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염색체마이크로어레이 검사에서 이형접합부재의 임상적 유용성과 보고

Clinical Utility and Reporting of Absence of Heterozygosity in Chromosomal Microarray Analysis

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초록

국내에서도 CMA 검사가 활발히 시행됨에 따라 검사실마다 AOH를 접할 기회가 많아지고 있다. CMA 검사에서 도출되는 AOH는 염색체결실, 자가접합 및 UPD 기전에 의해 발생될 수 있고, 열성질환과 각인질환의 진단적 근거를 제시할 뿐 아니라 근친과 같은 부모의 혈연관계 정보를 제공하게 된다. 각 검사실은 AOH의 임상적 중요성 및 관련 질환을 잘 이해하여 환자 진단에 적용해야 한다. 또한, 검사실별 AOH 검출기준과 보고기준을 마련하되, 근친과 같은 정보는 내포된 법적, 윤리적 측면에 대한 이해를 바탕으로 보고정책을 마련하여야 한다.

Abstract

With the widespread use of chromosomal microarray (CMA) testing in Korea, the chances for laboratories to detect the absence of heterozygosity (AOH) are increasing. AOH detected by CMA can be caused by chromosomal deletion, identity by descent (IBD) and uniparental disomy (UPD), and provides diagnostic clues for recessive and imprinted diseases, as well as information on parental blood relationship, such as consanguinity. Each laboratory should understand the clinical significance of AOH and apply it to the patient diagnosis. In addition, each laboratory should prepare laboratory policies for AOH detection and reporting results, including information of consanguinity, understanding the legal and ethical aspects.

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