The Journal of Molecular Diagnostics

Molecular Tumour Boards (MTBs) rely on different bioinformatics tools and knowledgebases for variant annotation, oncogenicity classification, and estimation of complex biomarkers to identify actionable alterations. However, the typical bioinformatics workflow to process raw next-generation sequencing (NGS) data into clinically meaningful variants involves multiple steps and is inherently complex, thus requiring repeated manual intervention and causing delays in providing molecularly informed pre...

Hereditary ataxias are complicated neurological disorders with enormous genetic heterogeneity as well as the diverse genetic mechanism. Among different genetic mechanism, tandem nucleotide repeat expansion (TNRex) are the most common cause for genetic ataxias followed by single nucleotide variations in over 200 genes. The detection and the diagnosis of tandem nucleotide repeats in clinics and laboratories has been at large common in comparison with SNVs owing to the large number of the mutations...

ObjectiveTo explore the application value of dual-staining for specific AT sequence binding protein 2 (SATB2) immunohistochemistry and elastic lamina in detecting elastic lamina invasion (ELI) in pT3 colon cancer, and to assess its association with clinicopathological characteristics, staging, and prognosis. MethodsThis retrospective cohort study enrolled 176 pT3 colon cancer patients who underwent radical resection at Affiliated Jinhua Hospital Zhejiang University School of Medicine. The deepe...

ObjectiveTo evaluate the analytical and clinical performance of fetal fraction (FF) enriched genome-wide noninvasive prenatal testing (GW-NIPT) for detection of clinically relevant copy number variants (CNVs) down to 1 Mb. MethodsWe retrospectively analyzed 10,501 singleton pregnancies tested with FF enrichment-based GW-NIPT between August 2023 and July 2025. CNV analysis was performed using BinDel and WisecondorX. ResultsFF enrichment increased median FF to 24% (2.4-fold increase). Clinically...

We present a streamlined, solid-phase workflow for Oxford Nanopore sequencing that integrates DNA extraction, purification, and library preparation within a single microfluidic cartridge. By eliminating tube transfers and performing all enzymatic steps directly on captured DNA, the method minimizes sample loss, reduces hands-on time, and simplifies library generation for long-read sequencing. Starting from volumes as small as a single drop of blood, this integrated approach produces high-quality...

A common signature of cancer genomes is a complex, rearranged karyotype, characterized by acquired gains or losses of chromosomal material, referred to as somatic copy number alterations (CNAs). Identification of haplotype-specific CNAs from bulk sequencing data is a key step in many short-read cancer genomic workflows; however, short reads have a limited phasing range. In contrast, long reads can directly phase genomic variants into contiguous haplotypes. Here, we present Wakhan, a long-read me...

MotivationFanconi anemia (FA) is a rare disease mainly caused by biallelic pathogenic variants, including structural variants such as large deletions and insertions in FA genes. Currently, variant detection is based on short-read sequencing and probe-based approaches. However, determining the exact genomic breakpoint or achieving allelic discrimination remains challenging. Nanopore-based long-read sequencing enables a comprehensive detection of FA variants, but a unified bioinformatic analysis p...

Accurate classification of BRCA1 and BRCA2 variants is essential for cancer risk assessment and therapy selection, yet over one-third remain variants of uncertain significance (VUS). Here, using 120,660 real-world cancer genomic profiles with BRCA1 or BRCA2 variants from a >800,000-sample cohort, we develop machine learning models that predict pathogenicity using clinical and tumor-derived features, including a pan-cancer homologous recombination deficiency signature, co-mutated genes, zygosity,...

While most individuals with familial medullary thyroid carcinoma (fMTC) carry RET mutations, in some instances the causative mutations remain unknown. We studied two related families with RET-negative fMTC in 21 affected individuals through linkage analysis, exome/genome sequencing, and high-density array comparative genomic hybridization. We identified a novel heterozygous 40kb intragenic SLC30A9 deletion which segregated with the disease in all affected individuals. The mutant transcript escap...

BackgroundAccurate and comparable human papillomavirus (HPV) testing is essential for HPV vaccine research, HPV surveillance, and cervical cancer screening. In 2008, the WHO HPV Laboratory Network initiated global HPV proficiency testing traceable to International Standards (IS), which has been issued regularly since. Here, we summarize recent results and trends over time. MethodsThe HPV genotyping panel, used since 2008, consists of 43 blinded samples, including HPV 6, HPV 11, all oncogenic an...

STUDY QUESTION[Do structural genomic variants, that can be identified by using optical genome mapping, contribute to male infertility?] SUMMARY ANSWER[By using optical genome mapping we can identify several types of structural variants, both known and new, that may contribute to male infertility.] WHAT IS KNOWN ALREADY[Traditional approaches such as karyotyping, CFTR and chromosome Y microdeletion testing are successful in explaining clinical findings in [~]30% of MI patients, leaving the rest...

Mycobacterium tuberculosis (MTB) disease is a major global health threat with most tuberculosis (TB) cases occurring in low-and middle-income countries (LMIC) with limited healthcare infrastructure. Near-point-of-care testing which can be deployed at peripheral clinical settings is needed to start treatment earlier and thereby improve treatment outcomes. Here we report the development and preliminary characterization of an MTB detection assay that utilizes tongue swab or sputum specimens for The...

BackgroundBreast cancer susceptibility gene testing (BCSG-testing) is expanding in relation to both eligibility for testing and number of genes included on testing panels. However, uncertainty remains regarding the most effective testing strategies for identifying clinically actionable germline pathogenic variants (gPVs) while balancing increased burden on breast and genetics clinical services. Patients and MethodsThe North Thames Mainstreaming of Breast Cancer Genetic Testing (NT-MBGT) program...

Copy number variants (CNV) contribute significantly to the pathogenic variation associated with developmental disorders. CNV detection is often not included in standard exome sequencing (ES) analysis. Complementary methods such as chromosomal microarray are typically offered in diagnostic laboratories to diagnose pathogenic CNV. In this study, we aimed to develop an optimal approach for incorporating CNV detection within our ES analysis process for the Deciphering Developmental Disorders in Afri...

Chronic myelomonocytic leukemia (CMML) is a clonal myelodysplastic/myeloproliferative neoplasm characterized by persistent monocytosis and heterogeneous risk of progression to acute leukemia. Mutations within the RAS/MAPK signaling pathway, particularly involving KRAS, are linked to a proliferative disease phenotype and adverse prognosis. We report the first Colombian CMML case harboring two concurrent activating KRAS mutations (p.G12S and p.G13D). Both variants were detected at variant allele f...

Early achievement of deep remission improves patients outcome in chronic myeloid leukemia (CML) treatment, highlighting the need for predictive indicators before therapy initiation. This study aimed to develop a tool to predict CML treatment responses to guide optimal therapy selection. Using hierarchical clustering of complete blood count (CBC) data at diagnosis, patients were stratified into two clusters. Patients in Cluster 1 had higher BCR::ABL1IS mRNA levels at 3 and 6 months post-treatment...

ObjectiveBladder cancer (BC) is the most common malignancy of the urinary system and among the most frequently diagnosed cancers worldwide. This systematic review and meta-analysis aimed to evaluate the diagnostic accuracy of commercially available urinary biomarkers tests (UBTs) for detecting BC recurrence, focusing on pooled sensitivity and specificity estimates across different tests. MethodsA systematic search was performed on PubMed and EMBASE up to May 2025 to identify studies assessing r...

PTEN hamartoma tumor syndrome (PHTS) is a cancer predisposition disorder caused by germline PTEN variants, yet its full clinical spectrum remains poorly defined due to reliance on highly selected cohorts. Accordingly, PHTS is underrecognized and its prevalence underestimated. Leveraging genomic and electronic health record data from 414,830 participants in the All of Us (AoU) Research Program, we identified 55 individuals with pathogenic or likely pathogenic PTEN variants, the majority of whom l...

Digitizing large histopathology archives requires processing millions of scanned whole slide images that must be validated rapidly. Automated organ-of-origin classification can accelerate quality control and enable early detection of mislabeled specimens. We developed a deep learning model that classifies the organ of origin from H&E-stained slides using a single low-resolution thumbnail per slide in under one second. For training, we used thumbnails from 16,624 slides from the TCGA and CPTAC ar...

T-cell lymphomas are often histologically indistinguishable from benign T-cell infiltrates. Clonality testing is frequently required for diagnosis. It lacks the spatial context and is slow and expensive, relying on complex, multiplexed PCR reactions, interpreted by experienced scientists or pathologists. We previously published details of a pair of highly specific monoclonal antibodies against the two alternatively used, but very similar, T-cell receptor {beta} constant regions, TCR{beta}1 and T...