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1.
Cancer Res ; 84(9): 1388-1395, 2024 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-38488507

RESUMO

Since 2014, the NCI has launched a series of data commons as part of the Cancer Research Data Commons (CRDC) ecosystem housing genomic, proteomic, imaging, and clinical data to support cancer research and promote data sharing of NCI-funded studies. This review describes each data commons (Genomic Data Commons, Proteomic Data Commons, Integrated Canine Data Commons, Cancer Data Service, Imaging Data Commons, and Clinical and Translational Data Commons), including their unique and shared features, accomplishments, and challenges. Also discussed is how the CRDC data commons implement Findable, Accessible, Interoperable, Reusable (FAIR) principles and promote data sharing in support of the new NIH Data Management and Sharing Policy. See related articles by Brady et al., p. 1384, Pot et al., p. 1396, and Kim et al., p. 1404.


Assuntos
Disseminação de Informação , National Cancer Institute (U.S.) , Neoplasias , Humanos , Estados Unidos , Neoplasias/metabolismo , Disseminação de Informação/métodos , Pesquisa Biomédica , Genômica/métodos , Animais , Proteômica/métodos
2.
J Clin Oncol ; 41(24): 4045-4053, 2023 08 20.
Artigo em Inglês | MEDLINE | ID: mdl-37267580

RESUMO

Data-driven basic, translational, and clinical research has resulted in improved outcomes for children, adolescents, and young adults (AYAs) with pediatric cancers. However, challenges in sharing data between institutions, particularly in research, prevent addressing substantial unmet needs in children and AYA patients diagnosed with certain pediatric cancers. Systematically collecting and sharing data from every child and AYA can enable greater understanding of pediatric cancers, improve survivorship, and accelerate development of new and more effective therapies. To accomplish this goal, the Childhood Cancer Data Initiative (CCDI) was launched in 2019 at the National Cancer Institute. CCDI is a collaborative community endeavor supported by a 10-year, $50-million (in US dollars) annual federal investment. CCDI aims to learn from every patient diagnosed with a pediatric cancer by designing and building a data ecosystem that facilitates data collection, sharing, and analysis for researchers, clinicians, and patients across the cancer community. For example, CCDI's Molecular Characterization Initiative provides comprehensive clinical molecular characterization for children and AYAs with newly diagnosed cancers. Through these efforts, the CCDI strives to provide clinical benefit to patients and improvements in diagnosis and care through data-focused research support and to build expandable, sustainable data resources and workflows to advance research well past the planned 10 years of the initiative. Importantly, if CCDI demonstrates the success of this model for pediatric cancers, similar approaches can be applied to adults, transforming both clinical research and treatment to improve outcomes for all patients with cancer.


Assuntos
Neoplasias , Adolescente , Estados Unidos/epidemiologia , Humanos , Criança , Adulto Jovem , Neoplasias/terapia , Ecossistema , Coleta de Dados , National Cancer Institute (U.S.)
3.
NPJ Precis Oncol ; 6(1): 38, 2022 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-35710826

RESUMO

Fully automated machine learning (AutoML) for predictive modeling is becoming a reality, giving rise to a whole new field. We present the basic ideas and principles of Just Add Data Bio (JADBio), an AutoML platform applicable to the low-sample, high-dimensional omics data that arise in translational medicine and bioinformatics applications. In addition to predictive and diagnostic models ready for clinical use, JADBio focuses on knowledge discovery by performing feature selection and identifying the corresponding biosignatures, i.e., minimal-size subsets of biomarkers that are jointly predictive of the outcome or phenotype of interest. It also returns a palette of useful information for interpretation, clinical use of the models, and decision making. JADBio is qualitatively and quantitatively compared against Hyper-Parameter Optimization Machine Learning libraries. Results show that in typical omics dataset analysis, JADBio manages to identify signatures comprising of just a handful of features while maintaining competitive predictive performance and accurate out-of-sample performance estimation.

4.
Cell ; 184(7): 1661-1670, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33798439

RESUMO

When it comes to precision oncology, proteogenomics may provide better prospects to the clinical characterization of tumors, help make a more accurate diagnosis of cancer, and improve treatment for patients with cancer. This perspective describes the significant contributions of The Cancer Genome Atlas and the Clinical Proteomic Tumor Analysis Consortium to precision oncology and makes the case that proteogenomics needs to be fully integrated into clinical trials and patient care in order for precision oncology to deliver the right cancer treatment to the right patient at the right dose and at the right time.


Assuntos
Neoplasias/diagnóstico , Proteogenômica/métodos , Bases de Dados Genéticas , Descoberta de Drogas , Estudos de Associação Genética , Humanos , Neoplasias/genética , Neoplasias/terapia , Medicina de Precisão
5.
J Natl Cancer Inst ; 113(1): 27-37, 2021 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-32339229

RESUMO

BACKGROUND: Tumor molecular profiling from patients experiencing exceptional responses to systemic therapy may provide insights into cancer biology and improve treatment tailoring. This pilot study evaluates the feasibility of identifying exceptional responders retrospectively, obtaining pre-exceptional response treatment tumor tissues, and analyzing them with state-of-the-art molecular analysis tools to identify potential molecular explanations for responses. METHODS: Exceptional response was defined as partial (PR) or complete (CR) response to a systemic treatment with population PR or CR rate less than 10% or an unusually long response (eg, duration >3 times published median). Cases proposed by patients' clinicians were reviewed by clinical and translational experts. Tumor and normal tissue (if possible) were profiled with whole exome sequencing and, if possible, targeted deep sequencing, RNA sequencing, methylation arrays, and immunohistochemistry. Potential germline mutations were tracked for relevance to disease. RESULTS: Cases reflected a variety of tumors and standard and investigational treatments. Of 520 cases, 476 (91.5%) were accepted for further review, and 222 of 476 (46.6%) proposed cases met requirements as exceptional responders. Clinical data were obtained from 168 of 222 cases (75.7%). Tumor was provided from 130 of 168 cases (77.4%). Of 117 of the 130 (90.0%) cases with sufficient nucleic acids, 109 (93.2%) were successfully analyzed; 6 patients had potentially actionable germline mutations. CONCLUSION: Exceptional responses occur with standard and investigational treatment. Retrospective identification of exceptional responders, accessioning, and sequencing of pretreatment archived tissue is feasible. Data from molecular analyses of tumors, particularly when combining results from patients who received similar treatments, may elucidate molecular bases for exceptional responses.


Assuntos
Neoplasias/tratamento farmacológico , Neoplasias/genética , Transcriptoma/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Viabilidade , Feminino , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Masculino , Pessoa de Meia-Idade , Mutação/genética , National Cancer Institute (U.S.) , Neoplasias/epidemiologia , Neoplasias/patologia , Projetos Piloto , Medicina de Precisão , Estudos Retrospectivos , Análise de Sequência de RNA , Estados Unidos/epidemiologia , Sequenciamento do Exoma
6.
Cancer Cell ; 39(1): 38-53.e7, 2021 01 11.
Artigo em Inglês | MEDLINE | ID: mdl-33217343

RESUMO

A small fraction of cancer patients with advanced disease survive significantly longer than patients with clinically comparable tumors. Molecular mechanisms for exceptional responses to therapy have been identified by genomic analysis of tumor biopsies from individual patients. Here, we analyzed tumor biopsies from an unbiased cohort of 111 exceptional responder patients using multiple platforms to profile genetic and epigenetic aberrations as well as the tumor microenvironment. Integrative analysis uncovered plausible mechanisms for the therapeutic response in nearly a quarter of the patients. The mechanisms were assigned to four broad categories-DNA damage response, intracellular signaling, immune engagement, and genetic alterations characteristic of favorable prognosis-with many tumors falling into multiple categories. These analyses revealed synthetic lethal relationships that may be exploited therapeutically and rare genetic lesions that favor therapeutic success, while also providing a wealth of testable hypotheses regarding oncogenic mechanisms that may influence the response to cancer therapy.


Assuntos
Antineoplásicos/uso terapêutico , Redes Reguladoras de Genes , Variação Genética , Genômica/métodos , Neoplasias/tratamento farmacológico , Biópsia , Epigênese Genética , Feminino , Humanos , Masculino , Neoplasias/genética , Neoplasias/patologia , Prognóstico , Análise de Sobrevida , Resultado do Tratamento , Microambiente Tumoral
7.
Int J Cancer ; 148(3): 560-571, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-32818326

RESUMO

Gaps in the translation of research findings to clinical management have been recognized for decades. They exist for the diagnosis as well as the management of cancer. The international standards for cancer diagnosis are contained within the World Health Organization (WHO) Classification of Tumours, published by the International Agency for Research on Cancer (IARC) and known worldwide as the WHO Blue Books. In addition to their relevance to individual patients, these volumes provide a valuable contribution to cancer research and surveillance, fulfilling an important role in scientific evidence synthesis and international standard setting. However, the multidimensional nature of cancer classification, the way in which the WHO Classification of Tumours is constructed, and the scientific information overload in the field pose important challenges for the translation of research findings to tumour classification and hence cancer diagnosis. To help address these challenges, we have established the International Collaboration for Cancer Classification and Research (IC3 R) to provide a forum for the coordination of efforts in evidence generation, standard setting and best practice recommendations in the field of tumour classification. The first IC3 R meeting, held in Lyon, France, in February 2019, gathered representatives of major institutions involved in tumour classification and related fields to identify and discuss translational challenges in data comparability, standard setting, quality management, evidence evaluation and copyright, as well as to develop a collaborative plan for addressing these challenges.


Assuntos
Detecção Precoce de Câncer/normas , Neoplasias/classificação , Neoplasias/diagnóstico , Medicina Baseada em Evidências , França , Humanos , Cooperação Internacional , Guias de Prática Clínica como Assunto , Organização Mundial da Saúde
8.
Cancer Discov ; 8(12): 1548-1565, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30322867

RESUMO

Malignant pleural mesothelioma (MPM) is a highly lethal cancer of the lining of the chest cavity. To expand our understanding of MPM, we conducted a comprehensive integrated genomic study, including the most detailed analysis of BAP1 alterations to date. We identified histology-independent molecular prognostic subsets, and defined a novel genomic subtype with TP53 and SETDB1 mutations and extensive loss of heterozygosity. We also report strong expression of the immune-checkpoint gene VISTA in epithelioid MPM, strikingly higher than in other solid cancers, with implications for the immune response to MPM and for its immunotherapy. Our findings highlight new avenues for further investigation of MPM biology and novel therapeutic options. SIGNIFICANCE: Through a comprehensive integrated genomic study of 74 MPMs, we provide a deeper understanding of histology-independent determinants of aggressive behavior, define a novel genomic subtype with TP53 and SETDB1 mutations and extensive loss of heterozygosity, and discovered strong expression of the immune-checkpoint gene VISTA in epithelioid MPM.See related commentary by Aggarwal and Albelda, p. 1508.This article is highlighted in the In This Issue feature, p. 1494.


Assuntos
Biomarcadores Tumorais/genética , Neoplasias Pulmonares/genética , Mesotelioma/genética , Mutação , Neoplasias Pleurais/genética , Idoso , Feminino , Histona-Lisina N-Metiltransferase , Humanos , Estimativa de Kaplan-Meier , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/terapia , Masculino , Mesotelioma/patologia , Mesotelioma/terapia , Pessoa de Meia-Idade , Neoplasias Pleurais/patologia , Neoplasias Pleurais/terapia , Prognóstico , Proteínas Metiltransferases/genética , Proteínas Supressoras de Tumor/genética , Ubiquitina Tiolesterase/genética
9.
Sci Data ; 5: 180158, 2018 08 14.
Artigo em Inglês | MEDLINE | ID: mdl-30106394

RESUMO

The Rembrandt brain cancer dataset includes 671 patients collected from 14 contributing institutions from 2004-2006. It is accessible for conducting clinical translational research using the open access Georgetown Database of Cancer (G-DOC) platform. In addition, the raw and processed genomics and transcriptomics data have also been made available via the public NCBI GEO repository as a super series GSE108476. Such combined datasets would provide researchers with a unique opportunity to conduct integrative analysis of gene expression and copy number changes in patients alongside clinical outcomes (overall survival) using this large brain cancer study.


Assuntos
Neoplasias Encefálicas/genética , Bases de Dados Genéticas , DNA de Neoplasias , Regulação Neoplásica da Expressão Gênica , Genômica , Humanos
10.
Cell ; 173(2): 283-285, 2018 04 05.
Artigo em Inglês | MEDLINE | ID: mdl-29625045

RESUMO

The Cancer Genome Atlas (TCGA) team now presents the Pan-Cancer Atlas, investigating different aspects of cancer biology by analyzing the data generated during the 10+ years of the TCGA project.


Assuntos
Bases de Dados Genéticas , Genes Neoplásicos , Neoplasias/patologia , Aneuploidia , Genoma Humano , Humanos , Mutação , Neoplasias/genética , Neoplasias/imunologia , Neoplasias/metabolismo
11.
Cell ; 173(2): 305-320.e10, 2018 04 05.
Artigo em Inglês | MEDLINE | ID: mdl-29625049

RESUMO

The Cancer Genome Atlas (TCGA) has catalyzed systematic characterization of diverse genomic alterations underlying human cancers. At this historic junction marking the completion of genomic characterization of over 11,000 tumors from 33 cancer types, we present our current understanding of the molecular processes governing oncogenesis. We illustrate our insights into cancer through synthesis of the findings of the TCGA PanCancer Atlas project on three facets of oncogenesis: (1) somatic driver mutations, germline pathogenic variants, and their interactions in the tumor; (2) the influence of the tumor genome and epigenome on transcriptome and proteome; and (3) the relationship between tumor and the microenvironment, including implications for drugs targeting driver events and immunotherapies. These results will anchor future characterization of rare and common tumor types, primary and relapsed tumors, and cancers across ancestry groups and will guide the deployment of clinical genomic sequencing.


Assuntos
Carcinogênese/genética , Genômica , Neoplasias/patologia , Reparo do DNA/genética , Bases de Dados Genéticas , Genes Neoplásicos , Humanos , Redes e Vias Metabólicas/genética , Instabilidade de Microssatélites , Mutação , Neoplasias/genética , Neoplasias/imunologia , Transcriptoma , Microambiente Tumoral/genética
12.
Cancer Cell ; 33(2): 244-258.e10, 2018 02 12.
Artigo em Inglês | MEDLINE | ID: mdl-29438696

RESUMO

Thymic epithelial tumors (TETs) are one of the rarest adult malignancies. Among TETs, thymoma is the most predominant, characterized by a unique association with autoimmune diseases, followed by thymic carcinoma, which is less common but more clinically aggressive. Using multi-platform omics analyses on 117 TETs, we define four subtypes of these tumors defined by genomic hallmarks and an association with survival and World Health Organization histological subtype. We further demonstrate a marked prevalence of a thymoma-specific mutated oncogene, GTF2I, and explore its biological effects on multi-platform analysis. We further observe enrichment of mutations in HRAS, NRAS, and TP53. Last, we identify a molecular link between thymoma and the autoimmune disease myasthenia gravis, characterized by tumoral overexpression of muscle autoantigens, and increased aneuploidy.


Assuntos
Mutação/genética , Neoplasias Epiteliais e Glandulares/genética , Timoma/genética , Neoplasias do Timo/genética , Fatores de Transcrição TFII/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Genômica , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
13.
Cell ; 171(5): 982-986, 2017 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-29149611

RESUMO

The Center for Medical Technology Policy and the Molecular Evidence Development Consortium gathered a diverse group of more than 50 stakeholders to develop consensus on a core set of data elements and values essential to understanding the clinical utility of molecularly targeted therapies in oncology.


Assuntos
Gestão da Informação em Saúde , Neoplasias/genética , Elementos de Dados Comuns , Consenso , Bases de Dados de Ácidos Nucleicos , Genoma Humano , Humanos
14.
Nat Med ; 22(5): 464-71, 2016 05 05.
Artigo em Inglês | MEDLINE | ID: mdl-27149219

RESUMO

Rapid and affordable tumor molecular profiling has led to an explosion of clinical and genomic data poised to enhance the diagnosis, prognostication and treatment of cancer. A critical point has now been reached at which the analysis and storage of annotated clinical and genomic information in unconnected silos will stall the advancement of precision cancer care. Information systems must be harmonized to overcome the multiple technical and logistical barriers to data sharing. Against this backdrop, the Global Alliance for Genomic Health (GA4GH) was established in 2013 to create a common framework that enables responsible, voluntary and secure sharing of clinical and genomic data. This Perspective from the GA4GH Clinical Working Group Cancer Task Team highlights the data-aggregation challenges faced by the field, suggests potential collaborative solutions and describes how GA4GH can catalyze a harmonized data-sharing culture.


Assuntos
Genoma , Disseminação de Informação , Neoplasias/genética , Biologia Computacional , Cultura , Bases de Dados Genéticas , Humanos
15.
Methods Mol Biol ; 1418: 111-41, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27008012

RESUMO

The Cancer Genome Atlas (TCGA) is one of the most ambitious and successful cancer genomics programs to date. The TCGA program has generated, analyzed, and made available genomic sequence, expression, methylation, and copy number variation data on over 11,000 individuals who represent over 30 different types of cancer. This chapter provides a brief overview of the TCGA program and detailed instructions and tips for investigators on how to find, access, and download this data.


Assuntos
Biologia Computacional/métodos , Bases de Dados Genéticas , Genômica/métodos , Neoplasias/genética , Animais , Humanos , Neoplasias/metabolismo , Software , Navegador
16.
PLoS One ; 6(2): e14681, 2011 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-21358821

RESUMO

Despite progress in the determination of miR interactions, their regulatory role in cancer is only beginning to be unraveled. Utilizing gene expression data from 27 glioblastoma samples we found that the mere knowledge of physical interactions between specific mRNAs and miRs can be used to determine associated regulatory interactions, allowing us to identify 626 associated interactions, involving 128 miRs that putatively modulate the expression of 246 mRNAs. Experimentally determining the expression of miRs, we found an over-representation of over(under)-expressed miRs with various predicted mRNA target sequences. Such significantly associated miRs that putatively bind over-expressed genes strongly tend to have binding sites nearby the 3'UTR of the corresponding mRNAs, suggesting that the presence of the miRs near the translation stop site may be a factor in their regulatory ability. Our analysis predicted a significant association between miR-128 and the protein kinase WEE1, which we subsequently validated experimentally by showing that the over-expression of the naturally under-expressed miR-128 in glioma cells resulted in the inhibition of WEE1 in glioblastoma cells.


Assuntos
Neoplasias Encefálicas/genética , Regulação Neoplásica da Expressão Gênica , Glioma/genética , MicroRNAs/fisiologia , Neoplasias Encefálicas/patologia , Proteínas de Ciclo Celular/genética , Células Cultivadas , Análise por Conglomerados , Biologia Computacional , Previsões/métodos , Perfilação da Expressão Gênica , Redes Reguladoras de Genes , Glioma/patologia , Humanos , MicroRNAs/genética , Análise em Microsséries , Proteínas Nucleares/genética , Proteínas Tirosina Quinases/genética , Transfecção , Regulação para Cima , Estudos de Validação como Assunto
17.
J Cancer Res Clin Oncol ; 137(1): 89-97, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-20238225

RESUMO

PURPOSE: ST7 has been proposed to be a tumor suppressor gene in the chromosome region 7q31.1-q31.2. In order to gain some insight into its role in cancer, the localization and verification of the ST7 expression levels were determined. METHODS: Various types of ST7 expression vectors tagged with the sequences of GFP, YFP or V5 were created using a gateway cloning system and full-length ST7 cDNA isolated from a human adult brain cDNA library. Cell cycle synchronization was also performed to analyze the expression of endogenous ST7 and its potentially related genes at each stage of the cell cycle. RESULTS: Cytosolic ST7 expression in HCT-116, MCF-7 and PC-3 cancer cell lines was detected via the fluorescence signal of the fusion proteins. ST7 translocation from the cytoplasm to the nucleus has not been observed in any of the conditions assayed. A cell cycle synchronization study demonstrated that both ST7 and SERPINE1 were overexpressed when cells were arrested. Expression of these genes was found to be diminished when the cells re-entered cell division status. In addition, we also found that Survivin, MMP-13 and Cyclin D1 were differentially expressed during the cell cycle. CONCLUSION: Our findings suggest that ST7 mediates tumor suppression through the regulation of the genes involved in maintaining the cellular structure of the cell and involved in oncogenic pathways.


Assuntos
Neoplasias/metabolismo , Proteínas Supressoras de Tumor/metabolismo , Adulto , Membrana Celular/metabolismo , Cromossomos Humanos Par 7/genética , Cromossomos Humanos Par 7/metabolismo , Citoplasma/metabolismo , DNA Complementar/metabolismo , Humanos , Microscopia de Fluorescência , Neoplasias/genética , Neoplasias/patologia , Inibidor 1 de Ativador de Plasminogênio/genética , Inibidor 1 de Ativador de Plasminogênio/metabolismo , Proteínas Supressoras de Tumor/análise , Proteínas Supressoras de Tumor/genética
18.
J Biomed Inform ; 43(6): 945-52, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20828632

RESUMO

Molecular diagnostic tools are increasingly being used in an attempt to classify primary human brain tumors more accurately. While methods that are based on the analysis of individual gene expression prove to be useful for diagnostic purposes, they are devoid of biological significance since tumorgenesis is a concerted deregulation of multiple pathways rather than single genes. In a proof of concept, we utilize two large clinical data sets and show that the elucidation of enriched pathways and small differentially expressed sub-networks of protein interactions allow a reliable classification of glioblastomas and oligodendrogliomas. Applying a feature selection method, we observe that an optimized subset of pathways and subnetworks significantly improves the prediction accuracy. By determining the enrichment of altered genes in pathways and subnetworks we show that optimized subsets of genes rarely seem to be a target of genomic alteration. Our results suggest that groups of genes play a decisive role for the phenotype of the underlying tumor samples that can be utilized to reliably distinguish tumor types. In the absence of enrichment of genes that are genomically altered we assume that genetic changes largely exert an indirect rather than direct regulatory influence on a number of tumor-defining regulatory networks.


Assuntos
Neoplasias Encefálicas/classificação , Neoplasias Encefálicas/genética , Redes Reguladoras de Genes , Glioma/classificação , Glioma/genética , Bases de Dados Genéticas , Perfilação da Expressão Gênica , Regulação Neoplásica da Expressão Gênica , Humanos , Oligodendroglioma/genética , Fenótipo
20.
BMC Med Genomics ; 3: 11, 2010 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-20380730

RESUMO

BACKGROUND: Genomic copy number alterations are widely associated with a broad range of human tumors and offer the potential to be used as a diagnostic tool. Especially in the emerging era of personalized medicine medical informatics tools that allow the fast visualization and analysis of genomic alterations of a patient's genomic profile for diagnostic and potential treatment purposes increasingly gain importance. RESULTS: We developed CNAReporter, a software tool that allows users to visualize SNP-specific data obtained from Affymetrix arrays and generate PDF-reports as output. We combined standard algorithms for the analysis of chromosomal alterations, utilizing the widely applied GenePattern framework. As an example, we show genome analyses of two patients with distinctly different CNA profiles using the tool. CONCLUSIONS: Glioma subtypes, characterized by different genomic alterations, are often treated differently but can be difficult to differentiate pathologically. CNAReporter offers a user-friendly way to visualize and analyse genomic changes of any given tumor genomic profile, thereby leading to an accurate diagnosis and patient-specific treatment.


Assuntos
Genômica/métodos , Polimorfismo de Nucleotídeo Único , Design de Software , Algoritmos , Cromossomos Humanos , Variações do Número de Cópias de DNA , Glioma/diagnóstico , Glioma/genética , Glioma/terapia , Humanos , Perda de Heterozigosidade
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