title: Mutation scanning of the NF2 gene: an improved service based on meta-PCR/sequencing, dosage analysis, and loss of heterozygosity analysis.
abstract: We describe the development and implementation of a neurofibromatosis type 2 (NF2) mutation scanning service based on novel techniques. All 17 exons of the NF2 gene are amplified in four polymerase chain reaction (PCR) reactions, using the meta-PCR technique to link the NF2 exons into chimeric concatamers. The meta-PCR products are then scanned for point mutations by direct sequencing. A four-exon dosage assay is used to test for large deletion/duplication mutations. In certain cases when tumour studies are necessary, these techniques are also combined with loss of heterozygosity analysis with three highly polymorphic microsatellite markers located within or close to the NF2 gene. Over a period of 2 years, we have applied these techniques in a service setting to the analysis of 271 patient samples (245 lymphocyte DNA; 26 schwannoma DNA). Meta-PCR and sequencing identified 90 point mutations in the 271 blood and tumor samples, 48 of which have not been reported previously. Dosage analysis identified large deletions in 12 of the lymphocyte DNA samples. In addition, over 84% of mutations were identified in 23 schwannoma DNA samples in which complete analysis was possible. Adoption of this novel strategy has increased the overall mutation detection rate in familial NF2 cases to 88% and sporadic NF2 cases to 59%. It has also allowed us to decrease our reporting turnaround times, and because of a low overall failure rate, permitted the running of an efficient and cost-effective service.
authors.affiliation: National Genetics Reference Laboratory (Manchester), St. Mary's Hospital, Hathersage Road, Manchester M13 0JH, UK. Andrew.wallace@cmmc.nhs.uk
authors.forename: A J
authors.initials: AJ
authors.lastname: Wallace
authors.forename: C J
authors.initials: CJ
authors.lastname: Watson
authors.forename: E
authors.initials: E
authors.lastname: Oward
authors.forename: D G R
authors.initials: DG
authors.lastname: Evans
authors.forename: R G
authors.initials: RG
authors.lastname: Elles
mesh_terms: D003365:Costs and Cost Analysis; D004247:DNA / Q000032:analysis; D004252:DNA Mutational Analysis / Q000379:methods*; D017931:DNA Primers; D005091:Exons; D018628:Gene Dosage; D016515:Genes, Neurofibromatosis 2; D005820:Genetic Testing; D006801:Humans; D019656:Loss of Heterozygosity; D008214:Lymphocytes; D016518:Neurofibromatosis 2 / Q000175:diagnosis* / Q000235:genetics*; D017354:Point Mutation; D016133:Polymerase Chain Reaction / Q000191:economics / Q000379:methods*; D012680:Sensitivity and Specificity; D017422:Sequence Analysis, DNA; D013997:Time Factors
chemical_list: D017931:DNA Primers; D004247:DNA