[Clinical Significance of Screening Thalassemia with High- Throughput Sequencing]

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2019 Aug;27(4):1220-1226. doi: 10.19746/j.cnki.issn.1009-2137.2019.04.037.
[Article in Chinese]

Abstract

Objective: To evaluate the diagnostic value of high-throughput sequencing (NGS) in screening the thalassemia genes.

Methods: The peripheral blood of 2 858 cases of pre-pregnancy and pregnancy from October 2014 to October 2016 randomly were collected in department of obstetrics, the third people's hospital in Dongguan city. Peripheral blood was used for the blood routine examination, hemoglobin electrophoresis, traditional thalassaemia gene screening and NGS.

Results: The rate of missed diagnosis for α-thalassemia and β-thalassemia using NGS was 0.87% and 1.59%, respectively. Meanwhile, the missed rate of screening for α-thalassemia and β-thalassemia by traditional screening models was 26.77% and 2.38%, respectively. The area under the ROC curve of α-thalassemia and β-thalassemia screened by NGS was 0.994 and 0.991, respectively, however, the area under the ROC curve of screening for α-thalassemia and β-thalassemia by the traditional screening model was 0.866 and 0.988, respectively. The sensitivity, rate of missed diagnosis, Youden index and negative predictive value of screening for α-thalassemia and β-thalassemia using NGS all were superior to those using traditional screening.

Conclusion: Compared with the traditional screening model, the NGS screening for thalassemia genes shows a high accuracy, moreover can avoid missed diagnosis resulted from screening by conventional method, suggesting that the NCS possesses the accurate and diagnostic value for screening of thalassemia and can widely apply to clinical practise so as to provid the guarantee for early diagnosis of thalassemia.

题目: 高通量测序技术筛检地中海贫血的临床意义.

目的: 评价高通量测序(NGS)技术在地中海贫血基因筛查中的诊断价值.

方法: 收集2014年10月- 2016年10月在东莞市第三人民医院产科进行孕前或孕期检查的2 858例广东户籍夫妇的外周血,进行血常规检测、血红蛋白电泳分析,传统地中海贫血基因筛查及高通量测序.

结果: 运用NGS筛选α地中海贫血和β地中海贫血的漏诊率分别为0.87%、1.59%,传统筛查模式筛选α地中海贫血和β地中海贫血的漏诊率分别为26.77%、2.38%;运用NGS筛选α地中海贫血和β地中海贫血ROC曲线下面积分别为0.994和0.991,而传统筛查模式筛选的地中海贫血ROC曲线下面积分别为0.866和0.988;运用NGS进行α和β地中海贫血筛查的灵敏度、漏诊率、约登指数、阴性预测值优于运用传统筛查模式.

结论: 与传统筛查模式相比,NGS筛查地中海贫血基因的结果精确度高,可避免了常规方法的漏诊,因而诊断价值高,可广泛应用于临床,为地中海贫血的早期诊断提供保障.

MeSH terms

  • Female
  • High-Throughput Nucleotide Sequencing
  • Humans
  • Mass Screening
  • Pregnancy
  • ROC Curve
  • alpha-Thalassemia*
  • beta-Thalassemia*