-200. [PMID: 31890067 PMCID: PMC6928291 DOI: 10.1016/j.radcr.2019.11.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 11/24/2019] [Accepted: 11/24/2019] [Indexed: 11/26/2022] Open
Abstract
We present a case of a 34-year old G1P0 female with twin-gestation and positive prenatal screening. Initial ultrasounds demonstrated a normal live fetus with an indeterminate but persistent placental lesion. The patient presented at 23 weeks of gestational age with vaginal bleeding. On examination, a 2 cm vaginal lesion was identified. Further cross-sectional imaging demonstrated a normal appearing fetus with a mixed solid and cystic placental lesion as well as an additional lesion in the vagina. Metastatic workup revealed diffuse pulmonary metastases. Intravascular embolization was carried out to minimize the bleeding from the vaginal lesion, followed by the delivery of the fetus with an urgent Caesarean section and treatment with chemotherapy. Pathology and genetics testing confirmed diagnosis of a complete molar pregnancy with a coexisting live fetus. This case highlights the importance of any unexpected findings within the placenta or the uterus in a pregnant patient. The radiologist should maintain a high index of suspicion for gestational trophoblastic disease in such cases, communicate clearly with the clinical team and suggest appropriate additional imaging.
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Affiliation(s)
- Devang Odedra
- Department of Radiology, McMaster University, Room 2S23-1, 1200 Main Street West, Hamilton, ON L8N 3Z5, USA
| | - Kelsey MacEachern
- Michael DeGroote School of Medicine, McMaster University, Hamilton, ON, USA
| | - Lorraine Elit
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON, USA.,Department of Oncology, McMaster University, Hamilton, ON, USA
| | - Sarab Mohamed
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, USA
| | - Elizabeth McCready
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, USA.,Department of Genetics, McMaster University, Hamilton, ON, USA
| | - Bryon DeFrance
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON, USA
| | - Yongdong Wang
- Department of Radiology, McMaster University, Room 2S23-1, 1200 Main Street West, Hamilton, ON L8N 3Z5, USA
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10
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Spence T, Stickle N, Yu C, Chow H, Feilotter H, Lo B, McCready E, Sadikovic B, Siu LL, Bedard PL, Stockley TL. Inter-laboratory proficiency testing scheme for tumour next-generation sequencing in Ontario: a pilot study. ACTA ACUST UNITED AC 2019; 26:e717-e732. [PMID: 31896942 DOI: 10.3747/co.26.5379] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background A pilot inter-laboratory proficiency scheme for 5 Ontario clinical laboratories testing tumour samples for the Ontario-wide Cancer Targeted Nucleic Acid Evaluation (octane) study was undertaken to assess proficiency in the identification and reporting of next-generation sequencing (ngs) test results in solid tumour testing from archival formalin-fixed, paraffin-embedded (ffpe) tissue. Methods One laboratory served as the reference centre and provided samples to 4 participating laboratories. An analyte-based approach was applied: each participating laboratory received 10 ffpe tissue specimens profiled at the reference centre, with tumour site and histology provided. Laboratories performed testing per their standard ngs tumour test protocols. Items returned for assessment included genes and variants that would be typically reported in routine clinical testing and variant call format (vcf) files to allow for assessment of ngs technical quality. Results Two main aspects were assessed:■ Technical quality and accuracy of identification of exonic variants■ Site-specific reporting practicesTechnical assessment included evaluation of exonic variant identification, quality assessment of the vcf files to evaluate base calling, variant allele frequency, and depth of coverage for all exonic variants. Concordance at 100% was observed from all sites in the technical identification of 98 exonic variants across the 10 cases. Variability between laboratories in the choice of variants considered clinically reportable was significant. Of the 38 variants reported as clinically relevant by at least 1 site, only 3 variants were concordantly reported by all participating centres as clinically relevant. Conclusions Although excellent technical concordance for ngs tumour profiling was observed across participating institutions, differences in the reporting of clinically relevant variants were observed, highlighting reporting as a gap where consensus on the part of Ontario laboratories is needed.
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Affiliation(s)
- T Spence
- Toronto, ON: Advanced Molecular Diagnostics Laboratory, Princess Margaret Cancer Centre, University Health Network (Spence, Stockley); Bioinformatics and HPC Core, Princess Margaret Cancer Centre, University Health Network (Stickle); Cancer Genomics Program, Princess Margaret Cancer Centre, University Health Network (Yu, Chow, Siu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network (Siu, Bedard); Department of Medicine, University of Toronto (Siu, Bedard); Department of Clinical Laboratory Genetics, University Health Network (Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Stockley)
| | - N Stickle
- Toronto, ON: Advanced Molecular Diagnostics Laboratory, Princess Margaret Cancer Centre, University Health Network (Spence, Stockley); Bioinformatics and HPC Core, Princess Margaret Cancer Centre, University Health Network (Stickle); Cancer Genomics Program, Princess Margaret Cancer Centre, University Health Network (Yu, Chow, Siu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network (Siu, Bedard); Department of Medicine, University of Toronto (Siu, Bedard); Department of Clinical Laboratory Genetics, University Health Network (Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Stockley)
| | - C Yu
- Toronto, ON: Advanced Molecular Diagnostics Laboratory, Princess Margaret Cancer Centre, University Health Network (Spence, Stockley); Bioinformatics and HPC Core, Princess Margaret Cancer Centre, University Health Network (Stickle); Cancer Genomics Program, Princess Margaret Cancer Centre, University Health Network (Yu, Chow, Siu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network (Siu, Bedard); Department of Medicine, University of Toronto (Siu, Bedard); Department of Clinical Laboratory Genetics, University Health Network (Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Stockley)
| | - H Chow
- Toronto, ON: Advanced Molecular Diagnostics Laboratory, Princess Margaret Cancer Centre, University Health Network (Spence, Stockley); Bioinformatics and HPC Core, Princess Margaret Cancer Centre, University Health Network (Stickle); Cancer Genomics Program, Princess Margaret Cancer Centre, University Health Network (Yu, Chow, Siu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network (Siu, Bedard); Department of Medicine, University of Toronto (Siu, Bedard); Department of Clinical Laboratory Genetics, University Health Network (Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Stockley)
| | - H Feilotter
- Kingston, ON: Molecular Diagnostics, Kingston Health Sciences Centre (Feilotter); Department of Pathology and Molecular Medicine, Queen's University (Feilotter)
| | - B Lo
- Ottawa, ON: Molecular Oncology Diagnostics Laboratory, The Ottawa Hospital (Lo); Department of Pathology and Laboratory Medicine, University of Ottawa (Lo)
| | - E McCready
- Hamilton, ON: Hamilton Health Sciences and St. Joseph's Healthcare (McCready); Department of Pathology and Molecular Medicine, McMaster University (McCready)
| | - B Sadikovic
- London, ON: Pathology and Laboratory Medicine Program, London Health Sciences Centre (Sadikovic); Department of Pathology and Laboratory Medicine, Western University (Sadikovic)
| | - L L Siu
- Toronto, ON: Advanced Molecular Diagnostics Laboratory, Princess Margaret Cancer Centre, University Health Network (Spence, Stockley); Bioinformatics and HPC Core, Princess Margaret Cancer Centre, University Health Network (Stickle); Cancer Genomics Program, Princess Margaret Cancer Centre, University Health Network (Yu, Chow, Siu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network (Siu, Bedard); Department of Medicine, University of Toronto (Siu, Bedard); Department of Clinical Laboratory Genetics, University Health Network (Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Stockley)
| | - P L Bedard
- Toronto, ON: Advanced Molecular Diagnostics Laboratory, Princess Margaret Cancer Centre, University Health Network (Spence, Stockley); Bioinformatics and HPC Core, Princess Margaret Cancer Centre, University Health Network (Stickle); Cancer Genomics Program, Princess Margaret Cancer Centre, University Health Network (Yu, Chow, Siu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network (Siu, Bedard); Department of Medicine, University of Toronto (Siu, Bedard); Department of Clinical Laboratory Genetics, University Health Network (Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Stockley)
| | - T L Stockley
- Toronto, ON: Advanced Molecular Diagnostics Laboratory, Princess Margaret Cancer Centre, University Health Network (Spence, Stockley); Bioinformatics and HPC Core, Princess Margaret Cancer Centre, University Health Network (Stickle); Cancer Genomics Program, Princess Margaret Cancer Centre, University Health Network (Yu, Chow, Siu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network (Siu, Bedard); Department of Medicine, University of Toronto (Siu, Bedard); Department of Clinical Laboratory Genetics, University Health Network (Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Stockley)
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11
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Malone ER, Saleh RR, Yu C, Ahmed L, Pugh T, Torchia J, Bartlett J, Virtanen C, Hotte SJ, Hilton J, Welch S, Robinson A, McCready E, Lo B, Sadikovic B, Feilotter H, Hanna TP, Kamel-Reid S, Stockley TL, Siu LL, Bedard PL. OCTANE (Ontario-wide Cancer Targeted Nucleic Acid Evaluation): a platform for intraprovincial, national, and international clinical data-sharing. ACTA ACUST UNITED AC 2019; 26:e618-e623. [PMID: 31708655 DOI: 10.3747/co.26.5235] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Cancer is a genetic disease resulting from germline or somatic genetic aberrations. Rapid progress in the field of genomics in recent years is allowing for increased characterization and understanding of the various forms of the disease. The Ontario-wide Cancer Targeted Nucleic Acid Evaluation (octane) clinical trial, open at cancer centres across Ontario, aims to increase access to genomic sequencing of tumours and to facilitate the collection of clinical data related to enrolled patients and their clinical outcomes. The study is designed to assess the clinical utility of next-generation sequencing (ngs) in cancer patient care, including enhancement of treatment options available to patients. A core aim of the study is to encourage collaboration between cancer hospitals within Ontario while also increasing international collaboration in terms of sharing the newly generated data. The single-payer provincial health care system in Ontario provides a unique opportunity to develop a province-wide registry of ngs testing and a repository of genomically characterized, clinically annotated samples. It also provides an important opportunity to use province-wide real-world data to evaluate outcomes and the cost of ngs for patients with advanced cancer. The octane study is attempting to translate knowledge to help deliver precision oncology in a Canadian environment. In this article, we discuss the background to the study and its implementation, current status, and future directions.
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Affiliation(s)
- E R Malone
- Toronto, ON-Laboratory Medicine Program, University Health Network (Kamel-Reid, Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Kamel-Reid, Stockley); Cancer Genomics Program, Princess Margaret Cancer Centre (Ahmed, Bedard, Kamel-Reid, Pugh, Siu, Stockley, Yu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre (Bedard, Malone, Saleh, Siu); Department of Medicine, University of Toronto (Bedard); Department of Medical Biophysics, University of Toronto (Kamel-Reid, Pugh, Siu); Princess Margaret Research Institute, Princess Margaret Cancer Centre (Pugh); Bioinformatics and High Performance Computing Core, University Health Network (Virtanen); Ontario Institute for Cancer Research (Torchia, Bartlett)
| | - R R Saleh
- Toronto, ON-Laboratory Medicine Program, University Health Network (Kamel-Reid, Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Kamel-Reid, Stockley); Cancer Genomics Program, Princess Margaret Cancer Centre (Ahmed, Bedard, Kamel-Reid, Pugh, Siu, Stockley, Yu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre (Bedard, Malone, Saleh, Siu); Department of Medicine, University of Toronto (Bedard); Department of Medical Biophysics, University of Toronto (Kamel-Reid, Pugh, Siu); Princess Margaret Research Institute, Princess Margaret Cancer Centre (Pugh); Bioinformatics and High Performance Computing Core, University Health Network (Virtanen); Ontario Institute for Cancer Research (Torchia, Bartlett)
| | - C Yu
- Toronto, ON-Laboratory Medicine Program, University Health Network (Kamel-Reid, Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Kamel-Reid, Stockley); Cancer Genomics Program, Princess Margaret Cancer Centre (Ahmed, Bedard, Kamel-Reid, Pugh, Siu, Stockley, Yu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre (Bedard, Malone, Saleh, Siu); Department of Medicine, University of Toronto (Bedard); Department of Medical Biophysics, University of Toronto (Kamel-Reid, Pugh, Siu); Princess Margaret Research Institute, Princess Margaret Cancer Centre (Pugh); Bioinformatics and High Performance Computing Core, University Health Network (Virtanen); Ontario Institute for Cancer Research (Torchia, Bartlett)
| | - L Ahmed
- Toronto, ON-Laboratory Medicine Program, University Health Network (Kamel-Reid, Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Kamel-Reid, Stockley); Cancer Genomics Program, Princess Margaret Cancer Centre (Ahmed, Bedard, Kamel-Reid, Pugh, Siu, Stockley, Yu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre (Bedard, Malone, Saleh, Siu); Department of Medicine, University of Toronto (Bedard); Department of Medical Biophysics, University of Toronto (Kamel-Reid, Pugh, Siu); Princess Margaret Research Institute, Princess Margaret Cancer Centre (Pugh); Bioinformatics and High Performance Computing Core, University Health Network (Virtanen); Ontario Institute for Cancer Research (Torchia, Bartlett)
| | - T Pugh
- Toronto, ON-Laboratory Medicine Program, University Health Network (Kamel-Reid, Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Kamel-Reid, Stockley); Cancer Genomics Program, Princess Margaret Cancer Centre (Ahmed, Bedard, Kamel-Reid, Pugh, Siu, Stockley, Yu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre (Bedard, Malone, Saleh, Siu); Department of Medicine, University of Toronto (Bedard); Department of Medical Biophysics, University of Toronto (Kamel-Reid, Pugh, Siu); Princess Margaret Research Institute, Princess Margaret Cancer Centre (Pugh); Bioinformatics and High Performance Computing Core, University Health Network (Virtanen); Ontario Institute for Cancer Research (Torchia, Bartlett)
| | - J Torchia
- Toronto, ON-Laboratory Medicine Program, University Health Network (Kamel-Reid, Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Kamel-Reid, Stockley); Cancer Genomics Program, Princess Margaret Cancer Centre (Ahmed, Bedard, Kamel-Reid, Pugh, Siu, Stockley, Yu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre (Bedard, Malone, Saleh, Siu); Department of Medicine, University of Toronto (Bedard); Department of Medical Biophysics, University of Toronto (Kamel-Reid, Pugh, Siu); Princess Margaret Research Institute, Princess Margaret Cancer Centre (Pugh); Bioinformatics and High Performance Computing Core, University Health Network (Virtanen); Ontario Institute for Cancer Research (Torchia, Bartlett)
| | - J Bartlett
- Toronto, ON-Laboratory Medicine Program, University Health Network (Kamel-Reid, Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Kamel-Reid, Stockley); Cancer Genomics Program, Princess Margaret Cancer Centre (Ahmed, Bedard, Kamel-Reid, Pugh, Siu, Stockley, Yu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre (Bedard, Malone, Saleh, Siu); Department of Medicine, University of Toronto (Bedard); Department of Medical Biophysics, University of Toronto (Kamel-Reid, Pugh, Siu); Princess Margaret Research Institute, Princess Margaret Cancer Centre (Pugh); Bioinformatics and High Performance Computing Core, University Health Network (Virtanen); Ontario Institute for Cancer Research (Torchia, Bartlett)
| | - C Virtanen
- Toronto, ON-Laboratory Medicine Program, University Health Network (Kamel-Reid, Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Kamel-Reid, Stockley); Cancer Genomics Program, Princess Margaret Cancer Centre (Ahmed, Bedard, Kamel-Reid, Pugh, Siu, Stockley, Yu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre (Bedard, Malone, Saleh, Siu); Department of Medicine, University of Toronto (Bedard); Department of Medical Biophysics, University of Toronto (Kamel-Reid, Pugh, Siu); Princess Margaret Research Institute, Princess Margaret Cancer Centre (Pugh); Bioinformatics and High Performance Computing Core, University Health Network (Virtanen); Ontario Institute for Cancer Research (Torchia, Bartlett)
| | - S J Hotte
- Hamilton, ON-Laboratory Genetic Services Division, Hamilton Regional Laboratory Medicine Program (McCready); McMaster University (Hotte); Juravinski Cancer Centre (Hotte)
| | - J Hilton
- Ottawa, ON-The Ottawa Hospital Research Institute (Lo); University of Ottawa (Hilton); The Ottawa Hospital Cancer Program (Hilton)
| | - S Welch
- London, ON-Department of Pathology and Laboratory Medicine, Western University, and Molecular Genetics Laboratory, Molecular Diagnostics Division, London Health Sciences Centre (Sadikovic); University of Western Ontario (Welch); London Health Sciences Health Centre (Welch)
| | - A Robinson
- Kingston, ON-Department of Pathology and Molecular Medicine, Queen's University (Feilotter); Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen's University (Hanna, Robinson); Kingston General Hospital (Hanna, Robinson)
| | - E McCready
- Hamilton, ON-Laboratory Genetic Services Division, Hamilton Regional Laboratory Medicine Program (McCready); McMaster University (Hotte); Juravinski Cancer Centre (Hotte)
| | - B Lo
- Ottawa, ON-The Ottawa Hospital Research Institute (Lo); University of Ottawa (Hilton); The Ottawa Hospital Cancer Program (Hilton)
| | - B Sadikovic
- London, ON-Department of Pathology and Laboratory Medicine, Western University, and Molecular Genetics Laboratory, Molecular Diagnostics Division, London Health Sciences Centre (Sadikovic); University of Western Ontario (Welch); London Health Sciences Health Centre (Welch)
| | - H Feilotter
- Kingston, ON-Department of Pathology and Molecular Medicine, Queen's University (Feilotter); Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen's University (Hanna, Robinson); Kingston General Hospital (Hanna, Robinson)
| | - T P Hanna
- Kingston, ON-Department of Pathology and Molecular Medicine, Queen's University (Feilotter); Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen's University (Hanna, Robinson); Kingston General Hospital (Hanna, Robinson)
| | - S Kamel-Reid
- Toronto, ON-Laboratory Medicine Program, University Health Network (Kamel-Reid, Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Kamel-Reid, Stockley); Cancer Genomics Program, Princess Margaret Cancer Centre (Ahmed, Bedard, Kamel-Reid, Pugh, Siu, Stockley, Yu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre (Bedard, Malone, Saleh, Siu); Department of Medicine, University of Toronto (Bedard); Department of Medical Biophysics, University of Toronto (Kamel-Reid, Pugh, Siu); Princess Margaret Research Institute, Princess Margaret Cancer Centre (Pugh); Bioinformatics and High Performance Computing Core, University Health Network (Virtanen); Ontario Institute for Cancer Research (Torchia, Bartlett)
| | - T L Stockley
- Toronto, ON-Laboratory Medicine Program, University Health Network (Kamel-Reid, Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Kamel-Reid, Stockley); Cancer Genomics Program, Princess Margaret Cancer Centre (Ahmed, Bedard, Kamel-Reid, Pugh, Siu, Stockley, Yu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre (Bedard, Malone, Saleh, Siu); Department of Medicine, University of Toronto (Bedard); Department of Medical Biophysics, University of Toronto (Kamel-Reid, Pugh, Siu); Princess Margaret Research Institute, Princess Margaret Cancer Centre (Pugh); Bioinformatics and High Performance Computing Core, University Health Network (Virtanen); Ontario Institute for Cancer Research (Torchia, Bartlett)
| | - L L Siu
- Toronto, ON-Laboratory Medicine Program, University Health Network (Kamel-Reid, Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Kamel-Reid, Stockley); Cancer Genomics Program, Princess Margaret Cancer Centre (Ahmed, Bedard, Kamel-Reid, Pugh, Siu, Stockley, Yu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre (Bedard, Malone, Saleh, Siu); Department of Medicine, University of Toronto (Bedard); Department of Medical Biophysics, University of Toronto (Kamel-Reid, Pugh, Siu); Princess Margaret Research Institute, Princess Margaret Cancer Centre (Pugh); Bioinformatics and High Performance Computing Core, University Health Network (Virtanen); Ontario Institute for Cancer Research (Torchia, Bartlett)
| | - P L Bedard
- Toronto, ON-Laboratory Medicine Program, University Health Network (Kamel-Reid, Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Kamel-Reid, Stockley); Cancer Genomics Program, Princess Margaret Cancer Centre (Ahmed, Bedard, Kamel-Reid, Pugh, Siu, Stockley, Yu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre (Bedard, Malone, Saleh, Siu); Department of Medicine, University of Toronto (Bedard); Department of Medical Biophysics, University of Toronto (Kamel-Reid, Pugh, Siu); Princess Margaret Research Institute, Princess Margaret Cancer Centre (Pugh); Bioinformatics and High Performance Computing Core, University Health Network (Virtanen); Ontario Institute for Cancer Research (Torchia, Bartlett)
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12
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Arts HH, Lynch L, Grafodatskaya D, Eng B, Malloy L, Duck J, White R, Woodside C, Bell K, Zbuk KM, McCready E. ATM whole gene deletion in an Italian family with hereditary pancreatic cancer: Challenges to cancer risk prediction associated with an 11q22.3 microdeletion. Cancer Genet 2019; 240:1-4. [PMID: 31671381 DOI: 10.1016/j.cancergen.2019.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 09/06/2019] [Accepted: 10/11/2019] [Indexed: 01/02/2023]
Abstract
Hereditary pancreatic cancer has been attributed to variants of several cancer predisposition genes including ATM. While heterozygous pathogenic variants in the ATM gene are implicated as a cause of familial breast and pancreatic cancers to our knowledge ATM whole gene deletions have not been previously reported. We describe a contiguous gene deletion of the ATM locus in a multi-generation family of Italian descent with a strong family history of pancreatic cancer. A deletion of one copy of the entire ATM gene was identified by routine panel testing and further characterized by chromosomal microarray analysis. An 11q22.3 microdeletion of approximately 960 kb was identified that is predicted to result in loss of 10 genes including ATM. The deletion was identified in two additional family members including a presymptomatic daughter and an affected sibling. A normal disomic complement of the 11q22.3 region was detected in a third family member with a history of prostate and pancreatic cancer. Additional family members were not available for testing. Given available evidence that ATM haploinsufficiency can increase cancer risk, we predict that the observed copy number loss has likely contributed to hereditary cancer in this family. However, absence of the familial microdeletion in at least one affected family member suggests that ATM deletions are unlikely the sole contributing factor influencing tumor development in affected individuals. This case highlights 11q22.3 microdeletions of the ATM gene region as a possible risk factor for hereditary cancer, including pancreatic cancer. The same case provides a further cautionary tale for over interpretation of cancer risk associated tumor suppressor microdeletions and suggests that the variant may not be sufficient for tumor development or may modify the cancer risks associated with other, yet unidentified hereditary cancer genes.
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Affiliation(s)
- Heleen H Arts
- McMaster University, Department of Pathology and Molecular Medicine, 1280 Main Street West, L8S 4L8, Hamilton, ON, Canada
| | - Lorrie Lynch
- Juravinski Cancer Centre, Hamilton Health Sciences, 699 Concession Street, L8V 5C2, Hamilton, ON, Canada
| | - Daria Grafodatskaya
- McMaster University, Department of Pathology and Molecular Medicine, 1280 Main Street West, L8S 4L8, Hamilton, ON, Canada; Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences, 1200 Main Street West, L8S 4J9, Hamilton, ON, Canada
| | - Barry Eng
- Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences, 1200 Main Street West, L8S 4J9, Hamilton, ON, Canada
| | - Lesley Malloy
- Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences, 1200 Main Street West, L8S 4J9, Hamilton, ON, Canada
| | - John Duck
- Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences, 1200 Main Street West, L8S 4J9, Hamilton, ON, Canada
| | - Robyn White
- Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences, 1200 Main Street West, L8S 4J9, Hamilton, ON, Canada
| | - Crystal Woodside
- Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences, 1200 Main Street West, L8S 4J9, Hamilton, ON, Canada
| | - Kathleen Bell
- Juravinski Cancer Centre, Hamilton Health Sciences, 699 Concession Street, L8V 5C2, Hamilton, ON, Canada; Department of Oncology, McMaster University, 699 Concession Street, L8V 5C2, Hamilton, ON, Canada
| | - Kevin M Zbuk
- Juravinski Cancer Centre, Hamilton Health Sciences, 699 Concession Street, L8V 5C2, Hamilton, ON, Canada; Department of Oncology, McMaster University, 699 Concession Street, L8V 5C2, Hamilton, ON, Canada
| | - Elizabeth McCready
- McMaster University, Department of Pathology and Molecular Medicine, 1280 Main Street West, L8S 4L8, Hamilton, ON, Canada; Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences, 1200 Main Street West, L8S 4J9, Hamilton, ON, Canada.
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13
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Hume S, Nelson TN, Speevak M, McCready E, Agatep R, Feilotter H, Parboosingh J, Stavropoulos DJ, Taylor S, Stockley TL. CCMG practice guideline: laboratory guidelines for next-generation sequencing. J Med Genet 2019; 56:792-800. [PMID: 31300550 PMCID: PMC6929709 DOI: 10.1136/jmedgenet-2019-106152] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 05/23/2019] [Accepted: 05/24/2019] [Indexed: 12/13/2022]
Abstract
PurposeThe purpose of this document is to provide guidance for the use of next-generation sequencing (NGS, also known as massively parallel sequencing or MPS) in Canadian clinical genetic laboratories for detection of genetic variants in genomic DNA and mitochondrial DNA for inherited disorders, as well as somatic variants in tumour DNA for acquired cancers. They are intended for Canadian clinical laboratories engaged in developing, validating and using NGS methods. METHODS OF STATEMENT DEVELOPMENT: The document was drafted by the Canadian College of Medical Geneticists (CCMG) Ad Hoc Working Group on NGS Guidelines to make recommendations relevant to NGS. The statement was circulated for comment to the CCMG Laboratory Practice and Clinical Practice committees, and to the CCMG membership. Following incorporation of feedback, the document was approved by the CCMG Board of Directors. DISCLAIMER: The CCMG is a Canadian organisation responsible for certifying medical geneticists and clinical laboratory geneticists, and for establishing professional and ethical standards for clinical genetics services in Canada. The current CCMG Practice Guidelines were developed as a resource for clinical laboratories in Canada and should not be considered to be inclusive of all information laboratories should consider in the validation and use of NGS for a clinical laboratory service.
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Affiliation(s)
- Stacey Hume
- Department of Medical Genetics, University of Alberta, Edmonton, Alberta, Canada
| | - Tanya N Nelson
- Department of Pathology and Laboratory Medicine, BC Children's Hospital, Vancouver, British Columbia, Canada.,Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, British Columbia, Canada.,Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Marsha Speevak
- Department of Laboratory Medicine and Genetics, Trillium Health Partners, Mississauga, Ontario, Canada
| | - Elizabeth McCready
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Ron Agatep
- Department of Biochemistry and Molecular Genetics, University of Manitoba, Winnipeg, Manitoba, Canada.,Genomics Laboratory, Shared Health Diagnostic Services, Winnipeg, Manitoba, Canada
| | - Harriet Feilotter
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada
| | - Jillian Parboosingh
- Department of Medical Genetics, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.,Research Institute, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Dimitri J Stavropoulos
- Department of Paediatric Laboratory Medicine, Genome Diagnostics, Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Sherryl Taylor
- Department of Medical Genetics, University of Alberta, Edmonton, Alberta, Canada
| | - Tracy L Stockley
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada .,Department of Clinical Laboratory Genetics, Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada
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Pizzo L, Jensen M, Polyak A, Rosenfeld JA, Mannik K, Krishnan A, McCready E, Pichon O, Le Caignec C, Van Dijck A, Pope K, Voorhoeve E, Yoon J, Stankiewicz P, Cheung SW, Pazuchanics D, Huber E, Kumar V, Kember RL, Mari F, Curró A, Castiglia L, Galesi O, Avola E, Mattina T, Fichera M, Mandarà L, Vincent M, Nizon M, Mercier S, Bénéteau C, Blesson S, Martin-Coignard D, Mosca-Boidron AL, Caberg JH, Bucan M, Zeesman S, Nowaczyk MJM, Lefebvre M, Faivre L, Callier P, Skinner C, Keren B, Perrine C, Prontera P, Marle N, Renieri A, Reymond A, Kooy RF, Isidor B, Schwartz C, Romano C, Sistermans E, Amor DJ, Andrieux J, Girirajan S. Rare variants in the genetic background modulate cognitive and developmental phenotypes in individuals carrying disease-associated variants. Genet Med 2018; 21:816-825. [PMID: 30190612 PMCID: PMC6405313 DOI: 10.1038/s41436-018-0266-3] [Citation(s) in RCA: 103] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 07/30/2018] [Indexed: 12/08/2022] Open
Abstract
Purpose To assess the contribution of rare variants in the genetic background toward variability of neurodevelopmental phenotypes in individuals with rare copy-number variants (CNVs) and gene-disruptive variants. Methods We analyzed quantitative clinical information, exome sequencing, and microarray data from 757 probands and 233 parents and siblings who carry disease-associated variants. Results The number of rare likely deleterious variants in functionally intolerant genes (“other hits”) correlated with expression of neurodevelopmental phenotypes in probands with 16p12.1 deletion (n=23, p=0.004) and in autism probands carrying gene-disruptive variants (n=184, p=0.03) compared with their carrier family members. Probands with 16p12.1 deletion and a strong family history presented more severe clinical features (p=0.04) and higher burden of other hits compared with those with mild/no family history (p=0.001). The number of other hits also correlated with severity of cognitive impairment in probands carrying pathogenic CNVs (n=53) or de novo pathogenic variants in disease genes (n=290), and negatively correlated with head size among 80 probands with 16p11.2 deletion. These co-occurring hits involved known disease-associated genes such as SETD5, AUTS2, and NRXN1, and were enriched for cellular and developmental processes. Conclusion Accurate genetic diagnosis of complex disorders will require complete evaluation of the genetic background even after a candidate disease-associated variant is identified.
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Affiliation(s)
- Lucilla Pizzo
- Department of Biochemistry and Molecular Biology, The Pennsylvania State University, University Park, PA, USA
| | - Matthew Jensen
- Department of Biochemistry and Molecular Biology, The Pennsylvania State University, University Park, PA, USA
| | - Andrew Polyak
- Department of Biochemistry and Molecular Biology, The Pennsylvania State University, University Park, PA, USA.,St. George's University School of Medicine, True Blue Point, Grenada
| | - Jill A Rosenfeld
- Department of Molecular & Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Katrin Mannik
- Center for Integrative Genomics, University of Lausanne, Lausanne, Switzerland.,Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Arjun Krishnan
- Department of Computational Mathematics, Science and Engineering, Michigan State University, East Lansing, MI, USA.,Department of Biochemistry and Molecular Biology, Michigan State University, East Lansing, MI, USA
| | - Elizabeth McCready
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | | | - Cedric Le Caignec
- CHU Nantes, Medical genetics department, Nantes, France.,INSERM, UMR1238, Bone sarcoma and remodeling of calcified tissue, Nantes, France
| | - Anke Van Dijck
- Department of Medical Genetics, University and University Hospital Antwerp, Antwerp, Belgium
| | - Kate Pope
- Department of Paediatrics, Royal Children's Hospital, Murdoch Children's Research Institute and University of Melbourne, Melbourne, Australia
| | - Els Voorhoeve
- Department of Clinical Genetics, Amsterdam UMC, Amsterdam, The Netherlands
| | - Jieun Yoon
- Department of Biochemistry and Molecular Biology, The Pennsylvania State University, University Park, PA, USA
| | - Paweł Stankiewicz
- Department of Molecular & Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Sau Wai Cheung
- Department of Molecular & Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Damian Pazuchanics
- Department of Biochemistry and Molecular Biology, The Pennsylvania State University, University Park, PA, USA
| | - Emily Huber
- Department of Biochemistry and Molecular Biology, The Pennsylvania State University, University Park, PA, USA
| | - Vijay Kumar
- Department of Biochemistry and Molecular Biology, The Pennsylvania State University, University Park, PA, USA
| | - Rachel L Kember
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Francesca Mari
- Medical Genetics, University of Siena, Siena, Italy.,Medical Genetics, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Aurora Curró
- Medical Genetics, University of Siena, Siena, Italy.,Medical Genetics, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | | | | | | | - Teresa Mattina
- Medical Genetics, University of Catania School of Medicine, Catania, Italy
| | - Marco Fichera
- Oasi Research Institute-IRCCS, Troina, Italy.,Medical Genetics, University of Catania School of Medicine, Catania, Italy
| | | | - Marie Vincent
- CHU Nantes, Medical genetics department, Nantes, France
| | | | | | | | - Sophie Blesson
- Department of genetics, Bretonneau university hospital, Tours, France
| | | | | | - Jean-Hubert Caberg
- Centre Hospitalier Universitaire de Liège. Domaine Universitaire du Sart Tilman, Liège, Belgium
| | - Maja Bucan
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | | | | | - Laurence Faivre
- Center for Rare Diseases and Reference Developmental Anomalies and Malformation Syndromes, CHU Dijon, Dijon, France
| | - Patrick Callier
- Laboratoire de Genetique Chromosomique et Moleculaire, CHU Dijon, France
| | | | | | | | - Paolo Prontera
- Medical Genetics Unit, Hospital "Santa Maria della Misericordia", Perugia, Italy
| | - Nathalie Marle
- Laboratoire de Genetique Chromosomique et Moleculaire, CHU Dijon, France
| | - Alessandra Renieri
- Medical Genetics, University of Siena, Siena, Italy.,Medical Genetics, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Alexandre Reymond
- Center for Integrative Genomics, University of Lausanne, Lausanne, Switzerland
| | - R Frank Kooy
- Department of Medical Genetics, University and University Hospital Antwerp, Antwerp, Belgium
| | | | | | | | - Erik Sistermans
- Department of Clinical Genetics, Amsterdam UMC, Amsterdam, The Netherlands
| | - David J Amor
- Department of Paediatrics, Royal Children's Hospital, Murdoch Children's Research Institute and University of Melbourne, Melbourne, Australia
| | - Joris Andrieux
- Institut de Genetique Medicale, Hopital Jeanne de Flandre, CHRU de Lille, Lille, France
| | - Santhosh Girirajan
- Department of Biochemistry and Molecular Biology, The Pennsylvania State University, University Park, PA, USA.
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15
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AlSubaihin A, VanderMeulen J, Harris K, Duck J, McCready E. Müllerian Agenesis in Cat Eye Syndrome and 22q11 Chromosome Abnormalities: A Case Report and Literature Review. J Pediatr Adolesc Gynecol 2018; 31:158-161. [PMID: 28919146 DOI: 10.1016/j.jpag.2017.09.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Revised: 09/04/2017] [Accepted: 09/09/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Although Müllerian agenesis is the second most common cause of primary amenorrhea the underlying etiology in most cases is unknown. Müllerian agenesis has been reported as a rare finding associated with chromosomal aberrations of the 22q11 chromosomal region including at least 1 individual with cat eye syndrome (CES) and 10 individuals with deletions or duplications of the 22q11.2 region. However, a potential link between 22q11 abnormalities and uterine malformations has been difficult to adequately ascertain because of the limited case reports in the literature. CASE We report a second case of Müllerian agenesis in a girl with CES. A 16-year-old girl presented with bilateral colobomata, primary amenorrhea, and absence of the uterus and upper vagina on pelvic magnetic resonance imaging. Microarray analysis showed tetrasomy of the pericentromeric region of chromosome 22 diagnostic of CES. SUMMARY AND CONCLUSION Müllerian aplasia/hypoplasia might represent a rare feature in CES and should be considered in the investigation of young girls with this syndrome. An increasing number of cases with 22q11 chromosome abnormalities and Müllerian agenesis further highlights the possibility of a gene within the 22q11 region that might mediate normal Müllerian development in girls.
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Affiliation(s)
- Abdulmajeed AlSubaihin
- Division of Endocrinology, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada; Department of Pediatrics, Faculty of Medicine, King Saud University Hospital, Riyadh, Saudi Arabia.
| | - John VanderMeulen
- Division of Endocrinology, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Kate Harris
- Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - John Duck
- Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Elizabeth McCready
- Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences, Hamilton, Ontario, Canada; Department Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
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16
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Clark DA, Dmetrichuk JM, McCready E, Dhesy-Thind S, Arredondo JL. Changes in expression of the CD200 tolerance-signaling molecule and its receptor (CD200R) by villus trophoblasts during first trimester missed abortion and in chronic histiocytic intervillositis. Am J Reprod Immunol 2017; 78. [PMID: 28326648 DOI: 10.1111/aji.12665] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 02/17/2017] [Indexed: 12/20/2022] Open
Abstract
PROBLEM Expression of CD200 at the feto-maternal interface is associated with successful murine and human pregnancy. CD200 binding to CD200 receptors on lymphomyeloid cells suppresses inflammation and induces Tregs. CD200 receptors are also expressed on mouse and human placental trophoblast cells. What is the expression of CD200 and CD200R in human missed abortions which have preserved Treg levels and in chronic histiocytic intervillositis (CHI) where maternal inflammatory cells cause IUGR? METHODS Immunohistiochemistry for CD200, CD200R, and Ki67 using human placental sections from missed abortions, term placenta, and CHI. PCR testing was done for trisomy in missed abortion. RESULTS CD200 and CD200R were expressed by human villus trophoblasts from 2 weeks post-implantation to term. Cytotrophoblast proliferation (Ki-67+ count) decreased at term. In first trimester missed abortion cases, CD200>CD200R villus trophoblasts accompanied missed abortion of non-trisomic male fetuses. CD200 and Ki67+ trophoblast proliferation was preserved in CHI with maternal inflammatory cell infiltration but CD200R was greatly decreased. CONCLUSION Residual CD200 activity may prevent completion of abortions via induction of Treg cells. In CHI, infiltrating maternal effector T cells may block Treg induction. An autocrine role for CD200-CD200R interaction versus inhibition of soluble CD200 by soluble CD200R is discussed.
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Affiliation(s)
- David A Clark
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada.,Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Jennifer M Dmetrichuk
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Elizabeth McCready
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada.,Genetics Services, Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | | | - Jorge L Arredondo
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
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17
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Affiliation(s)
- Elizabeth McCready
- Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences and St. Joseph's Healthcare, Hamilton, Ontario, Canada; Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
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18
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Schenkel LC, Rodenhiser D, Siu V, McCready E, Ainsworth P, Sadikovic B. Constitutional Epi/Genetic Conditions: Genetic, Epigenetic, and Environmental Factors. J Pediatr Genet 2017; 6:30-41. [PMID: 28180025 PMCID: PMC5288004 DOI: 10.1055/s-0036-1593849] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 04/14/2016] [Indexed: 12/12/2022]
Abstract
There are more than 4,000 phenotypes for which the molecular basis is at least partly known. Though defects in primary DNA structure constitute a major cause of these disorders, epigenetic disruption is emerging as an important alternative mechanism in the etiology of a broad range of congenital and developmental conditions. These include epigenetic defects caused by either localized (in cis) genetic alterations or more distant (in trans) genetic events but can also include environmental effects. Emerging evidence suggests interplay between genetic and environmental factors in the epigenetic etiology of several constitutional "epi/genetic" conditions. This review summarizes our broadening understanding of how epigenetics contributes to pediatric disease by exploring different classes of epigenomic disorders. It further challenges the simplistic dogma of "DNA encodes RNA encodes protein" to best understand the spectrum of factors that can influence genetic traits in a pediatric population.
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Affiliation(s)
- Laila C. Schenkel
- Department of Pathology and Laboratory Medicine, Western University, London, Ontario, Canada
- Children's Health Research Institute, London, Ontario, Canada
| | - David Rodenhiser
- Children's Health Research Institute, London, Ontario, Canada
- Department of Biochemistry, Western University, London, Ontario, Canada
- Department of Pediatrics, Western University, London, Ontario, Canada
- London Regional Cancer Program, London Health Sciences Centre, London, Ontario, Canada
- Department of Oncology, Western University, London, Ontario, Canada
| | - Victoria Siu
- Children's Health Research Institute, London, Ontario, Canada
- Department of Pediatrics, Western University, London, Ontario, Canada
- London Regional Cancer Program, London Health Sciences Centre, London, Ontario, Canada
| | - Elizabeth McCready
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Peter Ainsworth
- Department of Pathology and Laboratory Medicine, Western University, London, Ontario, Canada
- Children's Health Research Institute, London, Ontario, Canada
- Department of Biochemistry, Western University, London, Ontario, Canada
- Department of Pediatrics, Western University, London, Ontario, Canada
- London Regional Cancer Program, London Health Sciences Centre, London, Ontario, Canada
- Department of Oncology, Western University, London, Ontario, Canada
| | - Bekim Sadikovic
- Department of Pathology and Laboratory Medicine, Western University, London, Ontario, Canada
- Children's Health Research Institute, London, Ontario, Canada
- London Regional Cancer Program, London Health Sciences Centre, London, Ontario, Canada
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19
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McCready E, Grafodatskaya D, Schenkel L, Dell E, Li C, Nowaczyk M, Pare G, Sadikovic B. Utility of Genomic Methylation Microarrays to Measure Spreading of X-Inactivation in Association with X;Autosome Translocations. Cancer Genet 2016. [DOI: 10.1016/j.cancergen.2016.04.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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20
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Lowther C, Speevak M, Armour CM, Goh ES, Graham GE, Li C, Zeesman S, Nowaczyk MJM, Schultz LA, Morra A, Nicolson R, Bikangaga P, Samdup D, Zaazou M, Boyd K, Jung JH, Siu V, Rajguru M, Goobie S, Tarnopolsky MA, Prasad C, Dick PT, Hussain AS, Walinga M, Reijenga RG, Gazzellone M, Lionel AC, Marshall CR, Scherer SW, Stavropoulos DJ, McCready E, Bassett AS. Molecular characterization of NRXN1 deletions from 19,263 clinical microarray cases identifies exons important for neurodevelopmental disease expression. Genet Med 2016; 19:53-61. [PMID: 27195815 PMCID: PMC4980119 DOI: 10.1038/gim.2016.54] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 03/16/2016] [Indexed: 01/31/2023] Open
Abstract
Purpose The purpose of the current study was to assess the penetrance of NRXN1 deletions. Methods We compared the prevalence and genomic extent of NRXN1 deletions identified among 19,263 clinically referred cases to that of 15,264 controls. The burden of additional clinically relevant CNVs was used as a proxy to estimate the relative penetrance of NRXN1 deletions. Results We identified 41 (0.21%) previously unreported exonic NRXN1 deletions ascertained for developmental delay/intellectual disability, significantly greater than in controls [OR=8.14 (95% CI 2.91–22.72), p< 0.0001)]. Ten (22.7%) of these had a second clinically relevant CNV. Subjects with a deletion near the 3′ end of NRXN1 were significantly more likely to have a second rare CNV than subjects with a 5′ NRXN1 deletion [OR=7.47 (95% CI 2.36–23.61), p=0.0006]. The prevalence of intronic NRXN1 deletions was not statistically different between cases and controls (p=0.618). The majority (63.2%) of intronic NRXN1 deletion cases had a second rare CNV, a two-fold greater prevalence than for exonic NRXN1 deletion cases (p=0.0035). Conclusions The results support the importance of exons near the 5′ end of NRXN1 in the expression of neurodevelopmental disorders. Intronic NRXN1 deletions do not appear to substantially increase the risk for clinical phenotypes.
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Affiliation(s)
- Chelsea Lowther
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Marsha Speevak
- Trillium Health Partners Credit Valley Site, Toronto, Ontario, Canada
| | - Christine M Armour
- Regional Genetics Program, Children's Hospital of Eastern Ontario, Toronto, ON, Canada
| | - Elaine S Goh
- Trillium Health Partners Credit Valley Site, Toronto, Ontario, Canada
| | - Gail E Graham
- Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
| | - Chumei Li
- Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada.,McMaster Children's Hospital, Department of Pediatrics and Clinical Genetics Program, Hamilton, Ontario, Canada
| | - Susan Zeesman
- McMaster Children's Hospital, Department of Pediatrics and Clinical Genetics Program, Hamilton, Ontario, Canada
| | - Malgorzata J M Nowaczyk
- McMaster Children's Hospital, Department of Pediatrics and Clinical Genetics Program, Hamilton, Ontario, Canada.,Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Lee-Anne Schultz
- McMaster Children's Hospital, Department of Pediatrics and Clinical Genetics Program, Hamilton, Ontario, Canada
| | - Antonella Morra
- Trillium Health Partners Credit Valley Site, Toronto, Ontario, Canada
| | - Rob Nicolson
- Department of Psychiatry, Western University, London, Ontario, Canada
| | | | - Dawa Samdup
- Hotel Dieu Hospital, Child Development Centre, Kingston, Ontario, Canada
| | - Mostafa Zaazou
- Trillium Health Partners Credit Valley Site, Toronto, Ontario, Canada
| | - Kerry Boyd
- Department of Psychiatry, McMaster University, Hamilton, Ontario, Canada
| | - Jack H Jung
- London Health Sciences Centre, Children's Hospital of Western Ontario, London, Ontario, Canada
| | - Victoria Siu
- Department of Pediatrics, Schulich School of Medicine and Dentistry, London, Ontario, Canada
| | | | - Sharan Goobie
- Department of Pediatrics, Schulich School of Medicine and Dentistry, London, Ontario, Canada
| | - Mark A Tarnopolsky
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Chitra Prasad
- Department of Pediatrics, Schulich School of Medicine and Dentistry, London, Ontario, Canada
| | - Paul T Dick
- Grey Bruce Health Services, Owen Sound, Ontario, Canada
| | - Asmaa S Hussain
- London Health Sciences Centre, Children's Hospital of Western Ontario, London, Ontario, Canada
| | | | | | - Matthew Gazzellone
- The Centre for Applied Genomics, the Hospital for Sick Children, Toronto, Ontario, Canada
| | - Anath C Lionel
- The Centre for Applied Genomics, the Hospital for Sick Children, Toronto, Ontario, Canada
| | - Christian R Marshall
- The Centre for Applied Genomics, the Hospital for Sick Children, Toronto, Ontario, Canada
| | - Stephen W Scherer
- The Centre for Applied Genomics, the Hospital for Sick Children, Toronto, Ontario, Canada.,McLaughlin Centre and Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Dimitri J Stavropoulos
- Cytogenetics Laboratory, Department of Pediatric Laboratory Medicine, the Hospital for Sick Children, Toronto, Ontario, Canada
| | - Elizabeth McCready
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Anne S Bassett
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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21
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Grafodatskaya D, Dell E, Li C, McCready E. MG-121 Complexity of phenotypes of females with unbalanced x-autosomal translocations exemplified by a case with 46, x,der (x)t (x;16)(p11.2;p13.2) karyotype. J Med Genet 2015. [DOI: 10.1136/jmedgenet-2015-103578.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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22
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Lowther C, Speevak M, Armour C, Goh E, Graham G, Li C, Zeesman S, Nowaczyk MJM, Schultz LA, Morra A, Nicolson R, Rajguru M, Goobie S, Tarnopolsky MA, Prasad C, Dick PT, Hussain AS, Gazzellone M, Lionel AC, Marshall CR, Scherer SW, Stavropoulos DJ, McCready E, Bassett AS. MG-123 Exonic and intronic NRXN1 deletions: Novel genotype-phenotype correlations. J Med Genet 2015. [DOI: 10.1136/jmedgenet-2015-103578.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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23
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Zeesman S, McCready E, Sadikovic B, Nowaczyk MJM. Prader-Willi syndrome and Tay-Sachs disease in association with mixed maternal uniparental isodisomy and heterodisomy 15 in a girl who also had isochromosome Xq. Am J Med Genet A 2014; 167A:180-4. [DOI: 10.1002/ajmg.a.36790] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 08/22/2014] [Indexed: 02/02/2023]
Affiliation(s)
- Susan Zeesman
- Department of Pediatrics; McMaster University; Hamilton Ontario Canada
| | - Elizabeth McCready
- Department of Pathology and Molecular Medicine; McMaster University; Hamilton Ontario Canada
- Hamilton Regional Laboratory Medicine Program; Hamilton Health Sciences and St. Joseph's Healthcare; Hamilton Ontario Canada
| | - Bekim Sadikovic
- Department of Pathology and Molecular Medicine; McMaster University; Hamilton Ontario Canada
- Hamilton Regional Laboratory Medicine Program; Hamilton Health Sciences and St. Joseph's Healthcare; Hamilton Ontario Canada
| | - Małgorzata JM Nowaczyk
- Department of Pediatrics; McMaster University; Hamilton Ontario Canada
- Department of Pathology and Molecular Medicine; McMaster University; Hamilton Ontario Canada
- Hamilton Regional Laboratory Medicine Program; Hamilton Health Sciences and St. Joseph's Healthcare; Hamilton Ontario Canada
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24
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Omorodion J, Carter R, Carter T, Tarnopolsky M, McCready E. Molecular Characterization of WNT5B as a Candidate Gene for Developmental Delay Associated with 12p13.13 Microdeletions. Cancer Genet 2014. [DOI: 10.1016/j.cancergen.2014.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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