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Validation of BRCA2 mutation scanning using the LightScanner system for high resolution melt analysis Lewis Darnell Nottingham Regional Molecular Genetics Service. Breast cancer and the BRCA genes.
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Validation of BRCA2 mutation scanning using the LightScanner system for high resolution melt analysisLewis Darnell Nottingham Regional Molecular Genetics Service
Breast cancer and the BRCA genes • Breast cancer accounts for 22% of all cancers among women giving an annual worldwide incidence of approximately 1,000,000 cases. • 5%-10% of breast cancers are hereditary with 30%-50% due to mutations in either BRCA1 or BRCA2. • Mutations in BRCA1 or 2 confera high lifetime risk of both breast and ovarian cancers.
BRCA2 • BRCA2 covers approximately 70Kb of genomic DNA of 13q12. • 27 exons make up an approximately 11Kb mRNA, coding for a 3,418 amino acid protein. • BRCA2 is involved in double-strand break DNA repair. • Pathogenic mutations: • Point mutations (nonsense, missense and splicing alterations) • Small deletions, duplications and insertions. • Large, whole exon deletions and duplications.
Current mutation scanning strategy • Currently both BRCA1 and BRCA2 are screened concurrently: • Two week sample collection • Multiplex ligation-dependent probe amplification (MLPA) for deletion/duplication detection • Conformation sensitive capillary electrophoresis (CSCE) pre-screen. 33 and 46 amplicons for BRCA1 and BRCA2 • Bi-directional sequencing of any patient amplicons that do not match the wild-type (WT) or polymorphic controls • In the last year the results for all BRCA1/2 mutation scans were reported within the 40-day reporting time. • However, a high failure rate for CSCE increases the cost of the screen and can put pressure on reporting times.
High Resolution Melt analysis • High Resolution Melt (HRM) analysis offers rapid and low cost detection of sequence variants. • The DNA region of interest is amplified and heteroduplexed in the presence of LCGreen. • LCGreen binds dsDNA to saturation and will emit a fluorescent signal when incorporated. • Sequence variants alter the melting profile of a heteroduplexed sample. • Fluorescence change, under controlled melting, is analysed using the LightScanner (Idaho Technologies).
BRCA2 primers and validation criteria • 47 primer pairs designed by Idaho Technologies. • Cover the entire coding region of BRCA2 and at least 15 base pairs either side of coding exons. • Primers covering sites of known frequency single nucleotide polymorphisms (SNPs) were modified to contain inosine or degenerate bases where applicable. • Validation criteria: • No false-negative results • Fewer than 25% false positives
Initial amplicon Validation • Each amplicon was tested using a panel of 20 wild type (WT) controls and samples containing all available amplicon specific variants. • Using the standard protocol supplied with the primer sequences, 25 of the 47 amplicons met the validation criteria. • Further optimisation was carried out with the remaining 22 amplicons.
WT Variant False-positive Further optimisation • Primer concentration: • Reduced from 0.25μM to 0.20μM • Number of false-positives reduced • 7 amplicons needed lower primer concentrations to meet the validation criteria • Further reductions decrease the amplification Amplicon 11-3: 0.25μM 0.20μM
WT Variant False-positive Further optimisation • PCR cycles: • Cycles increased from 35 to 40 • Results improved for all amplicons trialled • Amplification more consistent between samples • Reduced false positive rate and increased variant detection Amplicon 11-12: 35 cycles 40 cycles
Further optimisation • Genomic DNA clean up: • Using CA reagent, supplied by Clent Life Science, prior to sample dilution • Reduced variation between samples of the same genotype Amplicon 10-3: Untreated DNA CA reagent cleaned DNA WT c.1365A>G c.1359delA False-positive
Amplicons that have not met the validation criteria • Amplicons 03 and 10-3 both failed to detect a variant: • c.68-7T>A and c.1359delA respectively • Both variants lie within mononucleotide tracts close to the end of their respective fragments • Other variants have been detected closer to the end of a fragment • Variants have also been detected in mononucleotide tracts E.g. c.8940insA in amplicon 22
Amplicons that have not met the validation criteria • Amplicons 10-1b, 10-2 and 11-1 all have problems with common polymorphisms: • 10-1b – common SNPs under both primers • 10-2 – common internal polymorphism, poor results • 11-1 – three common polymorphisms in fragment • These five amplicons would be sequenced directly using alternative primers where appropriate.
Results after optimisation • After amplicon optimisation 42 of 47 amplicons met the validation criteria. • 140 of 142 variants detected. Sensitivity: 98.6%. • Not including results from amplicons 10-1b, 10-2 and 11-1.
Summary of validation results • Even amplification and low variation between samples are essential. • All amplicons are now run with the 40-cycle PCR. • Seven amplicons will be amplified using 0.2μM primers. • All samples will be cleaned up prior to dilution using CA reagent. • Polymorphisms can make analysis difficult. • WT and polymorphism controls will need to be run with amplicons 11-5, 11-6, 14-2 and 17 to differentiate WT and polymorphic groups. Amplicon 17: WT c.7806-14T>C Het c.7806-14T>C Hom c.7822C>G c.7927G>A
Advantages of HRM as a pre-screen in the Nottingham laboratory • Rapid: • The 42 amplicons for 10 patients can be amplified, analysed and scored in two days by one person • CSCE would take five days to do the same screen using a 16-capillary ABI 3130xl. • Low cost: • HRM is approximately 35% cheaper than CSCE for consumables • Quick setup and analysis reduce the cost further • Reduced sequencing: • Very low failure rate • Fewer samples to sequence than CSCE, including the five amplicons needing direct sequencing • Increased sequencing capacity for other applications
Future work • Direct comparison to CSCE: • HRM analysis for BRCA2 currently running concurrently with CSCE using the same patient samples • Will provide more conclusive sensitivity and specificity values • Further validate HRM as a diagnostic tool • Amplicons requiring further work: • Trial high sensitivity mastermix for amplicons 03 and 10-3 • Potentially redesign primers for 10-1b, 10-2 and 11-1
Acknowledgements • Nottingham Molecular Genetics Service • Rachael Tredwell • Jo Field • Gareth Cross • All staff • Clent Life Science • David Harris • Idaho Technologies • Jason McKinney