CN111505300B - Early esophageal cancer joint screening test strip - Google Patents
Early esophageal cancer joint screening test strip Download PDFInfo
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Abstract
The invention belongs to the technical field of medical biology, and discloses a combined screening test strip for early esophageal cancer, which comprises a combination pad and a chromatography pad, wherein the combination pad is coated with a mouse anti-human IgG monoclonal antibody and a rabbit IgG monoclonal antibody, and the mouse anti-human IgG monoclonal antibody and the rabbit IgG monoclonal antibody are both provided with detectable markers; the chromatography pad is provided with three detection lines and a quality control line, and detection antigens coated by the three detection lines are KPNA6 protein, PDE1A protein and CASK protein respectively; the quality control band is coated with goat anti-rabbit IgG. The test strip combines three tumor-related antigens of KPNA6 protein, PDE1A protein and CASK protein as markers for early esophageal cancer screening, is used for detecting the expression levels of autoantibodies of KPNA6, PDE1A and CASK in serum, can effectively detect esophageal cancer, particularly early esophageal cancer, and greatly improves the detection rate of early esophageal cancer.
Description
Technical Field
The invention belongs to the technical field of medical biology, and particularly relates to a combined screening test strip for early esophageal cancer.
Background
Esophageal cancer is one of the most common digestive system malignancies in humans, with the incidence of esophageal cancer at the 8 th position and mortality at the 6 th position of death due to cancer in all malignancies worldwide. China is a world with high incidence of esophageal cancer, and the tissue type is mainly squamous cell carcinoma (in the invention, esophageal cancer refers to esophageal squamous cell carcinoma, namely ductal squamous cell carcinoma). The latest data of 'Chinese tumor registration annual newspaper' published in 2018 shows that esophageal cancer in China has the sixth malignant tumor and the fourth death, and the latest data of the esophageal cancer registration annual newspaper has serious threats to the quality of life and family happiness of people.
The early onset of the esophageal cancer is very hidden, most early esophageal cancer patients have symptoms which are not typical or have no symptoms, when the patients go to the clinic due to the occurrence of typical symptoms such as progressive dysphagia and the like, the patients often reach the middle and late stages, the optimal treatment time is missed, the life quality is poor, the prognosis is poor, the five-year survival rate is only about 20 percent, and the five-year survival rate is far lower than that of the early esophageal cancer patients (more than about 90 percent). It follows that one of the major reasons for the poor overall prognosis of patients with esophageal cancer is the lack of effective early screening and diagnosis methods and means.
At present, early detection and diagnosis of esophageal cancer mainly depend on endoscopic examination and mucosal pathological biopsy, but the method has the characteristics of long diagnosis period, invasiveness, poor acceptance, high cost and the like, and has low efficiency. Conventionally, when endoscope screening is carried out on asymptomatic people in a high-incidence area, over 40 years old, male, smoking, drinking and having a positive family history, namely asymptomatic high-risk people with ductal cancer, the early cancer discovery rate is only about 2%, and more than 90% of asymptomatic high-risk people are accompanied and checked. These all limit the popularization and application of endoscopic screening in asymptomatic populations. Therefore, it is important to find a new non-invasive diagnosis method for screening people to further reduce the mortality rate of esophageal cancer, improve the prognosis of patients and improve the early detection, early diagnosis and early treatment of esophageal cancer.
The detection of the tumor marker in peripheral blood has the advantages of rapidness, small wound, easy acceptance and the like, is suitable for large-scale population screening, is convenient for long-term dynamic monitoring, and provides a simple and convenient noninvasive diagnosis method for early discovery of esophageal cancer. Although some tumor markers commonly used in clinic at present, such as CA125 (cancer antigen 125), CA199 (cancer antigen 199), CEA (carcinoembryonic antigen), SCCA (squamous cell carcinoma antigen) and the like, can be used for diagnosing esophageal cancer, the sensitivity and specificity are not high, and the diagnostic value of patients with early esophageal squamous cell carcinoma is not high enough.
During the development of tumorigenesis, tumor patients have a variety of tumorigenesis-associated antigens (tumor associated antigens, TAAs) and autoantibodies (TAAbs) present in their blood. Over the last decade, tumor-associated antigen autoantibodies have been extensively studied as early biomarkers in various tumor types, such as liver cancer, lung cancer, breast cancer, and the like. Autoantibodies have the following advantages: 1. the tumor-associated antigen autoantibodies can exist in serum continuously and stably, and the concentration of the tumor-associated antigen autoantibodies in the blood of normal individuals is extremely low; 2. tumor-associated antigen autoantibodies can be detected months or even years before a tumor patient develops major clinical symptoms; 3. methods for detecting autoantibodies are well established and related reagents are commercially available. These advantages make possible the use of tumor-associated antigen autoantibodies as very potential tumor diagnostic markers.
Esophageal carcinogenesis is also a very complex process, and not only relates to the influence of multiple factors such as environment-heredity-gene interaction, but also relates to the complex processes of multiple factors and multiple stages which influence cell growth and change of key molecules in multigroup (genes, RNA, proteins, metabolites and the like), namely tumorigenesis. Autoantibodies to tumor-associated antigens have also been found in serum from patients with esophageal cancer. Research shows that the frequency of the single tumor-associated antigen autoantibody in the serum of a tumor patient is very low, generally about 10-30%, and the purpose of early diagnosis of esophageal cancer is difficult to achieve, so that the combined detection of multiple anti-tumor-associated antigen antibodies in the serum of an esophageal cancer patient has certain possibility and feasibility for early diagnosis of esophageal cancer and screening of high risk groups.
Over the years, the research team has been working on the mechanism of the development of esophageal cancer, and a great deal of research has been conducted on the autoantibody profile of esophageal cancer. The serum of an esophagus cancer patient is taken as a research object, 3 tumor-related antigens (KPNA6, PDE1A and CASK) are screened by utilizing an esophagus cancer genomics database established by the research team in combination with an autoantibody chip technology, the expression level of the corresponding tumor autoantibodies in the serum of the esophagus cancer patient is obviously different from that of a normal control group, the tumor-related antigens can be detected in the early stage of the esophagus cancer and even in a blood sample of precancerous lesions, and the combination of the 3 tumor-related antigen autoantibodies has higher sensitivity and specificity for the early diagnosis of the esophagus cancer. TAAs applied in most of the related studies in the past are identified by other types of tumors rather than esophageal cancer, and the sensitivity and specificity in esophageal cancer detection need to be fully evaluated; some studies have identified esophageal cancer-associated tumor antigens using proteomics, but have rarely performed comprehensive and deep evaluation of autoantibodies induced by them as markers for early immunodiagnostics of esophageal cancer. Therefore, the research team screens out TAAs screened out by using the serum of the esophageal squamous cell carcinoma patient and the tumor-associated antigen autoantibody, and the early diagnosis of the esophageal squamous cell carcinoma is more reliable.
KPNA6 (nuclear transport protein alpha 6, also known as import protein alpha 7) is a kind of nuclear transport protein Imp family, widely exists in eukaryotic cells, can realize the transport of macromolecular proteins across nuclear membrane, and its ligand has many important signal molecules, such as cyclin, histone, oncoprotein, etc., which are closely related to important vital activities such as signal transduction, cell division, growth and development, apoptosis, etc. of cells. PDE1A (phosphodiesterase 1A), plays a key role in the signaling pathway involved in cell proliferation, primarily by hydrolyzing cAMP and cGMP within the cell. The reduction of the activity or expression level of PDE1A can obviously promote apoptosis and obviously up-regulate cancer-inhibiting genes, and the effect is reported on melanoma cell lines and acute lymphocytic leukemia cell lines. CASK (calcium/calmodulin-dependent serine protein kinase) is a member of membrane-bound guanylate kinase (MAGuk) family, is positioned at a cell adhesion site, is combined with a plurality of target proteins to form a multi-protein compound, and participates in processes such as cell proliferation and differentiation, gene transcription, cell membrane skeleton construction, cell connection, transmission of intracellular and extracellular information and the like.
Therefore, the combination of 3 tumor-associated antigen autoantibodies corresponding to KPNA6, PDE1A and CASK is found in the laboratory, so that the sensitivity and specificity of the detection of early esophageal squamous cell carcinoma patients are high, and the kit is particularly suitable for early esophageal carcinoma screening (noninvasive, simple and economic) of asymptomatic people in esophageal carcinoma high-incidence areas, so that the early detection rate of esophageal carcinoma is improved, the survival quality of patients is improved, and the burden of families and society is relieved.
Disclosure of Invention
In view of the problems and disadvantages in the prior art, an object of the present invention is to provide a marker for early esophageal cancer screening, a second object of the present invention is to provide an application of the marker for early esophageal cancer screening, and a third object of the present invention is to provide a combined screening test strip for early esophageal cancer.
In order to realize the purpose of the invention, the technical scheme adopted by the invention is as follows:
the invention firstly provides a marker for screening early esophageal cancer, and the marker is any one or any two or any three of KPNA6 protein, PDE1A protein and CASK protein.
The invention also provides application of the marker for screening early esophageal cancer in preparation of products for screening early esophageal cancer.
According to the above application, preferably, the product detects the antibody of the marker in the sample by an enzyme-linked immunosorbent assay, and determines the expression level of the antibody corresponding to the marker. More preferably, the antibody is an autoantibody to which the marker corresponds.
Preferably, the sample is serum, according to the above-mentioned use.
According to the above application, preferably, the product is a test strip or a kit.
The invention also provides a test strip for early esophageal cancer combined screening, which comprises a binding pad and a chromatography pad, wherein the binding pad is coated with a mouse anti-human IgG monoclonal antibody and a rabbit IgG monoclonal antibody, and the mouse anti-human IgG monoclonal antibody and the rabbit IgG monoclonal antibody are both provided with detectable markers; the chromatography pad is provided with three detection lines and a quality control line, the detection lines are coated with detection antigens, and the detection antigens coated by the three detection lines are KPNA6 protein, PDE1A protein and CASK protein respectively; the quality control band is coated with goat anti-rabbit IgG.
Preferably, the marker is colloidal gold particles according to the above-mentioned test strip for combined screening of early esophageal cancer. More preferably, the diameter of the colloidal gold particles is in the range of 25-35 nm.
According to the above-mentioned test strip for combined screening of early esophageal cancer, preferably, the test strip further comprises a sample pad, a sample sucking pad and a bottom plate, wherein the sample pad, the binding pad, the chromatography pad and the sample sucking pad are sequentially fixed on the bottom plate; wherein, one end of the combination pad is pressed below the sample pad, and the other end of the combination pad is pressed above the chromatography pad; one end of the chromatographic pad is pressed below the conjugate pad, and the other end of the chromatographic pad is pressed below the sample suction pad.
According to the above-mentioned combined test strip for early esophageal cancer screening, preferably, the three detection lines and one quality control line on the chromatographic pad are arranged in the following order: the chromatography pad is sequentially provided with a quality control line C coated with goat anti-rabbit IgG, a detection line T3 coated with CASK protein, a detection line T2 coated with PDE1A protein and a detection line T1 coated with KPNA6 protein from one end close to the sample sucking pad to one end close to the combination pad.
According to the combined screening test strip for early esophageal cancer, preferably, the intervals between the detection lines T1, T2, T3 and the quality control line C on the chromatographic pad are not less than 5 mm.
According to the above-mentioned early esophageal cancer joint-screening test strip, preferably, the material of the sample pad is water-absorbent glass fiber, the material of the conjugate pad is glass fiber membrane, and the material of the chromatographic pad is nitrocellulose membrane; the sample absorbing pad is made of absorbent paper or an absorbent glass fiber membrane; the bottom plate is a PVC bottom plate, a hard board or a hard fiberboard.
The invention also provides a preparation method of the early esophageal cancer combined screening test strip, which comprises the following steps:
(1) preparing a bonding pad: labeling a mouse anti-human IgG monoclonal antibody and a rabbit IgG monoclonal antibody with colloidal gold particles, coating the mouse anti-human IgG monoclonal antibody and the rabbit IgG monoclonal antibody labeled with the colloidal gold particles on a glass fiber membrane, and freeze-drying to obtain a binding pad;
(2) preparing a chromatographic pad: respectively coating KPNA6 protein, PDE1A protein, CASK protein and goat anti-rabbit IgG on detection lines T1, T2, T3 and a quality control line C of a nitrocellulose membrane, drying after coating, then putting the nitrocellulose membrane into a sealing solution for sealing, and drying after sealing to obtain a chromatography pad;
(3) assembling the test strip: and fixing the combination pad and the chromatography pad on the bottom plate, connecting one end of the combination pad with one end of the chromatography pad, placing the sample pad at the other end of the combination pad, placing the sample suction pad at the other end of the chromatography pad, and drying to complete the assembly of the test strip, thereby obtaining the early esophageal cancer joint screening test strip.
According to the above preparation method, preferably, the specific operation of step (1) is:
(1a) adding a mouse anti-human IgG monoclonal antibody and a rabbit IgG monoclonal antibody into the colloidal gold solution, uniformly mixing, standing at room temperature for 15min, adding a stabilizer, uniformly mixing, standing for 10min, centrifuging at 12000rpm for 30min, discarding supernatant, and re-suspending precipitates with a buffer solution to obtain a mixed solution of the mouse anti-human IgG monoclonal antibody marked by the colloidal gold particles and the rabbit IgG monoclonal antibody marked by the colloidal gold particles;
(1b) coating the mixed solution of the mouse anti-human IgG monoclonal antibody marked by the colloidal gold particles and the rabbit IgG monoclonal antibody marked by the colloidal gold particles on a glass fiber membrane in a spraying or dipping mode, and freeze-drying to obtain the combined pad.
According to the preparation method, in the step (1a), the concentrations of the colloidal gold particle-labeled mouse anti-human IgG monoclonal antibody and the colloidal gold particle-labeled rabbit IgG monoclonal antibody in the mixed solution are preferably 20 to 40 μ g/mL. More preferably, the concentrations of the colloidal gold particle-labeled mouse anti-human IgG monoclonal antibody and the colloidal gold particle-labeled rabbit IgG monoclonal antibody in the mixed solution are both 30 mug/mL.
According to the above preparation method, preferably, in the step (1a), the stabilizer is 10% BSA (bovine serum albumin) solution.
According to the above preparation method, preferably, in step (1a), the buffer solution is a 0.01mol/L PBS solution at pH8.0 containing 1% BSA and 5% sucrose.
According to the preparation method, preferably, in the step (2), the concentrations of the KPNA6 protein, the PDE1A protein and the CASK protein are all 0.6-1.5 mg/mL; the concentration of the goat anti-rabbit IgG is 1-3 mg/mL. More preferably, the concentrations of the KPNA6 protein, the PDE1A protein and the CASK protein are all 1.0 mg/mL; the concentration of the goat anti-rabbit IgG is 2 mg/mL.
According to the above preparation method, preferably, in the step (2), the blocking solution is a 0.01mol/L PBS solution with 1% BSA at pH 8.0.
According to the preparation method, preferably, in the step (3), before assembly, the sample pad is placed into the sample pad sealing solution to be soaked for 30min, and then dried at 37 ℃ for standby. More preferably, the sample pad blocking solution is a 0.01mol/L PBS solution (pH 7.4) containing 1% BSA, 1.0% to 2.0% sucrose, 0.1 to 0.5% Tween-20, 0.1 to 1.0% PVP polyvinylpyrrolidone.
The invention also provides a test paper card containing the test paper strip, the test paper card comprises the test paper strip and a card shell, the test paper strip is embedded in the card shell, an observation window is arranged at the position, corresponding to the chromatographic pad, of the upper surface of the card shell, and identification characters corresponding to detection lines T1, T2, T3 and a quality control line C on the chromatographic pad are arranged on the observation window; the position of the upper surface of the card shell corresponding to the sample pad is provided with a sample adding hole.
The invention also provides a kit containing the early esophageal cancer combined screening test strip.
The use method of the early esophageal cancer combined screening test strip comprises the following steps: taking 3-5mL of whole blood, naturally agglutinating for 10min, centrifuging at 3500rmp for 10min, and taking supernatant to obtain a serum sample to be detected; and (3) taking 100 mu L of serum sample to be detected, inserting the test strip sample pad into the serum sample to be detected for at least 10s, observing the color change of the detection line and the quality control line within 5-15min, and recording the result.
The result judgment method of the early esophageal cancer combined screening test strip comprises the following steps:
positive results: and (3) displaying a mauve strip on any 1 detection line of the chromatographic pads T1, T2 and T3 of the test strip, displaying 1 mauve strip on the quality control line C, and judging that the detection result is positive.
Negative results: and (3) no mauve strip appears in the T1, T2 and T3 detection lines on the test strip chromatographic pad, only one mauve strip appears on the quality control line C, and the detection result is judged to be negative.
Invalid result: and (4) judging that the detection result is invalid if no mauve strip appears on the quality control line C on the chromatographic pad of the test strip.
The detection principle of the early esophageal cancer combined screening test strip is as follows:
inserting the test strip into a serum sample to be detected, wherein the sample flows to the direction of the sample suction pad, and when the sample flows to the combination pad, dissolving gold-labeled mouse anti-human IgG (colloidal gold-labeled mouse anti-human IgG) and gold-labeled rabbit IgG (colloidal gold-labeled rabbit IgG) on the combination pad, wherein the gold-labeled mouse anti-human IgG is combined with KPNA6 autoantibody, PDE1A autoantibody and CASK autoantibody possibly contained in the serum sample to respectively form KPNA6 autoantibody-gold-labeled mouse anti-human IgG immune complex, PDE1A autoantibody-gold-labeled mouse anti-human IgG immune complex and CASK autoantibody-gold-labeled mouse anti-human IgG immune complex; due to capillary effect, rabbit IgG labeled by colloidal gold and the three immune complexes swim to the sample sucking pad, the immune complexes and KPNA6 antigen (KPNA6 protein) coated on a detection line T1 of the chromatographic pad, PDE1A antigen (PDE1A protein) on the detection line T2 and CASK antigen (CASK protein) on the detection line T3 generate specific immune combination reaction to respectively form KPNA6 antigen-KPNA 6 autoantibody-gold-labeled mouse anti-human IgG triplet immune complex, PDE1A antigen-PDE 1A autoantibody-gold-labeled mouse anti-human IgG triplet immune complex, CASK antigen-CASK autoantibody-gold-labeled mouse anti-human IgG triplet immune complex, the three triplet complexes are sequentially trapped on the detection lines T1, T2 and T3 to gradually enrich and form a purplish red strip; the gold-labeled rabbit IgG continuously swims forwards due to capillary effect, and has specific immunoreaction with the goat anti-rabbit IgG coated on the quality control line and is intercepted, the gold-labeled rabbit IgG is gradually enriched on the quality control line to form a deeper mauve strip, and redundant unbound substances are continuously chromatographed on the sample suction pad, so that the result that the strips appear on both the detection line and the quality control line is judged to be positive. If the serum sample does not contain KPNA6, PDE1A and CASK autoantibodies, when the colloidal gold labeled mouse anti-human IgG and rabbit IgG reach the detection line, immunoreaction with KPNA6 antigen, PDE1A antigen and CASK antigen coated on the detection line is not generated, so a color development band does not appear at the detection line, the gold labeled rabbit IgG continuously swims forwards and generates specific immunoreaction with goat anti-rabbit IgG coated on the quality control line to be trapped, and the gold labeled rabbit IgG is gradually enriched on the quality control line to form a mauve strip, so that the strip appearing only on the quality control line is judged to be a negative result. If the quality control line is not developed, the reagent is invalid.
Compared with the prior art, the invention has the following positive beneficial effects:
(1) the invention takes three proteins of KPNA6 protein, PDE1A protein and CASK protein as markers for screening early esophageal cancer for the first time, is used for detecting the expression levels of KPNA6 autoantibodies, PDE1A autoantibodies and CASK autoantibodies in human serum, can effectively detect esophageal cancer, in particular early esophageal cancer, has the detection sensitivity of up to 88 percent (namely the ratio of early esophageal cancer to early esophageal cancer correctly diagnosed by using the 3 tumor-associated antigen autoantibodies in diagnosis of patients with early esophageal cancer is 88 percent) and the specificity of up to 90 percent (namely the ratio of patients without esophageal cancer to non-esophageal cancer determined by using the 3 tumor-associated antigen autoantibodies in diagnosis of non-esophageal cancer patients is 90 percent) when the three proteins are used as a combination for jointly detecting the KPNA6 autoantibodies, the PDE1A autoantibodies and the CASK autoantibodies in human serum, therefore, the markers of the invention have higher sensitivity and specificity, the detection rate of early esophageal cancer is greatly improved, and the detection rate of the esophageal cancer is far higher than that of the existing clinical endoscope for screening the esophageal cancer, so that the method can be used for large-scale screening of asymptomatic crowds in high-incidence regions of the esophageal cancer, and is beneficial to early discovery of asymptomatic esophageal cancer high-risk crowds, thereby greatly reducing the death rate of esophageal cancer patients and bringing great welfare to the esophageal cancer patients and families.
(2) The test strip provided by the invention realizes that one test strip simultaneously and jointly detects a plurality of target points, has higher sensitivity and specificity, has high detection accuracy for early cancer, greatly improves the detection rate of early esophageal cancer, is beneficial to early discovery of asymptomatic esophageal cancer high risk groups, greatly reduces the death rate of esophageal cancer patients, provides an important detection means for realizing long-term tracking of asymptomatic high risk groups in esophageal cancer high incidence areas, and has wide market prospect and social benefit.
(3) The test strip for early esophageal cancer combined screening is simple and convenient to operate, convenient to use and short in detection result time, and the detection result can be judged within 15min only by inserting the test end of the test strip into a sample liquid to be detected for about 10 s.
(4) The early esophageal cancer combined screening test strip does not need other instruments and reagents, and can be used for detection at any time by non-professional personnel, so that the detection cost and the detection expense can be greatly reduced.
(5) The detection sample of the early esophageal cancer combined screening test strip is serum, so that the blood consumption is low, the pain of the masses is low, and the acceptance is high.
Drawings
Fig. 1 is a schematic diagram of the early esophageal cancer joint-screening test strip prepared in embodiment 1 of the present invention.
FIG. 2 is a graph showing the results of the positive rates of 3 TAA autoantibodies in the early esophageal squamous cell carcinoma group and the control group.
FIG. 3 shows the ROC curve of 3 TAA autoantibodies in combination for early stage esophageal cancer detection.
Detailed Description
To better illustrate the objects, aspects and advantages of the present invention, the present invention will be further described with reference to the following detailed description and accompanying drawings. It will be appreciated by those skilled in the art that the following examples are illustrative of the invention only and should not be taken as limiting the scope of the invention.
The experimental procedures described in the following examples, unless otherwise specified, are conventional in the art or according to the conditions recommended by the manufacturers; the reagents, materials and instruments used are not indicated by manufacturers, and are all conventional products commercially available.
Example 1: preparation of test paper strip
1. Experimental Material
The bioactive raw materials used in the invention are all commercial products. Wherein, the mouse anti-human IgG monoclonal antibody is purchased from abcam and has the cargo number ab 211339; rabbit IgG monoclonal antibody was purchased from abcam, cat # ab 133470; KPNA6 protein was purchased from Invitrogen under the accession number PEP-1150; PDE1A protein was purchased from abcam, cat # ab 125661; CASK protein was purchased from abcam, cat # ab 131707; goat anti-rabbit IgG monoclonal antibody was purchased from abcam, cat # ab 238531.
PVC base plate, nitrocellulose membrane, glass fiber membrane, absorbent paper, etc. are all the products sold in the market.
2. Preparation of the bonding pad
(1) Colloidal alloy composition:
preparing a colloidal gold solution with the diameter of 25-35 nm by adopting a trisodium citrate reduction method. 300mL of a 0.01% chloroauric acid solution was added to the washed flask, and the flask was heated to boiling. Rapidly adding 4.8mL of 0.1% trisodium citrate aqueous solution under magnetic stirring, and continuously heating and boiling for 15min until the color gradually stabilizes to transparent wine red. The flask was cooled at room temperature, returned to the original volume with distilled water, and stored at 4 ℃.
(2) Determining the optimal pH value of the colloidal gold label:
with 0.1M K2CO3Adjusting the pH value of the colloidal gold solution to 6.0, 6.5, 7.0, 7.5, 8.0, 8.5, 9.0 and 9.5, respectively taking 1mL of the colloidal gold solution with different pH values, respectively adding 10 mu g of mouse anti-human IgG and 10ug of rabbit IgG, uniformly mixing, reacting for 10min at room temperature, standing for 2 hours, and observing the color change of the solution. Centrifuging at 12000rpm for 10min, removing supernatant, adding PBS containing 1% BSA to dissolve precipitate, and optimally selecting the value of transparent purple red solution tube in which the precipitate is completely dissolved. The results showed that the optimal pH for the colloidal gold label was 8.0.
(3) Preparing a mouse anti-human IgG monoclonal antibody marked by the colloidal gold particles and a rabbit IgG monoclonal antibody marked by the colloidal gold particles:
adjusting the pH value of 1mL of colloidal gold solution to 8.0 by using 0.1M potassium carbonate solution, adding a mouse anti-human IgG monoclonal antibody and a rabbit IgG monoclonal antibody into the colloidal gold solution, uniformly mixing, standing at room temperature for 15min, adding a stabilizer (10% BSA solution), uniformly mixing, standing at room temperature for 10min, centrifuging at 12000rpm for 30min, discarding the supernatant, and re-suspending the precipitate by using a buffer solution to obtain a mixed solution of the mouse anti-human IgG monoclonal antibody marked by the colloidal gold particles and the rabbit IgG monoclonal antibody marked by the colloidal gold particles (the concentrations of the mouse anti-human IgG monoclonal antibody marked by the colloidal gold particles and the rabbit IgG monoclonal antibody marked by the colloidal gold particles in the mixed solution are both 35 mu g/mL); wherein the buffer solution is 0.01mol/L PBS solution with pH8.0 and containing 1% BSA and 5% sucrose.
(4) Preparation of the bonding pad:
selecting a glass fiber membrane as a binding pad material, soaking the glass fiber membrane in a mixed solution of a mouse anti-human IgG monoclonal antibody marked by colloidal gold particles and a rabbit IgG monoclonal antibody marked by colloidal gold particles for 5-15min, taking out, and freeze-drying to obtain the binding pad.
3. Preparation of a chromatography pad
A nitrocellulose membrane is selected as a chromatography pad material, and the positions of three detection lines T1, T2, T3 and a quality control line C are marked on the nitrocellulose membrane, and the positions are spaced by 6 mm. Diluting KPNA6 antigen (KPNA6 protein), PDE1A antigen (PDE1A protein) and CASK antigen (CASK protein) to 1mg/mL, diluting goat anti-rabbit IgG to 2mg/mL, scribing on positions of three detection lines T1, T2, T3 and three quality control lines C on a nitrocellulose membrane according to the dosage of 0.1-0.5 muL/mm by using a scribing instrument, and drying at 37 ℃ for overnight; then, the nitrocellulose membrane was immersed in a 1% BSA solution of 0.01mol/l, pH8.0 in PBS, and then the nitrocellulose membrane was taken out, washed with PBS, and dried to obtain a chromatography pad.
4. Sample pad preparation
The sample pad is made of a glass fiber membrane, the glass fiber membrane is placed into a sample pad sealing solution to be soaked for 30min, and the sample pad is dried at 37 ℃ to obtain the sample pad; wherein the sample pad blocking solution is 0.01mol/L PBS solution (pH 7.4) containing 1% BSA, 1.0% -2.0% sucrose, 0.1-0.5% Tween-20, and 0.1-1.0% PVP polyvinylpyrrolidone.
5. Test strip assembly
The test strip consists of a sample pad, a combination pad, a chromatography pad, a sample absorption pad and a bottom plate, wherein the sample absorption pad is made of water absorption filter paper.
The sample pad, the combination pad, the chromatography pad and the sample suction pad are cut into proper sizes in sequence, wherein the width is 1cm, and the length is 8 cm. Attaching the chromatographic pad to the middle of the bottom plate to form a detection area and a quality control area, namely arranging detection lines T1, T2, T3 and a quality control line C for interpreting results on the chromatographic pad; the right end (upper section) of the chromatography pad is a handheld part, and a sample absorbing pad (water absorbing filter paper) is fixed on the right end (upper section) of the chromatography pad and absorbs redundant liquid in a detection sample; a binding pad is fixed at the left end of the chromatography pad, and mouse anti-human IgG and rabbit IgG labeled by colloidal gold are adsorbed; the combination pad and the sample sucking pad are respectively overlapped with two ends of the nitrate chromatography pad; and (3) fixing a sample pad at one end (lower section) of the combination pad, which is far away from the chromatography pad, for contacting a sample to be detected, and drying after the assembly is finished to obtain the early esophageal cancer combined screening test strip (see figure 1).
6. Using method of test strip
And inserting the sample pad into a serum sample to be detected for at least 10s, taking out the test strip, laying and standing for 5-15min, and observing the color change of the detection line and the quality control line.
7. Determination of test result of test strip
Positive results: and (3) displaying a mauve strip on any 1 detection line of the chromatographic pads T1, T2 and T3 of the test strip, displaying 1 mauve strip on the quality control line C, and judging that the detection result is positive.
Negative results: and (3) no mauve strip appears in the T1, T2 and T3 detection lines on the test strip chromatographic pad, only one mauve strip appears on the quality control line C, and the detection result is judged to be negative.
Invalid result: and (4) judging that the detection result is invalid if no mauve strip appears on the quality control line C on the chromatographic pad of the test strip.
8. Attention points in test paper strip detection
(1) The sample to be tested is tested at room temperature (about 20 ℃).
(2) The sample to be tested is required to be a fresh sample. And the sample is collected for detection within 1h, so that the reliability of the result is ensured.
(3) The test strip is only used for in vitro detection and coarse screening, cannot be used as a confirmation reagent, and the positive result needs to be subjected to further auxiliary diagnosis of gastrointestinal endoscopy.
(4) After 30min the observation was invalid.
(5) The test strip should be stored in the dark.
Example 2: diagnostic value analysis of test strips
The test strip prepared in the embodiment 1 of the invention is used for detecting serum samples of early esophageal cancer patients and normal persons which are pathologically diagnosed, and evaluating and analyzing the value of the test strip for screening and diagnosing early esophageal cancer.
1. Sample source
Serum samples of 100 patients with early esophageal squamous carcinoma from the first subsidiary hospital of zhengzhou university were collected, and 100 normal human sera were used as controls. 100 sera of esophageal cancer patients (esophageal cancer group) are from primary patients who are pathologically diagnosed and do not receive any radiotherapy and chemotherapy, 50 male patients and 50 female patients, wherein the average age is 59.1 +/-6.8 years, and the age range is 40-80 years; 100 normal human sera (control group) were obtained from the outpatient health examination population, and were subjected to gastroscopic pathological biopsy to exclude esophageal precancerous lesions or early esophageal cancer without any evidence related to tumors, wherein 50 males and 50 females had an average age of 58.8 + -6.5 years and an age range of 42-81 years.
2. Experimental methods
The test paper prepared in the embodiment 1 of the invention is used for respectively detecting the serum samples of the esophageal cancer group and the control group. The specific detection method comprises the following steps: taking 100 mu L of serum sample to be detected, inserting the sample pad at the lower end of the test strip into the serum sample to be detected for 10 s-15 s, taking out the test strip, flatly placing the test strip for 5-15min, observing the color changes of the detection line and the quality control line, and judging the detection result.
Respectively calculating the positive rates of the 3 tumor-associated antigen autoantibodies in the esophageal cancer group and the control group according to a result judgment standard (the positive rate is obtained by dividing the number of the positive objects detected in each group by the total number of the detected objects in the group), and drawing bar graphs of the positive rates of the autoantibodies of the 4 tumor-associated antigens in the early esophageal squamous cell carcinoma group and the control group by using Excel software (figure 2); statistical tests are carried out by using the sps 26.0 software, the antibody positive rates of early esophageal squamous cell carcinoma and a control group are compared by using a two-independent sample chi-square test method, the test level alpha is 0.05, when p is less than 0.05, the result has statistical significance, and then the diagnostic value of detecting esophageal squamous cell carcinoma by using the autoantibody is evaluated by using a screening test method (Table 1 and figure 3).
3. Analysis of results
As can be seen from Table 1 and FIG. 2, the 3 KPNA6, PDE1A and CASK tumor-associated autoantibody have higher positive rate in the esophageal cancer group than in the control group, and the difference between the esophageal cancer group and the control group has statistical significance (P < 0.05). Therefore, the tumor-related autoantibodies KPNA6, PDE1A and CASK3 can be used as early esophageal cancer diagnosis and detection indexes, are used for early esophageal cancer detection, and have diagnosis values.
TABLE 1 Authenticity evaluation of diagnostic value of different tumor-associated antigen autoantibodies Combined detection in esophageal cancer
Note: TAA represents a tumor-associated antigen; TAAb means tumor-associated autoantibody.
As can be seen from Table 1, with the increase of the parallel detection indexes (antigens) on the test strip chromatographic pad, the positive rate (i.e., sensitivity) of the tumor-associated antigen autoantibody in the serum of the patient with early esophageal cancer gradually increases, while the specificity gradually decreases; when 3 tumor-associated antigens KPNA6, PDE1A and CASK are jointly used, the detection sensitivity reaches 88 percent, namely the percentage of esophageal cancer squamous cell carcinoma which can be correctly diagnosed by applying the detection method in esophageal cancer patients is 88 percent. Although the detection specificity is gradually reduced along with the increase of the number of the antigens, when 3 tumor-associated antigens are combined, the detection specificity can still reach 90 percent, namely, when the non-esophageal cancer patients are detected by the method, the percentage of the healthy people is correctly diagnosed.
Moreover, compared with the detection of one tumor-associated antigen alone, the sensitivity of the early esophageal squamous carcinoma diagnosis by using the 3 tumor-associated antigens KPNA6, PDE1A and CASK in combination is 3.4 times, 2.7 times and 2.4 times of that of the single indicators KPNA6, PDE1A and CASK respectively.
Therefore, the 3 tumor-associated antigens such as KPNA6, PDE1A and CASK are used for detecting the autoantibody corresponding to the tumor-associated antigen in the serum sample to screen early esophageal cancer, so that the diagnostic sensitivity is greatly improved on the premise of ensuring the diagnostic specificity.
In addition, the john index statistically means that 1 is subtracted from the sum of sensitivity and specificity, and the range of the john index is 0-1, and the closer the john index is to 1, the higher the diagnostic value is. In the invention, with the increase of the number of the coating antigens on the chromatographic pad, the johnsen index is continuously increased and gradually approaches to 1, which indicates that the 3 tumor-associated antigens have better diagnostic value when being combined for diagnosing and screening early esophageal cancer.
In a word, the autoantibodies of the 3 tumor-associated antigens KPNA6, PDE1A and CASK are used for jointly detecting early esophageal cancer, so that higher specificity and sensitivity can be ensured, and better diagnosis and application values are provided for esophageal cancer risk assessment of a to-be-detected object.
As can be seen from FIG. 3, when 3 tumor-associated antigens, namely KPNA6, PDE1A and CASK, and autoantibodies are used for combined detection of the autoantibodies in early esophageal squamous cell carcinoma serum, the area under the ROC curve is continuously increased along with the increase of the number of combined indexes, and when the 3 indexes are combined, the area under the ROC curve reaches 0.890 at most, which indicates that the early esophageal carcinoma combined detection test strip has high sensitivity and specificity for diagnosis of early esophageal squamous cell carcinoma, and is suitable for diagnosis of early esophageal squamous cell carcinoma and screening of high-risk groups of esophageal carcinoma.
The above description is only for the purpose of illustrating the preferred embodiments of the present invention and is not to be construed as limiting the present invention, but rather as the following description is intended to cover all modifications, equivalents and improvements falling within the spirit and scope of the present invention.
Claims (9)
1. A marker for early esophageal cancer screening, wherein the marker is a combination of an autoantibody to a KPNA6 protein, an autoantibody to a PDE1A protein and an autoantibody to a CASK protein; the source of the marker is serum.
Use of a KPNA6 protein, a PDE1A protein and a CASK protein for the preparation of a product for screening early esophageal cancer for the detection of an autoantibody to the KPNA6 protein, an autoantibody to the PDE1A protein and an autoantibody to the CASK protein; the detection sample of the product is serum.
3. The use of claim 2, wherein the product is used for the detection of autoantibodies to the KPNA6 protein, PDE1A protein and CASK protein in a sample by an enzyme linked immunosorbent assay.
4. The use of claim 3, wherein the product is a test strip or kit.
5. The early esophageal cancer combined screening test strip is characterized by comprising a binding pad and a chromatography pad, wherein the binding pad is coated with a mouse anti-human IgG monoclonal antibody and a rabbit IgG monoclonal antibody, and both the mouse anti-human IgG monoclonal antibody and the rabbit IgG monoclonal antibody are provided with detectable markers; the chromatography pad is provided with three detection lines and a quality control line, the detection lines are coated with detection antigens, and the detection antigens coated by the three detection lines are KPNA6 protein, PDE1A protein and CASK protein respectively; the quality control band is coated with goat anti-rabbit IgG; the detection object of the test strip is serum.
6. The combined screening test strip for early esophageal cancer according to claim 5, wherein the marker is colloidal gold particles.
7. The combined early esophageal cancer screening test strip of claim 5, further comprising a sample pad, a sample sucking pad and a bottom plate, wherein the sample pad, the combination pad, the chromatography pad and the sample sucking pad are sequentially fixed on the bottom plate.
8. The combined screening test strip for early esophageal cancer according to claim 7, wherein the three detection lines and one quality control line on the chromatographic pad are arranged in the following order: the chromatography pad is sequentially provided with a quality control line C coated with goat anti-rabbit IgG, a detection line T3 coated with CASK protein, a detection line T2 coated with PDE1A protein and a detection line T1 coated with KPNA6 protein from one end close to the sample sucking pad to one end close to the combination pad.
9. A kit comprising the test strip for early esophageal cancer joint screening according to any one of claims 5-8.
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