Familial Intrahepatic Cholestasis-related Genes Associated with Disease Susceptibility in Hepato-biliary Cancers
Ориентир для пациента и семьи
Простыми словами
Автоматическая сводка по структурированным данным реестра. Она помогает сориентироваться, но не заменяет официальный протокол или оценку врача.
- Что изучают
- Это наблюдательное исследование: исследуемое лечение участникам по протоколу не назначают.
- Кому может быть актуально
- Состояния в реестре: Hepatobiliary Cancers, Progressive Familial Intrahepatic Cholestasis (PFIC), Cholestatic Liver Disease. Базовые параметры: от 12 мес. · Все.
- Что важно проверить
- Возраст, диагноз и пол — только базовые ориентиры. Предыдущее лечение, анализы и другие обязательные условия указаны ниже в критериях участия.
- Где проводится
- Италия
- Следующий шаг
- Сохраните исследование, покажите его лечащему врачу и уточните актуальный статус у исследовательского центра. Расходы, документы и поездка →
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Обзор
This is a cross-sectional, multicenter tissue study with an exploratory aim to estimate the prevalence of genetic mutations that predispose individuals to diseases in the context of cholestatic disorders and hepatobiliary neoplasms. It is intended as a hypothesis-generating study for future empirical investigations.
Подробное описание
This is a multicenter, cross-sectional tissue study designed to explore the prevalence of genetic mutations associated with cholestatic liver diseases and hepatobiliary neoplasms. It aims to generate hypotheses for future empirical research.
Patient data will be collected, including medical history, imaging tests (e.g., abdominal ultrasound, CT, and MRI), and liver function tests, along with \[BA\] levels. Non-invasive liver fibrosis assessment (FibroScan or Shear-Wave elastography) and, where applicable, liver biopsies will be included, all referenced to the time of genetic testing.
Molecular genetic analysis of PFIC will be conducted using a multiplex PCR NGS panel covering 37 genes. If clinical suspicion remains high despite negative NGS results, Whole Exome Sequencing (WES) will be used to identify previously unknown PFIC-related genes. WES will prioritize patients with hepatobiliary cancers on a healthy liver or without advanced fibrosis and those with a family history of PFIC or related conditions.
Variants will be filtered based on clinical significance, gene-disease associations, and functional predictions, using resources like ClinVar, HGMD, and Personal Genomics PGVD. WES analysis will include at least one affected parent when available, with de novo mutations considered when both parents are involved.
Only pathogenic or potentially pathogenic variants will be reported, confirmed by Sanger sequencing. Genetic counseling will be offered for patients with significant findings. Tumor tissue samples will also be analyzed for somatic mutations, potentially guiding therapeutic decisions or family screening.
NGS for somatic mutations will use tumor samples collected for clinical purposes, with findings compared to germline mutations. This may inform treatment options and surveillance protocols for relatives. The data will be stored in an electronic archive using REDCap and analyzed by clinical staff. The collected data will include clinical history, liver function tests, response to ursodeoxycholic acid, liver fibrosis stage, and molecular results, along with relevant family histories and therapies.
For patients undergoing surgery, the data will also cover pre-operative assessments, surgical techniques, and post-operative outcomes.
Первичные конечные точки
- Prevalence of Pathogenic and Variant Mutations in PFIC Genes in HBCs and CCLDs Patients [Срок оценки: 3 years]
Вторичные конечные точки (4)
- Identifying New PFIC-Associated Genes in HBCs and CCLDs Patients Negative for NGS Analysis via WES [Срок оценки: 3 years]
- Identification of Somatic Mutations in Tumor Tissue Samples from Patients Undergoing Liver Resection or Transplantation for HBCs [Срок оценки: 3 years]
- Laboratory and Clinical Features of HBCs and CCLDs Patients [Срок оценки: 3 years]
- Comparison of Allelic Frequency of PFIC-Related Mutations in the NGS Panel between the Study Population and gnomAD Database [Срок оценки: 3 years]
Критерии участия
Критерии включения
- Instrumental or histological diagnosis of HBCs, defined as primary liver and/or biliary tumors (hepatocellular carcinoma, cholangiocarcinoma, hepatocholangiocarcinoma) occurring in patients without apparent underlying chronic liver disease or in the context of cryptogenic chronic liver disease;
- Curative treatment through surgical resection of the neoplasm or liver transplantation
- Diagnosis of CCLDs defined as:
- GGT and/or alkaline phosphatase >1.5 times the normal values in two or more measurements taken at least 6 months apart,
- A history of pruritus combined with \[BA\] >10 mmol/l for a period of ≥6 months.
- Obtaining written informed consent
Критерии исключения
- Other documented causes of chronic liver disease that can justify the clinical phenotype include:
Primary biliary cholangitis Primary sclerosing cholangitis IgG4-related cholangiopathy Obstructive jaundice excluded by the demonstration of normal bile duct anatomy Negative virological tests for HBV, HCV, HEV Alcohol abuse Hemochromatosis Wilson's disease Alpha-1 antitrypsin deficiency
Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.
Здоровые добровольцы: Нет
Дизайн исследования
- Модель наблюдения
- Другое
Центры проведения
Италия · 5 центров
- IRCCS Azienda Ospedaliero-Universitaria di Bologna - Programma Chirurgia addominale nell'i — Bologna
- IRCCS Azienda Ospedaliero-Universitaria di Bologna - UO Chirurgia Epatobiliare e dei Trapi — Bologna
- IRCCS Azienda Ospedaliero-Universitaria di Bologna - UO Gastroenterologia — Bologna
- IRCCS Azienda Ospedaliero-Universitaria di Bologna - UO Medicina Interna per il trattament — Bologna
- IRCCS Azienda Ospedaliero-Universitaria di Bologna - UO Medicina Interna, malattie epatobi — Bologna
Идентификаторы
NCT: NCT06777914 · HBCs-PFIC · RC-2024-2790618