TWI702400B - Method for detecting ovarian cancer, method for monitoring progression of ovarian cancer in an ovarian cancer patient, and use of a reagent that recognizes a cleaved c3 polypeptide - Google Patents

Method for detecting ovarian cancer, method for monitoring progression of ovarian cancer in an ovarian cancer patient, and use of a reagent that recognizes a cleaved c3 polypeptide Download PDF

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TWI702400B
TWI702400B TW106132298A TW106132298A TWI702400B TW I702400 B TWI702400 B TW I702400B TW 106132298 A TW106132298 A TW 106132298A TW 106132298 A TW106132298 A TW 106132298A TW I702400 B TWI702400 B TW I702400B
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ovarian cancer
ovarian
cleaved
multipeptide
polypeptide
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TW202004183A (en
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童寶玲
蔡有光
沈仁達
周松男
簡靜香
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豐宥科技股份有限公司
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The present invention relates to biomarkers, methods and assay kits for the identification and screening for ovarian cancer and monitoring treatment of ovarian cancer.

Description

偵測卵巢癌之方法、監控卵巢癌病患之卵巢癌發展之方法及 可辨識切割型C3多胜肽之試劑的用途 Methods for detecting ovarian cancer, methods for monitoring the development of ovarian cancer in patients with ovarian cancer, and Use of reagent capable of identifying cleavage C3 multipeptide

本發明關於生物標記、方法及檢驗套組,用於辨識及篩檢卵巢癌以及監控卵巢癌之治療。 The present invention relates to biomarkers, methods and test kits for identifying and screening ovarian cancer and monitoring the treatment of ovarian cancer.

卵巢癌是全球婦女常見的癌症之一,在已開發國家具有高盛行率,且其發生率與死亡率仍持續上升。無疑地,若能早期偵測卵巢癌,可提供最好之治癒機會,提高病人之存活率。超音波雖可看到疑似腫瘤的影像,但無法區辨是否為卵巢癌,且靈敏度不高,也受限於設備,難以推動大規模篩檢。目前已報導的卵巢癌標記包括CA-125(癌抗原125,cancer antigen 125)和HE4(副睪蛋白4,epididymis protein 4),但主要還是作預後的指標,至於作為卵巢癌篩檢,尤其是檢測早期卵巢癌,效果仍不佳。 Ovarian cancer is one of the most common cancers among women in the world. It has a high prevalence rate in developed countries, and its incidence and mortality are still rising. Undoubtedly, if ovarian cancer can be detected early, it can provide the best cure opportunity and improve the survival rate of patients. Although ultrasound can see images of suspected tumors, it cannot distinguish whether it is ovarian cancer, and the sensitivity is not high, and it is also limited by equipment, which makes it difficult to promote large-scale screening. The currently reported ovarian cancer markers include CA-125 (cancer antigen 125, cancer antigen 125) and HE4 (paratestin 4, epididymis protein 4), but they are mainly used as prognostic indicators. As for ovarian cancer screening, especially Detection of early ovarian cancer, the effect is still not good.

CA-125是婦產科範圍內最廣泛應用的腫瘤指標,但第I期的卵巢癌只有約50-60%的病人會出現CA-125表現量異常。此外,其他惡性腫瘤,例如,子宮頸癌和乳癌等癌症,或是懷孕期間、子宮內膜異位、骨盆腔炎等,也都會提高CA-125的水平。因此,CA-125對卵巢癌專一性並不佳。再者,有約20%的卵 巢癌病患只能偵測到少量,甚至完全無法測到CA-125的表現(Moore RG.et al.,Curr Opin.Oncol.Sep.22(5):492-7.2010)。 CA-125 is the most widely used tumor indicator in obstetrics and gynecology, but only about 50-60% of patients with stage I ovarian cancer will have abnormal expression of CA-125. In addition, other malignant tumors, such as cervical cancer and breast cancer, or during pregnancy, endometriosis, pelvic inflammatory disease, etc., will also increase the level of CA-125. Therefore, CA-125 is not very specific for ovarian cancer. Furthermore, about 20% of patients with ovarian cancer can only detect a small amount, or even not detect CA-125 at all (Moore RG. et al ., Curr Opin.Oncol.Sep.22(5):492 -7.2010).

HE4基因位於染色體20,蛋白質結構由四個雙硫鍵組成,最早是從男性副睪中被鑑定出來(Hellström I.et al.,CANCER RESEARCH 63,3695-3700,July 1,2003),在其他正常組織也有此蛋白的表現,例如,在氣管和唾液腺中基因表現量最高。雖然目前對於HE4的功能還不清楚,但近年來將HE4用於檢測卵巢癌,發現比CA-125較少出現偽陽性的情況,也較能區辨子宮內膜異位和惡性卵巢腫瘤,以及在部分未表現CA-125指標的卵巢癌病患中,可偵測到血液中的HE4的含量上升(Rosen DG.et al.,Gynecologic Oncology,November 2005 Volume 99,Issue 2,p255-526)。然而,即便如此,研究指出,HE4在血液中的含量只在病灶明顯經手術診斷為卵巢癌的病患才會明顯上升,所以,HE4主要還是作預後的指標,難以作為卵巢癌篩檢及早期診斷的有效標記。 The HE4 gene is located on chromosome 20, and the protein structure consists of four disulfide bonds. It was first identified from male paratestines (Hellström I. et al ., CANCER RESEARCH 63, 3695-3700, July 1, 2003). Normal tissues also have the expression of this protein, for example, the gene expression is highest in the trachea and salivary glands. Although the function of HE4 is still unclear, in recent years, HE4 has been used to detect ovarian cancer, and it has been found that there are fewer false positives than CA-125, and it can better distinguish endometriosis and malignant ovarian tumors, and In some patients with ovarian cancer who did not show CA-125 indicators, increased levels of HE4 in the blood can be detected (Rosen DG. et al ., Gynecologic Oncology, November 2005 Volume 99, Issue 2, p255-526). However, even so, studies have pointed out that the content of HE4 in the blood will only increase significantly in patients whose lesions are obviously diagnosed as ovarian cancer after surgery. Therefore, HE4 is mainly used as a prognostic indicator, and it is difficult to be used for ovarian cancer screening and early stage Effective marker for diagnosis.

卵巢癌種類複雜,至少包括子宮內膜型(endometrioid)卵巢癌、亮細胞型(clear cell)卵巢癌、漿液型(serous)卵巢癌、黏液型(mucinous)卵巢癌、及其他類型卵巢癌,例如,卵巢癌肉瘤(ovarian carcinosarcoma)、卵巢未成熟畸胎瘤(Immature teratoma)、卵巢黏液及顆粒型癌(ovarian mucinous and granulosa tumor)、及轉移性卵巢癌(Krukenberg,卵巢克魯根勃氏瘤)等。目前為止,並無有效的生物標記可用以廣泛性檢測出不同種類的卵巢癌,也無針對早期卵巢癌檢測的有效生物標記。 The types of ovarian cancer are complex, including at least endometrioid ovarian cancer, clear cell ovarian cancer, serous ovarian cancer, mucinous ovarian cancer, and other types of ovarian cancer, such as , Ovarian carcinosarcoma (ovarian carcinosarcoma), ovarian immature teratoma (Immature teratoma), ovarian mucinous and granulosa tumor (ovarian mucinous and granulosa tumor), and metastatic ovarian cancer (Krukenberg, ovarian Krukenberg tumor) Wait. So far, there is no effective biomarker that can be used to widely detect different types of ovarian cancer, and there is no effective biomarker for early detection of ovarian cancer.

因此,仍有需要提出一種卵巢癌的生物標記,可用於廣泛性的卵巢癌篩檢,尤其是針對早期卵巢癌檢測。 Therefore, there is still a need to propose a biomarker for ovarian cancer, which can be used for extensive ovarian cancer screening, especially for early detection of ovarian cancer.

本發明不可預期地發現,於卵巢癌病患中,其血漿蛋白補體成分3(complement component 3;C3)發生活化反應,產生一大小約40kDa之胜肽片段,此片段可專一地於不同型態的卵巢癌病患血漿中測得,尤其在早期也可測得,但在沒有卵巢癌個體中則無法或幾乎無法測得。此外,在惡化的卵巢癌病患測得此片段的含量提升。因此,該切割型態之C3蛋白,可做為專一的分子標記,用於診斷卵巢癌,特別是早期診斷,亦可用於監控患有卵巢癌病患之卵巢癌之進展,或評估卵巢癌療法之治療有效性。 The present invention has unexpectedly discovered that in patients with ovarian cancer, the plasma protein complement component 3 (C3) is activated to produce a peptide fragment with a size of about 40kDa, which can be specific to different types It can be detected in the plasma of ovarian cancer patients, especially in the early stage, but it is impossible or almost impossible to detect in individuals without ovarian cancer. In addition, the content of this fragment increased in patients with worsening ovarian cancer. Therefore, the cleavage type of C3 protein can be used as a specific molecular marker for the diagnosis of ovarian cancer, especially for early diagnosis. It can also be used to monitor the progress of ovarian cancer in patients with ovarian cancer, or to evaluate ovarian cancer therapy The effectiveness of treatment.

在一方面,本發明提供一種偵測卵巢癌之方法,包含:(a)提供來自待測個體之生物樣本;(b)檢測該來自待測個體之生物樣本之切割型補體成分3(C3)多胜肽的含量,獲得切割型C3多胜肽檢測量;(c)比較該切割型C3多胜肽檢測量與來自正常個體之切割型C3多胜肽正常量,獲得比較結果;以及(d)根據該比較結果判斷該待測個體罹患卵巢癌之可能性,其中如該比較結果顯示切割型C3多胜肽檢測量高於切割型C3多胜肽正常量,則判斷該待測個體患有卵巢癌或有罹患卵巢癌之風險。 In one aspect, the present invention provides a method for detecting ovarian cancer, comprising: (a) providing a biological sample from an individual to be tested; (b) detecting the cleaved complement component 3 (C3) of the biological sample from the individual to be tested The content of the multipeptide to obtain the detection amount of the cleaved C3 multipeptide; (c) compare the detection amount of the cleaved C3 multipeptide with the normal amount of the cleaved C3 multipeptide from a normal individual to obtain a comparison result; and (d ) Determine the possibility of ovarian cancer of the individual to be tested according to the comparison result, wherein if the comparison result shows that the detected amount of cleaved C3 multipeptide is higher than the normal amount of cleaved C3 multipeptide, then it is determined that the test individual has Ovarian cancer may be at risk of ovarian cancer.

在另一方面,本發明提供一種監控卵巢癌病患之卵巢癌發展之方法,該方法包含:(a)於第一時間點,提供源自該病患之第一生物樣本;(b)於第二時間點,提供源自該病患之第二生物樣本,其中該第二時間點係晚於第一時間點; (c)檢測第一生物樣本中之切割型C3多胜肽的含量,獲得切割型C3多胜肽第一檢測量,以及檢測第二生物樣本中之切割型C3多胜肽的含量,獲得切割型C3多胜肽第二檢測量;(d)比較切割型C3多胜肽第一檢測量與切割型C3多胜肽第二檢測量,獲得比較結果;以及(e)基於該比較結果,判斷該病患中之卵巢癌進程,其中如該比較結果顯示切割型C3多胜肽第二檢測量高於切割型C3多胜肽第一檢測量,則表示卵巢癌進展中。 In another aspect, the present invention provides a method for monitoring the development of ovarian cancer in a patient with ovarian cancer, the method comprising: (a) at a first time point, providing a first biological sample derived from the patient; (b) in At a second time point, a second biological sample derived from the patient is provided, wherein the second time point is later than the first time point; (c) Detect the content of cleaved C3 multipeptide in the first biological sample to obtain the first detection amount of cleaved C3 multipeptide, and detect the content of cleaved C3 multipeptide in the second biological sample to obtain the cut The second detection amount of type C3 multipeptide; (d) compare the first detection amount of cleaved C3 multipeptide with the second detection amount of cleaved C3 multipeptide to obtain a comparison result; and (e) judge based on the comparison result For the progression of ovarian cancer in the patient, if the comparison result shows that the second detected amount of cleaved C3 multipeptide is higher than the first detected amount of cleaved C3 multipeptide, it means that ovarian cancer is progressing.

在部分具體實施例中,根據本發明之方法,該病患係接受卵巢癌治療中,以及該第一生物樣本及第二生物樣本係取自於治療之前或治療之後,或治療期間。 In some specific embodiments, according to the method of the present invention, the patient is receiving treatment for ovarian cancer, and the first biological sample and the second biological sample are taken before or after treatment, or during treatment.

在部分具體實施例中,本發明之方法進一步包含評估該卵巢癌治療對於該病患之療效,其中如經治療後、或於治療期間,該切割型C3多胜肽的含量呈現降低趨勢,則代表該治療對於該病患有效。 In some specific embodiments, the method of the present invention further comprises evaluating the therapeutic effect of the ovarian cancer treatment on the patient, wherein if the content of the cleaved C3 polypeptide shows a decreasing trend after treatment or during treatment, It means that the treatment is effective for the patient.

在部分具體實施例中,該切割型C3多胜肽係C3阿法(α)鏈片段2。 In some specific embodiments, the cleaved C3 multipeptide is C3 alpha ( α ) chain fragment 2.

在部分具體實施例中,該切割型C3多胜肽係具有對應於SEQ ID NO:1的C3蛋白之位置1321至位置1663的胺基酸序列。 In some specific embodiments, the cleaved C3 polypeptide has an amino acid sequence corresponding to position 1321 to position 1663 of the C3 protein of SEQ ID NO:1.

在部分具體實施例中,該切割型C3多胜肽係具有SEQ ID NO:2的胺基酸序列的胜肽片段。 In some specific embodiments, the cleaved C3 multipeptide is a peptide fragment having the amino acid sequence of SEQ ID NO: 2.

在部分具體實施例中,本發明之檢測步驟係由質譜分析或免疫分析法進行。 In some specific embodiments, the detection step of the present invention is performed by mass spectrometry or immunoassay.

在部分具體實施例中,本發明之檢測步驟係由免疫分析法進行,該免疫分析法使用專一性結合至切割型C3多胜肽之抗體。 In some specific embodiments, the detection step of the present invention is performed by an immunoassay method that uses an antibody that specifically binds to the cleaved C3 polypeptide.

在部分具體實施例中,本發明之方法使用的生物樣本為體液樣本、組織樣本、或生物檢體樣本。 In some specific embodiments, the biological sample used in the method of the present invention is a body fluid sample, a tissue sample, or a biological specimen sample.

在部分具體實施例中,本發明之方法使用的生物樣本體液樣本,係選自由血液樣本(如血漿樣本、肝素化血漿樣本、EDTA-血漿樣本、血清樣本)、尿液樣本、及腹水樣本所組成之群組。 In some specific embodiments, the biological sample and body fluid sample used in the method of the present invention is selected from blood samples (such as plasma samples, heparinized plasma samples, EDTA-plasma samples, serum samples), urine samples, and ascites samples. Formed group.

在部分具體實施例中,本發明之方法可檢測的卵巢癌可為子宮內膜型(endometrioid)卵巢癌、亮細胞型(clear cell)卵巢癌、漿液型(serous)卵巢癌、黏液型(mucinous)卵巢癌、及其他類型卵巢癌,例如,卵巢癌肉瘤(ovarian carcinosarcoma)、卵巢未成熟畸胎瘤(Immature teratoma)、卵巢黏液及顆粒型癌(ovarian mucinous and granulosa tumor)、及轉移性卵巢癌(Krukenberg,卵巢克魯根勃氏瘤)等。 In some specific embodiments, the ovarian cancer detectable by the method of the present invention can be endometrioid ovarian cancer, clear cell ovarian cancer, serous ovarian cancer, mucinous ovarian cancer ) Ovarian cancer, and other types of ovarian cancer, for example, ovarian carcinosarcoma (ovarian carcinosarcoma), ovarian immature teratoma (Immature teratoma), ovarian mucinous and granulosa tumor (ovarian mucinous and granulosa tumor), and metastatic ovarian cancer (Krukenberg, Krugenberg tumor of the ovary) and so on.

在部分具體實施例中,本發明之方法可檢測第I期卵巢癌、第II期卵巢癌、第III期卵巢癌及第IV期卵巢癌。 In some specific embodiments, the method of the present invention can detect stage I ovarian cancer, stage II ovarian cancer, stage III ovarian cancer, and stage IV ovarian cancer.

在另一方面,本發明提供一種可辨識切割型C3多胜肽之試劑的用途,其係用於診斷卵巢癌或監控卵巢癌發展,或用於製備供診斷卵巢癌或監控卵巢癌發展之試劑或套組。 In another aspect, the present invention provides the use of a reagent that can identify cleavage-type C3 polypeptides, which is used for diagnosing or monitoring the development of ovarian cancer, or for preparing reagents for diagnosing or monitoring the development of ovarian cancer Or set.

本發明之一種或多種具體實施例之詳細說明,皆於以下說明敘述之。本發明之其他特徵或優點將可藉由以下詳細說明各種具體實施例及所附之申請專利範圍得以明晰。 The detailed description of one or more specific embodiments of the present invention is described in the following description. Other features or advantages of the present invention will be clarified by the following detailed description of various specific embodiments and the scope of the attached patent application.

圖1顯示源自卵巢癌病患(P,patient)及正常個體(N,normal)之血漿樣本之西方墨點分析,係使用抗切割型補體成分3(C3)蛋白之抗體。將源自受測試個體之血漿樣本中之蛋白,於還原狀態進行電泳。左邊的數字,代表分子量(kDa),是分子重量標記之位置。箭頭係指補體成分3蛋白之約40kDa的胜肽片段。 Figure 1 shows Western blot analysis of plasma samples derived from ovarian cancer patients (P, patient) and normal individuals (N, normal), using antibodies against cleavage-type complement component 3 (C3) protein. The protein in the plasma sample derived from the subject is subjected to electrophoresis in a reduced state. The number on the left represents the molecular weight (kDa) and is the position of the molecular weight marker. The arrow indicates the approximately 40kDa peptide fragment of the complement component 3 protein.

圖2顯示卵巢癌病患在不同時間點之血漿樣本之西方墨點分析,其中編號1是卵巢癌病患在第一時間點的血漿樣本分析結果,編號2是同一名病患在接受化療後約一年回診的血漿樣本分析結果,顯示切割型C3蛋白含量增加,該病患經進一步確認病情惡化,已發生癌症轉移;編號3是正常個體的血漿樣本分析結果,顯示未測得切割型C3蛋白。 Figure 2 shows the Western blot analysis of plasma samples of patients with ovarian cancer at different time points. Number 1 is the result of plasma sample analysis of patients with ovarian cancer at the first time point, and number 2 is the same patient after receiving chemotherapy The analysis results of plasma samples returned to the clinic for about one year showed that the content of cleaved C3 protein increased. The patient was further confirmed that his condition had deteriorated and cancer metastasis had occurred; number 3 is the analysis result of plasma samples of normal individuals, showing that cleaved C3 was not detected protein.

為了提供一清晰且便於瞭解本發明之方式,部分術語係首先進行定義。其他定義亦於詳細說明中有說明。除非另有定義,本文中所有技術及科學性術語,具有與屬於本發明領域具有技藝者所習知之相同意義。 In order to provide a clear and easy way to understand the present invention, some terms are first defined. Other definitions are also explained in the detailed description. Unless otherwise defined, all technical and scientific terms in this article have the same meaning as those known to those skilled in the field of the invention.

本文所用之術語「一(a)」及「一(an)」係指一種或一種以上(即至少一種)符合文義之物體。舉例,「一種元件」意旨一種元件或多於一種元件。 The terms "一(a)" and "一(an)" as used herein refer to one or more (ie at least one) objects that conform to the context. For example, "a component" means one type of component or more than one type of component.

本文所用之「多胜肽」或「蛋白」乙詞係指透過胜肽鍵相連之由胺基酸殘基所組成之聚合物。「蛋白」乙詞一般係指分子量相對較大(胺基酸殘基較多)之聚合物(如含有高於500、600、700、800、900、1000、1100、1200、 1300、1400、或1500個胺基酸殘基)。「多胜肽」或「胜肽」乙詞一般係分子量相對較小(胺基酸殘基較少)之聚合物(如含有至多達500、400、300、或更少的胺基酸殘基)。胺基酸可以本領域所習知之三個字母或一個字母表示。 As used herein, the term "multipeptide" or "protein" refers to a polymer composed of amino acid residues connected by peptide bonds. The term ``protein'' generally refers to polymers with relatively large molecular weight (more amino acid residues) (e.g., containing more than 500, 600, 700, 800, 900, 1000, 1100, 1200, 1300, 1400, or 1500 amino acid residues). The term "multipeptide" or "peptide" generally refers to polymers with relatively small molecular weight (fewer amino acid residues) (e.g., containing up to 500, 400, 300, or less amino acid residues). ). Amino acids can be represented by three letters or one letter as known in the art.

本文所述之「約」或「近似」乙詞係指對於該領域具有通常技藝者,可接受之變動程度,其根據所述之內容有可能會有不同程度之不同。一般而言,「約」或「近似」可能係指一數值具有所述數值±10%之範圍。 The term "about" or "approximately" mentioned in this article refers to the acceptable degree of variation for those with ordinary skills in the field, and it may vary to different degrees depending on the content. Generally speaking, "about" or "approximately" may mean that a value has a range of ±10% of the stated value.

本文所述之「對象」、「個體」、及「病患」等詞,於此可交換替用,係指任何哺乳動物個體,其適用於診斷、預後、治療或療程,具體而言係指人類。其他個體可包含牛、狗、貓、天竺鼠、兔子、大鼠、小鼠、馬等。 The terms "subject", "individual", and "patient" mentioned herein are used interchangeably herein and refer to any mammalian individual, which is suitable for diagnosis, prognosis, treatment or course of treatment, specifically refers to Humanity. Other individuals may include cows, dogs, cats, guinea pigs, rabbits, rats, mice, horses, etc.

本文所述之「診斷」乙詞,一般包含判定一個體是否有可能患有疾病、病症或喪失功能。此領域具有技藝者通常基於一種或多於一種指標(如一種標記,出現與否、或其的含量,可做為疾病、疾患或喪失功能之有無或嚴重程度的指標)以做出診斷。本領域可以理解的是,診斷並非指以100%準確度確定特定疾病的存在或不存在,而是指在受試者中存在某種疾病的可能性增加。 The second word "diagnosis" mentioned in this article generally includes determining whether an individual is likely to suffer from a disease, illness or loss of function. Those skilled in the field usually make a diagnosis based on one or more indicators (such as a marker, presence or absence, or its content, which can be used as an indicator of the presence or severity of a disease, disease, or loss of function). It can be understood in the art that diagnosis does not refer to determining the presence or absence of a specific disease with 100% accuracy, but refers to an increase in the possibility of a certain disease in the subject.

此處所使用的「治療」乙詞是指為了治癒、癒合、減輕、舒緩、改變、矯正、改善、改進或影響該疾病、該疾病的症狀、該疾病引起的殘疾或罹患該疾病的傾向的目的,而將一或多種活性成分施用或投與至患有該疾病、該疾病的症狀或有罹患該疾病的傾向的個體。 The term "treatment" as used herein refers to the purpose of curing, healing, alleviating, alleviating, changing, correcting, improving, improving or affecting the disease, the symptoms of the disease, the disability caused by the disease, or the tendency to suffer from the disease , While administering or administering one or more active ingredients to individuals suffering from the disease, symptoms of the disease, or prone to suffering from the disease.

此處所使用的「正常個體」或「對照個體」可交互使用,是指健康正常未罹患所指疾病(如卵巢癌)之個體,可以是指單一正常個體或一群正常個體之族群。 As used herein, "normal individuals" and "control individuals" can be used interchangeably, and refer to individuals who are healthy and do not suffer from the specified disease (such as ovarian cancer), and can refer to a single normal individual or a group of normal individuals.

本文所述之「不正常之量」乙詞意旨對於一指標而言,相較於沒有目標疾病(如卵巢癌)之個體或一參考量或一對照量,具有增加之量。具體而言,對於檢驗者而言,所測得之不正常的量,係相較於參考量或對照量,高於10%、20%、30%、40%、50%、60%、70%、80%、90%或100%。參考量或對照量可為來自正常個體或對照樣本(如不含有目標疾病之組織或細胞)中的生物標記所測得之量。此領域可運用習知檢測及統計方法,經由分析正常個體族群的樣本的標記檢測量,獲得正常量的數值範圍。 The term "abnormal amount" mentioned herein means that an indicator has an increased amount compared to an individual without a target disease (such as ovarian cancer) or a reference amount or a control amount. Specifically, for the examiner, the measured abnormal amount is higher than the reference amount or the control amount by 10%, 20%, 30%, 40%, 50%, 60%, 70% %, 80%, 90% or 100%. The reference amount or the control amount can be the amount measured by a biomarker from a normal individual or a control sample (such as a tissue or cell that does not contain the target disease). In this field, conventional detection and statistical methods can be used to obtain the numerical range of the normal amount by analyzing the labeled detection amount of samples of normal individual populations.

本文所用者,生物標記是一種特徵(如蛋白、基因、基因表現),其可藉由客觀地測量及評估,以作為正常或不正常生物性反應、疾病、治病過程、或對於治療之反應、或介入治療之指標。標記可包含該特徵、或該特徵之模式、或集合之存在與否,該特徵可為一特定生物反應之指標。該生物標記之測量,可為增加或減少,以代表特定生物性事件或過程。標記主要用於診斷及預後之目的。然而,其亦可用於治療、監控、藥物篩選及其他本文所述之目的,包含評估癌症療法之有效性。 As used herein, a biomarker is a characteristic (such as protein, gene, gene expression), which can be measured and evaluated objectively as a normal or abnormal biological response, disease, treatment process, or response to treatment , Or indicators of interventional therapy. The marker can include the feature, or the pattern of the feature, or the presence or absence of the set, and the feature can be an indicator of a specific biological response. The measurement of the biomarker can be increased or decreased to represent a specific biological event or process. Markers are mainly used for diagnosis and prognosis purposes. However, it can also be used for treatment, monitoring, drug screening, and other purposes described herein, including evaluating the effectiveness of cancer therapy.

本文所述之生物樣本可藉由任何本文所述之方法分析,所分析之樣本類型可為任何從受診斷之個體中所取得之樣本,包含源自血液、尿液、或腹水之樣本。典型地,血液樣本可為全血或其部分,如血清或血漿、肝素化或EDTA處理後之樣本,以避免凝血。此外,該生物樣本可為組織樣本或生物檢體。 The biological samples described herein can be analyzed by any of the methods described herein, and the type of sample analyzed can be any sample obtained from a diagnosed individual, including samples derived from blood, urine, or ascites. Typically, the blood sample may be whole blood or a portion thereof, such as serum or plasma, heparinized or EDTA processed sample to avoid blood clotting. In addition, the biological sample may be a tissue sample or a biological specimen.

本發明主要(其中至少一部分)發現一種新穎之可信賴的卵巢癌生物標記,即切割型C3多胜肽。經以下實例證實,該生物標記專一性地顯著存在於各種階段及各種細胞態樣的卵巢癌病患的血液樣本中,但患有其它癌症種類或其他疾病的個體之血液樣本,則未檢出此生物標記。因此,本文所述之卵 巢癌偵測方法,可辨識個體具有、疑似患有、或有罹患卵巢癌之風險。本文所述之偵測方法可供任何個體(如女性人類個體),特別是進行初期、常規篩檢,以篩檢出患有卵巢癌之病患,或可能有進展中(progressing)卵巢癌之風險之病患。 The present invention mainly (at least part of it) discovers a novel and reliable biomarker for ovarian cancer, namely the cleaved C3 polypeptide. The following examples confirm that the biomarker is specifically and significantly present in blood samples of ovarian cancer patients of various stages and various cell types, but blood samples of individuals with other cancer types or other diseases are not detected This biomarker. Therefore, the eggs described in this article The nest cancer detection method can identify individuals with, suspected, or risk of ovarian cancer. The detection methods described in this article can be used by any individual (such as female human individuals), especially for initial and routine screening, to screen patients with ovarian cancer, or those who may have ovarian cancer in progress. Patients at risk.

I.切割型C3多胜肽可作為新穎的卵巢癌生物標記I. Cleaved C3 multipeptides can be used as novel biomarkers for ovarian cancer

補體成分3(C3)為一種血漿醣蛋白,是免疫系統的成員之一,具有約187kDa之分子量,為補體系統中含量最多的成分。補體系統活化時,C3可被轉化酶裂解為三個片段,包括一個較大的C3貝塔(β)片段,以及二段較小的C3阿法(α)片段,包括C3 α鏈片段1(C3 α chain fragment 1)及C3 α鏈片段2(C3 α chain fragment 2)。具體而言,人類C3蛋白包含全長胺基酸序列如SEQ ID NO:1所示(1663胺基酸),裂解後的C3β片段為位置23至位置667的胺基酸序列的多胜肽片段,C3 α鏈片段1為位置749至位置954的胺基酸序列的多胜肽片段,以及C3 α鏈片段2為位置1321至位置1663的胺基酸序列的多胜肽片段(約C3全長之C端約具342個胺基酸的胜肽片段)。 Complement component 3 (C3) is a plasma glycoprotein, a member of the immune system, with a molecular weight of about 187kDa, and is the most abundant component in the complement system. When the complement system is activated, C3 can be cleaved by invertase into three fragments, including a larger C3 beta (β) fragment, and two smaller C3 alpha ( α ) fragments, including C3 α chain fragment 1 (C3 α chain fragment 1) and C3 α chain fragment 2 (C3 α chain fragment 2). Specifically, the human C3 protein contains a full-length amino acid sequence as shown in SEQ ID NO:1 (1663 amino acid), and the cleaved C3β fragment is a multi-peptide fragment of the amino acid sequence from position 23 to position 667. C3 α chain fragment 1 is a multipeptide fragment of the amino acid sequence from position 749 to position 954, and C3 α chain fragment 2 is a multipeptide fragment of the amino acid sequence from position 1321 to position 1663 (about C3 full length C A peptide fragment with about 342 amino acids at the end).

如本文所述,本發明係關於切割型C3多胜肽之存在及量與卵巢癌之出現及發展有關連。本文所用之「切割型C3多胜肽」乙詞或類似用語(如「切割型態之C3」)係指C3全長裂解後的C3 α鏈片段2。具體而言,本文所用之切割型C3多胜肽係指人類C3 α鏈片段2,位於人類C3多胜肽之C端約具342個胺基酸的胜肽片段,分子量約為40kDa,又更具體而言,係具有對應於SEQ ID NO:1的C3蛋白之位置1321至位置1663的胺基酸序列的多胜肽片段,其係在SEQ ID NO:1的C3蛋白之位置1320的Arg(R)與位置1321的Ser(S)之間發生水解切割而產生。更特定而言,本文所用之切割型C3多胜肽係具有SEQ ID NO:2的胺基酸序列的多 胜肽片段。可以理解的是,多胜肽可以具有有限數量的變化或修飾,其可以在與其活性或功能無關的多胜肽的某一部分內進行,且仍然導致具有可接受程度的等同或類似的生物活性或功能。 As described herein, the present invention relates to the presence and amount of the cleaved C3 polypeptide related to the appearance and development of ovarian cancer. The term "cleaved C3 polypeptide" as used herein or similar terms (such as "cleaved C3") refers to the C3 α chain fragment 2 after the full-length cleavage of C3. Specifically, the cleaved C3 polypeptide used herein refers to human C3 α chain fragment 2, which is a peptide fragment with about 342 amino acids at the C-terminus of the human C3 polypeptide, and has a molecular weight of about 40kDa. Specifically, it is a multi-peptide fragment having an amino acid sequence corresponding to the amino acid sequence from position 1321 to position 1663 of the C3 protein of SEQ ID NO:1, which is the Arg( at position 1320 of the C3 protein of SEQ ID NO:1 R) and Ser(S) at position 1321 are produced by hydrolytic cleavage. More specifically, the cleaved C3 multipeptide used herein is a multipeptide fragment having the amino acid sequence of SEQ ID NO:2. It is understandable that the polypeptide can have a limited number of changes or modifications, which can be carried out within a certain part of the polypeptide that is not related to its activity or function, and still result in an acceptable degree of equivalent or similar biological activity or Features.

根據本發明之切割型C3多胜肽可藉由傳統方法製備,如重組技術,使用適用之宿主細胞(如大腸桿菌、酵母菌、哺乳動物、昆蟲或無細胞之宿主系統)或合成方式。於部分實例中,切割型C3多胜肽與天然存在者,於至少轉譯後修飾(像是醣化)部分不同。該切割型C3多胜肽可與一醫藥可接受試劑(如:自然界中不會與切割型C3多胜肽共同存在之載劑,或非自然存在之載劑,或如免疫佐劑)混合,以形成一組合物,用於如醫藥用途或如誘導抗體產生。 The cleaved C3 multipeptide according to the present invention can be prepared by traditional methods, such as recombinant technology, using suitable host cells (such as E. coli, yeast, mammalian, insect or cell-free host systems) or synthetic methods. In some examples, the cleaved C3 multipeptide is different from the naturally occurring peptide in at least post-translational modification (such as glycation). The cleaved C3 polypeptide can be mixed with a pharmaceutically acceptable reagent (such as a carrier that does not co-exist with the cleaved C3 polypeptide in nature, or a non-naturally occurring carrier, or an immune adjuvant), To form a composite, for medical purposes or for inducing antibody production.

Ⅱ.偵測切割型C3多胜肽及測量其量之方法Ⅱ. Method for detecting cleaved C3 multipeptide and measuring its amount

可藉由任何常規技術以測定生物樣本中切割型C3多胜肽之存在及量。於部分具體實施例中,切割型C3多胜肽之存在及/或量,可藉由質譜分析測定,其可以高敏感性及再現性之直接測量該分析物。許多不同之質譜分析方法可被使用。質譜分析的例子包含,但不限於,介質輔助雷射脫附離子化/時差測距(MALDI-TOF)、表面增強鐳射脫附離子化/時差測距(SELDI-TOF)、液相色譜法-質譜聯用(LC-MS)、液相色譜法串聯式質譜儀(LC-MS-MS)、及電噴灑離子化質譜(ESI-MS)。一部分之該方法之實例為串聯式質譜儀(MS/MS),其牽涉多個步驟以進行質量選擇或分析,通常藉由部分片段化型態分開。 Any conventional technique can be used to determine the presence and amount of cleaved C3 polypeptide in a biological sample. In some embodiments, the presence and/or amount of the cleaved C3 polypeptide can be determined by mass spectrometry, which can directly measure the analyte with high sensitivity and reproducibility. Many different mass spectrometry methods can be used. Examples of mass spectrometry include, but are not limited to, media-assisted laser desorption ionization/time difference ranging (MALDI-TOF), surface enhanced laser desorption ionization/time difference ranging (SELDI-TOF), liquid chromatography- Mass spectrometry (LC-MS), liquid chromatography tandem mass spectrometer (LC-MS-MS), and electrospray ionization mass spectrometry (ESI-MS). An example of a part of this method is a tandem mass spectrometer (MS/MS), which involves multiple steps for mass selection or analysis, usually separated by partial fragmentation patterns.

在其他具體實施例中,切割型C3多胜肽的存在及/或量可藉由免疫分析方法判定。免疫分析法之實例包含,但不限於西方墨點分析(還原態或變性電泳)、酵素連結免疫吸附法(ELISA)、放射免疫法(RIA)、放射免疫沉 澱法(RIPA)、免疫螢光法(IFA)及電化學螢光法(ECL)。 In other specific embodiments, the presence and/or amount of the cleaved C3 polypeptide can be determined by immunoassay methods. Examples of immunoassay methods include, but are not limited to, Western blot analysis (reduced or denaturing electrophoresis), enzyme-linked immunosorbent assay (ELISA), radioimmunoassay (RIA), radioimmunoassay The precipitation method (RIPA), immunofluorescence method (IFA) and electrochemical fluorescence method (ECL).

在部分實例中,切割型C3多胜肽之存在及/或量,可藉由使用可專一地辨識切割型C3多胜肽的試劑,例如,抗體,予以檢測。 In some examples, the presence and/or amount of the cleaved C3 polypeptide can be detected by using a reagent that can specifically identify the cleaved C3 polypeptide, for example, an antibody.

(i)專一性結合至切割型C3多胜肽之抗體 (i) Antibodies that specifically bind to the cleaved C3 multipeptide

本文所述之「抗體」乙詞係指一種完整的免疫球蛋白,或其片段,以及包含一種含有抗原結合域或抗原結合片段之多胜肽,其可專一地與特定抗原結合。該術語包含但不限於單株的、單專一性的、多株的、多專一性的、人化的、人類的、單股的、嵌合的、合成的、重組的、突變的及雜合的抗體。可根據該領域所習知方法以製備適用的抗體。該抗體可能非自然存在者(如不經過人工方式,即不會於自然界中產生)。 The term "antibody" as used herein refers to a complete immunoglobulin, or a fragment thereof, and a multipeptide containing an antigen-binding domain or antigen-binding fragment, which can specifically bind to a specific antigen. The term includes, but is not limited to, single-strain, single-specific, multi-strain, multi-specific, humanized, human, single-stranded, chimeric, synthetic, recombinant, mutant, and heterozygous Of antibodies. Applicable antibodies can be prepared according to methods known in the field. The antibody may not exist in nature (if not artificially, it will not be produced in nature).

完好的或完整的抗體,包含兩股重鏈,及兩股輕鏈。每一個重鏈係由可變區(VH)及第一、第二及第三恆定區(CH1、CH2及CH3)所組成,且每一個輕鏈係由一個可變區(VL)及一個恆定區(CL)所組成。 An intact or complete antibody contains two heavy chains and two light chains. Each heavy chain variable region by a line (V H) and a first, second, and third constant region (C H 1, C H 2 and C H 3) consisting, and each line consists of a light chain variable It consists of a region (V L ) and a constant region (C L ).

「抗原結合域(antigen-binding domain)」或「抗原結合片段(antigen-binding fragment)」乙詞係指整個抗體分子之部分或區域,其負責與抗原結合。可被抗體所專一地結合或辨識之抗原的一部分,稱作「抗原決定基(或抗原表位,epitope)」。一抗原結合域可包含重鏈可變區(VH)及輕鏈可變區(VL);然而,其並不一定要包含兩者。該於兩股鏈中之可變區域典型地含有三個高可變性區域,稱作互補決定區域(complementarity determining regions;CDRs)。該三個CDRs係由框架區域(framework regions;FRs)所隔開,該FRs較CDRs更為高度保守。重鏈及輕鏈之恆定區與抗原結合無關,但存在著不同功能子(effector)之功用。抗體之分類係基於其重鏈之恆定區之胺基酸序列以分類。5種主要抗體 類型或同型為IgG、IgM、IgA、IgD及IgE,其分別以重鏈之恆定區之γ、μ、α、δ及ε定義之。抗體之抗原結合片段之實例,包含:(1)一Fab片段,一具有VL、VH、CL及CH1域之單價片段;(2)一F(ab′)2片段,一具有兩個Fab片段之二價片段,係透過雙硫鍵於橋接區進行連結,即Fab之雙體;(3)一具有VL及VH域之Fv片段之單股抗體;(4)一單離的互補決定區(CDR);(5)一單股的Fv(scFv),一單股多胜肽鏈,係由VH域及VL域所組成,其透過胜肽連接子連結;及(6)一種(scFv)2包含三個胜肽鏈;兩個VH域藉由胜肽連接子及雙硫鍵與兩個VL域結合。 The term "antigen-binding domain" or "antigen-binding fragment" refers to the part or region of the entire antibody molecule that is responsible for binding to the antigen. The part of an antigen that can be specifically bound or recognized by an antibody is called an "antigenic determinant (or epitope, epitope)". Antigen-binding domain may comprise a heavy chain variable region (V H) and light chain variable region (V L); however, it is not necessary to include both. The variable regions in the two strands typically contain three highly variable regions, which are called complementarity determining regions (CDRs). The three CDRs are separated by framework regions (FRs), which are more highly conserved than CDRs. The constant regions of the heavy chain and light chain have nothing to do with antigen binding, but have different functions. The classification of antibodies is based on the amino acid sequence of the constant region of the heavy chain. The five main antibody types or isotypes are IgG, IgM, IgA, IgD, and IgE, which are defined by the constant regions of the heavy chain γ, μ, α , δ, and ε, respectively. Antibody antigen-binding example fragment, comprising: (1) a Fab fragment, having a V L, a monovalent fragment V H, C L and C H 1 domain of the; (2) a F (ab ') 2 fragments, having a bivalent fragment comprising two Fab fragments, the lines were bridged through disulfide bonds to the coupling region, i.e., the Fab diabodies; (3) having a single-stranded V L and V H domains of the Fv fragment of the antibody; (4) a single complementarity determining region isolated (CDR); (5) a single-stranded Fv (scFv), a single strand of multiple peptide chains, Department of the V H domain and a V L domain, whose link through peptide linker; and (6) A (scFv) 2 comprises three peptide chains; two V H domains by linker peptides and a disulfide bond and two V L domains.

「人類抗體(human antibody)」乙詞包含具有可變的及恆定區之抗體,本質上對應於,或衍生自人類生殖系(germline)的免疫球蛋白序列。本發明之人類抗體,然而,可包含非編碼人類生殖系免疫球蛋白序列之胺基酸殘基(如藉由隨機或體外特定位置突變所誘導之突變,或藉由體內之體突變),例如於CDRs中。具體而言,該人類抗體可具有至少1、2、3、4、5或更多位置以胺基酸殘基替換,其非編碼人類生殖系免疫球蛋白序列。 The term "human antibody" includes antibodies with variable and constant regions that essentially correspond to, or are derived from, the immunoglobulin sequence of the human germline. The human antibody of the present invention, however, may contain amino acid residues that do not encode human germline immunoglobulin sequences (such as mutations induced by random or in vitro mutations at specific locations, or by body mutations in vivo), for example In CDRs. Specifically, the human antibody may have at least 1, 2, 3, 4, 5 or more positions replaced with amino acid residues, which are non-coding human germline immunoglobulin sequences.

於部分具體實施例中,被應用於本文所述之任何方法之抗體,為可專一性結合至切割型C3多胜肽結合之抗體,例如,可專一性結合至具有SEQ ID NO:2序列之切割型C3多胜肽。 In some specific embodiments, the antibody used in any of the methods described herein is an antibody that can specifically bind to the cleavage-type C3 multipeptide, for example, can specifically bind to the sequence of SEQ ID NO: 2 Cleaved C3 multi-peptide.

一種抗體其可「專一性」辨認一標的(如切割型C3多胜肽)係為該領域所熟知之術語,且用於判斷該專一性辨認之方法亦是該領域所習知的。若一分子與特定標的抗原(而不與其他標的)之反應或關聯更為頻繁、更為快速、更長時間及/或更高的親和性,則該分子被稱作具有「專一性辨認」的能力。特定而言,若一抗體與其標的抗原(與其他物質相較)之結合,具有更高親和性、傾向、更快速、及/或更長時間,則該抗體對於標靶抗原有「專一性辨認」 的能力。例如,一抗體可專一地(或優選地)與切割型C3多胜肽或其抗原決定基結合,則代表該抗體與其之標靶抗原(相較於其與其他抗原結合、,如全長的C3,或於相同抗原中之其他抗原決定基)具有更高之親和性、傾向、更快速、及/或更長時間之結合能力。應可被理解的是,「專一性結合」或「優選結合」並非一定要獨占式結合(雖然可包括獨占式結合)。一般而言,但非必要,提及結合係指優選地結合。 An antibody that can "specifically" identify a target (such as cleavage-type C3 polypeptide) is a term well known in the field, and the method used to determine the specific identification is also well-known in the field. If a molecule reacts or associates with a specific target antigen (but not with other targets) more frequently, faster, longer, and/or with higher affinity, the molecule is said to have "specific identification" Ability. Specifically, if an antibody binds to its target antigen (compared to other substances) with a higher affinity, tendency, faster, and/or longer time, then the antibody has a "specific recognition of the target antigen" " Ability. For example, an antibody can specifically (or preferably) bind to the cleaved C3 multipeptide or its epitope, which means that the antibody and its target antigen (compared to its binding to other antigens, such as full-length C3 , Or other epitopes in the same antigen) have higher affinity, tendency, faster, and/or longer binding capacity. It should be understood that "specific combination" or "preferred combination" does not necessarily require exclusive combination (although it may include exclusive combination). In general, but not necessarily, reference to bonding refers to preferably bonding.

在具體實施例中,用於本文所述方法之抗體,係可專一性辨認切割型C3多胜肽之抗體,例如,可專一性辨認SEQ ID NO:2之多胜肽之抗體。更特定而言,本文所述抗體可專一性辨認切割型C3多胜肽係指抗體可專一性結合至切割型C3多胜肽中的抗原決定基(epitope,抗原表位),以致於在待測的生物樣本中,該抗體可藉由習知的免疫分析方法(如,西方墨點法,例如,經由分子量大小的判斷),區辨出是否存在切割型C3多胜肽,或測得切割型C3多胜肽的含量。又在某些實例中,本發明之可專一性辨認切割型C3多胜肽之抗體係可專一性辨認切割型C3多胜肽之N端單一胺基酸殘基,例如,SEQ ID NO:2的N端的絲胺酸(S),故該抗體不會與全長的C3蛋白結合,並可用以區辨出是否存在切割型C3多胜肽,或進一步測得切割型C3多胜肽的含量。 In a specific embodiment, the antibody used in the method described herein is an antibody that can specifically recognize the cleaved C3 polypeptide, for example, an antibody that can specifically recognize the polypeptide of SEQ ID NO: 2. More specifically, the antibodies described herein that can specifically identify the cleaved C3 multipeptide means that the antibody can specifically bind to the epitope (epitope) in the cleaved C3 multipeptide, so that it can be In the biological sample tested, the antibody can be distinguished by conventional immunoassay methods (eg, Western blotting method, for example, by the determination of molecular weight) whether there is a cleaved C3 polypeptide, or the cleavage can be measured Type C3 multi-peptide content. In some embodiments, the antibody system capable of specifically identifying the cleavage C3 multipeptide of the present invention can specifically identify the N-terminal single amino acid residue of the cleavage C3 multipeptide, for example, SEQ ID NO: 2 The N-terminal serine (S) of the antibody does not bind to the full-length C3 protein, and can be used to distinguish whether there is a cleaved C3 polypeptide, or to further measure the content of the cleaved C3 polypeptide.

任何本文所述之抗體,皆屬於本發明之範疇。 Any antibody described herein belongs to the scope of the present invention.

(ii)抗體製備 (ii) Antibody preparation

本文所述之抗體可與切割型C3結合,其可藉由該領域所習知之任何方法製備。請參閱,如Harlow and Lane,(1988)Antibodies:A Laboratory Manual,Cold Spring Harbor Laboratory,New York。 The antibodies described herein can bind to cleaved C3, which can be prepared by any method known in the art. See, for example, Harlow and Lane, (1988) Antibodies: A Laboratory Manual, Cold Spring Harbor Laboratory, New York.

於部分具體實施例中,本文所述之抗體可為多株抗體,可依例行 多株抗體製備方法獲得。具體而言,將從人類血清純化的切割型C3或以遺傳工程製得之重組胜肽作為抗原,可加入載體蛋白,如牛血清白蛋白(bovine serum albumin,BSA)或鑰孔蟲戚血藍蛋白(keyhole limpet hemocyanin,KLH),以增加其免疫原性。將抗原(或與載體蛋白混合者)注射於動物(如兔子)體內誘發免疫反應,可追加免疫,例如,每兩周免疫一次,共免疫約2-5次。後續先以酵素免疫分析法檢測,確保免疫後血清效價大於1:4000即可進行全部採血。採血後,待血液凝固,離心取上清液,即可取得含對抗切割型C3之多株抗體的抗血清。較佳地,可將抗血清予以純化,例如,利用親和性層析法(蛋白A/G)進行免疫球蛋白(Ig)的純化,更進一步以硫酸銨沉澱即可得到含有目標專一性的抗體,也可搭配結合離子交換管柱層析去除沉澱中的雜質。 In some specific embodiments, the antibodies described herein can be multiple strains of antibodies, which can be routinely Obtained by multiple antibody preparation methods. Specifically, cleaved C3 purified from human serum or recombinant peptides prepared by genetic engineering as antigens can be added with carrier proteins, such as bovine serum albumin (BSA) or keyhole blood blue Protein (keyhole limpet hemocyanin, KLH) to increase its immunogenicity. The antigen (or mixed with the carrier protein) is injected into an animal (such as a rabbit) to induce an immune response, and additional immunization can be performed, for example, once every two weeks, for a total of about 2-5 times. Subsequent detection is performed by enzyme immunoassay to ensure that the serum titer after immunization is greater than 1:4000 before all blood sampling can be performed. After the blood is collected, after the blood is coagulated, the supernatant is centrifuged to obtain an antiserum containing multiple antibodies against cleavage C3. Preferably, the antiserum can be purified, for example, by affinity chromatography (protein A/G) for the purification of immunoglobulin (Ig), and further precipitation with ammonium sulfate to obtain antibodies containing target specificity It can also be combined with ion exchange column chromatography to remove impurities in the precipitate.

於部分具體實施例中,抗體專一地與一標靶抗原(如切割型態之C3,如SEQ ID NO:2)結合,可藉由習知融合瘤技術而製備。全長標靶抗原或其片段,可視需要地與載體蛋白(如KLH)結合,以用於致免疫宿主動物,以產生可與該抗原結合之抗體。宿主動物之免疫時程及路徑,一般皆與已建立的及常規用於刺激抗體生成及產生之技術相同(本文進一步說明)。一般技術用於生產小鼠、人化的、及人類抗體,皆為該領域所習知者,且於本文所描述。應考慮的是,任何哺乳動物個體,包含人類或產生抗體之細胞,可被操作以作為生產哺乳動物包含人類之融合瘤細胞株之基礎。一般而言,該宿主動物以腹腔、肌肉、口服、皮下、足底、及/或皮內的方式,接種一定量之免疫原,包含本文所述者。 In some specific embodiments, the antibody specifically binds to a target antigen (such as the cleavage type C3, such as SEQ ID NO: 2), which can be prepared by conventional fusion tumor technology. The full-length target antigen or fragments thereof can optionally be combined with a carrier protein (such as KLH) to immunize host animals to produce antibodies that can bind to the antigen. The immune time course and route of the host animal are generally the same as established and conventional techniques used to stimulate antibody production and production (further explanation herein). The general techniques used to produce mouse, humanized, and human antibodies are all known in the art and are described herein. It should be considered that any mammalian individual, including human or antibody-producing cells, can be manipulated as the basis for the production of mammalian and human-containing fusionoma cell lines. Generally speaking, the host animal is vaccinated with a certain amount of immunogens, including those described herein, by intraperitoneal, intramuscular, oral, subcutaneous, plantar, and/or intradermal methods.

使用一般體細胞雜和技術(Kohler,B.and Milstein,C.(1975)Nature 256:495-497或修改自Buck,D.W.,et al.,In Vitro,18:377-381(1982)),可自淋巴球 及不死的骨髓瘤細胞以製備融合瘤。可取得之骨髓瘤細胞系,包含但不限於,X63-Ag8.653及該等源自Salk Institute,Cell Distribution Center,San Diego,Calif.,USA之細胞,皆可用於雜合。一般而言,該技術涉及使用融合劑以融合骨髓瘤細胞及淋巴細胞,該融合劑諸如聚乙二醇、或藉由電力方式,皆為該領域具有技藝者所熟知者。經融合後,將細胞自融合培養基中分離出來,並置於選擇性生長培養基中培養,像是次黃嘌呤-氨喋呤-胸苷(hypoxanthine-aminopterin-thymidine;HAT)培養基,以排出非融合之親代細胞。任何本文所述之培養基,可添加或不添加血清,可被用於培養融合瘤,其可分泌出單株抗體。該等融合瘤經增殖及繼代,如需要,可將上清液以常規免疫方法步驟(如放射免疫分析、酵素免疫分析、或螢光免疫分析)進行分析抗免疫原之活性。 Use general somatic cell hybridization technique (Kohler, B. and Milstein, C. (1975) Nature 256: 495-497 or modified from Buck, DW, et al., In Vitro , 18: 377-381 (1982)), Fusion tumors can be prepared from lymphocytes and immortal myeloma cells. The available myeloma cell lines, including but not limited to X63-Ag8.653 and the cells derived from Salk Institute, Cell Distribution Center, San Diego, Calif., USA, can all be used for heterozygous. Generally speaking, this technique involves the use of a fusion agent to fuse myeloma cells and lymphocytes. The fusion agent, such as polyethylene glycol, or by electrical means, is well known to those skilled in the art. After fusion, the cells are separated from the fusion medium and cultured in a selective growth medium, such as hypoxanthine-aminopterin-thymidine (HAT) medium to eliminate the non-fusion Parental cells. Any of the medium described herein, with or without serum, can be used to cultivate fusion tumors, which can secrete monoclonal antibodies. After these fusion tumors are proliferated and subcultured, if necessary, the supernatant can be analyzed for anti-immunogen activity by routine immunoassay steps (such as radioimmunoassay, enzyme immunoassay, or fluorescence immunoassay).

融合瘤可做為抗體之來源,其包含所有衍生物,親代融合瘤之子代細胞,可產生單株抗體,其可與切割的C3結合。可產生該等抗體之融合瘤可使用習知方式於體外或體內進行培養。該單株抗體可從培養基或體液中分離出來,藉由傳統免疫球蛋白純化步驟,像是硫酸銨沉澱、膠體電泳、透析、層析法、及超過濾,如果適用的話。若出現不欲之活性,則可將之移除,例如藉由將該製備物,以一由免疫原所製備之吸收物作用,該免疫原係貼附於一固相,並將所欲之抗體從該免疫原上洗提或釋放出來。使用標的抗原或與蛋白連結之含有標的胺基酸序列之片段,免疫一宿主動物,以獲得產製之抗體(如單株抗體);其中該抗原係對於免疫物種具有免疫原性,如鑰孔蟲戚血藍蛋白、血清白蛋白、牛的甲狀腺球蛋白、或使用雙功能或衍生劑之豆胰蛋白酶抑制子,例如馬來醯亞胺基苯甲酸磺基琥珀醯亞胺酯(透過與半胱胺酸殘基連結)、N-羥基丁二醯亞胺(透過離胺酸殘基)、戊二醛、丁二酸酐、SOCl、或R1N=C=NR, 其中R及R1為不同之烷基。 Fusion tumors can be used as a source of antibodies, which include all derivatives. The progeny cells of parental fusion tumors can produce monoclonal antibodies, which can bind to cleaved C3. Fusion tumors that can produce these antibodies can be cultured in vitro or in vivo using conventional methods. The monoclonal antibody can be separated from the culture medium or body fluids by traditional immunoglobulin purification steps such as ammonium sulfate precipitation, colloidal electrophoresis, dialysis, chromatography, and ultrafiltration, if applicable. If undesired activity occurs, it can be removed, for example, by using the preparation with an absorbent prepared from an immunogen, the immunogen is attached to a solid phase, and the desired The antibody is eluted or released from the immunogen. Use the target antigen or a fragment containing the target amino acid sequence linked to a protein to immunize a host animal to obtain the produced antibody (such as a monoclonal antibody); wherein the antigen system is immunogenic to the immune species, such as keyhole Insect hemocyanin, serum albumin, bovine thyroglobulin, or soybean trypsin inhibitors using bifunctional or derivative agents, such as maleiminobenzoic acid sulfosuccinimidyl ester (through and half Cystine residues), N-hydroxysuccinimide (through lysine residues), glutaraldehyde, succinic anhydride, SOCl, or R1N=C=NR, Where R and R1 are different alkyl groups.

若需要,感興趣(如以融合瘤所生產)之抗體(如單株或多株)可進行定序,且該多核苷酸序列可被選殖至一載體中,用於表現或增殖。編碼感興趣抗體之序列可被維持於宿主細胞之載體中,且該宿主細胞可被增殖並冷凍以供未來使用。可選擇地,該多核苷酸序列可被用於進行基因改造成「人化(humanize)」抗體或改善其親和性(親合性成熟度)、或其他抗體之特徵。例如,若該抗體用於臨床試驗中,且對人類進行治療時,該恆定區可被改造以成為更與人類恆定區相似,以避免免疫反應。另外可能經由基因改造該抗體序列,以獲得對於標的抗原更高親和性,及偵測切割C3更高之效率。對於該領域具有技藝者,應可理解的是,可對該抗體進行一種或多種多核苷酸之改變,且仍可維持其與標的抗原之結合專一性。 If necessary, the antibody (such as a single strain or multiple strains) of interest (such as produced by a fusion tumor) can be sequenced, and the polynucleotide sequence can be cloned into a vector for expression or propagation. The sequence encoding the antibody of interest can be maintained in a host cell's vector, and the host cell can be propagated and frozen for future use. Alternatively, the polynucleotide sequence can be used to genetically transform into a "humanize" antibody or improve its affinity (affinity maturity) or other antibody characteristics. For example, if the antibody is used in clinical trials and humans are treated, the constant region can be modified to be more similar to human constant regions to avoid immune response. In addition, it is possible to genetically modify the antibody sequence to obtain a higher affinity for the target antigen and a higher efficiency in detecting cleavage of C3. For those skilled in the art, it should be understood that one or more polynucleotide changes can be made to the antibody and still maintain its binding specificity to the target antigen.

於其他具體實施例中,完整的人類抗體可使用市售可得小鼠以製備,其經改造可表現專一的人類免疫球蛋白。該轉殖基因動物係設計用於產生更多所欲(如完整人類抗體)、或更強的免疫反應,亦可用於生成人化或人類抗體(humanized or human antibodies)。該技術之實例為Amgen,Inc.(Fremont,Calif.)之XenomouseRTM,及Medarex,Inc.(Princeton,N.J.)之HuMAb-MouseRTM及TC MouseTM。於另一種可能,該等抗體可藉由噬菌體表現或酵母菌技術以製備。請參閱,如,美國專利號5,565,332;5,580,717;5,733,743及6,265,150;及Winter et al.,(1994)Annu.Rev.Immunol.12:433-455。此外,噬菌體表現技術(McCafferty et al.,(1990)Nature 348:552-553),源自未免疫之貢獻者之免疫球蛋白可變區(V)基因群,被用於產生人類抗體,及體外之抗體片段。 In other specific embodiments, intact human antibodies can be prepared using commercially available mice, which are modified to express specific human immunoglobulins. The transgenic animal line is designed to generate more desired (such as intact human antibodies) or stronger immune response, and can also be used to generate humanized or human antibodies. Examples of such technologies as Amgen, Inc. (Fremont, Calif .) The Xenomouse RTM, and Medarex, Inc. (Princeton, NJ ) and the HuMAb-MouseRTM TC Mouse TM. In another possibility, the antibodies can be prepared by phage expression or yeast technology. See, for example, US Patent Nos. 5,565,332; 5,580,717; 5,733,743 and 6,265,150; and Winter et al., (1994) Annu. Rev. Immunol. 12:433-455. In addition, phage expression technology (McCafferty et al., (1990) Nature 348:552-553), derived from immunoglobulin variable region (V) gene groups from unimmunized contributors, was used to produce human antibodies, and Antibody fragments in vitro.

完整抗體(全長抗體)之抗原結合片段可藉由常規方法製備。例 如,F(ab')2片段可藉由胃蛋白酶水解抗體分子以製備,以及Fab片段可藉由還原F(ab')2片段之雙硫鍵以生成。 The antigen-binding fragments of intact antibodies (full-length antibodies) can be prepared by conventional methods. For example, F(ab') 2 fragments can be prepared by pepsin hydrolyzing antibody molecules, and Fab fragments can be produced by reducing the disulfide bonds of F(ab') 2 fragments.

基因工程抗體,像是人化抗體、嵌合型抗體、單鏈抗體、及雙特異性抗體,可藉由如傳統重組技術製備。於一實例中,可單離一編碼單株抗體(對標的抗原具專一性)之DNA,並使用常規步驟定序(如藉由使用寡核苷酸探針,其可專一的與編碼單株抗體之重鏈及輕鏈之基因結合)。該融合瘤細胞可做為該等DNA之較佳來源。一旦分離後,該DNA可被置入一個或多個表現載體中,接著將其轉染至宿主細胞,像是大腸桿菌細胞、猿的COS細胞、中國倉鼠卵巢(CHO)細胞、或骨髓瘤細胞,其不會產生免疫球蛋白,以從該等重組宿主細胞中取得合成之單株抗體。請參閱,如PCT專利公開號WO 87/04462。該DNA可接著被修飾,例如,藉由取代方式,將編碼人類重鏈及輕鏈恆定區之序列,置換成同源的鼠序列,Morrison et al.,(1984)Proc.Nat.Acad.Sci.81:6851,或藉由共價結合方式,將編碼免疫球蛋白之序列,全部或部分之編碼序列與一非免疫球蛋白多胜肽之序列連結。於此種方式中,基因工程改造之抗體,像是「嵌合的」或「融合的」抗體,可被製備,且可與標的抗原具專一性結合。 Genetically engineered antibodies, such as humanized antibodies, chimeric antibodies, single chain antibodies, and bispecific antibodies, can be prepared by, for example, traditional recombinant techniques. In one example, a DNA encoding a monoclonal antibody (specific to the target antigen) can be isolated and sequenced using conventional procedures (for example, by using oligonucleotide probes, it can be specifically compared with the encoding monoclonal antibody). Gene combination of heavy and light chains of antibodies). The fusion tumor cell can be used as a better source of the DNA. Once isolated, the DNA can be placed in one or more expression vectors and then transfected into host cells, such as E. coli cells, ape COS cells, Chinese hamster ovary (CHO) cells, or myeloma cells , It does not produce immunoglobulins to obtain synthetic monoclonal antibodies from these recombinant host cells. See, for example, PCT Patent Publication No. WO 87/04462. The DNA can then be modified, for example, by replacing the sequences encoding the human heavy and light chain constant regions with homologous murine sequences, Morrison et al., (1984) Proc. Nat. Acad. Sci .81:6851, or by covalently binding the immunoglobulin coding sequence, all or part of the coding sequence and a non-immunoglobulin polypeptide sequence. In this way, genetically engineered antibodies, such as "chimeric" or "fusion" antibodies, can be prepared and can specifically bind to the target antigen.

涉及製備「嵌合型抗體(chimeric antibodies)」之技術,皆為該領域所習知者。請參閱如Morrison et al.(1984)Proc.Natl.Acad.Sci.USA 81,6851;Neuberger et al.(1984)Nature 312,604;及Takeda et al.(1984)Nature 314:452。 The techniques involved in the preparation of "chimeric antibodies" are all well-known in this field. See, for example, Morrison et al. (1984) Proc. Natl. Acad. Sci. USA 81,6851; Neuberger et al. (1984) Nature 312,604; and Takeda et al. (1984) Nature 314:452.

用於構築人化抗體之方法,亦為該領域所熟知者。請參閱,如Queen et al.,Proc.Natl.Acad.Sci.USA,86:10029-10033(1989)。於一實例中,親代非人類抗體之VH及VL可變區係以該領域所熟知方法進行三維分子模型分析。接著,框架胺基酸殘基被預測對於形成正確CDR結構是重要的,使用相同分子模型分析 以辨識出該等框架胺基酸殘基。同時,人類VH及VL鏈具有之胺基酸序列,與該等親代非人類抗體係屬同源;該人類胺基酸序列係以親代VH及VL序列作為搜尋字,從各種抗體基因資料庫中所找出。接著挑選人類VH及VL接受器基因。 The methods used to construct humanized antibodies are also well known in the art. See, for example, Queen et al., Proc. Natl. Acad. Sci. USA, 86: 10029-10033 (1989). In one example, parental V H and V L variable regions of a non-human antibody-based three-dimensional molecular model analysis performed to methods well known in the art. Next, the framework amino acid residues are predicted to be important for forming the correct CDR structure, and the same molecular model analysis is used to identify the framework amino acid residues. Meanwhile, the human V H and V L chain having the amino acid sequence, with such a non-human parent antibody is homologous to the genus; to the human amino acid sequence of the parental lines V H and V L sequence as a search word, from Found in various antibody gene databases. Then the selection of human V H and V L receptor gene.

位於所挑選之人類接受器基因中之CDR區,可將之以親代非人類抗體之CDR區或其功能性變異體置換。當必需時,位於親代鏈之框架區中之殘基被預測為重要的,係用於與該CDR區交互作用(請參閱前述),可被用於取代於人類接受器基因中之對應的殘基。 The CDR region located in the selected human receptor gene can be replaced with the CDR region of the parental non-human antibody or its functional variant. When necessary, residues located in the framework region of the parental chain are predicted to be important and are used to interact with the CDR region (see above) and can be used to replace the corresponding counterpart in the human receptor gene Residues.

一單鏈抗體可藉由重組技術製備,藉由將編碼重鏈可變區之核苷酸序列,與一編碼輕鏈可變區之核苷酸序列連結。較佳地,一具彎折性之連接子可被加入該兩個可變區域間。或是,於(美國專利號4,946,778及4,704,692)所述之產生單股抗體之技術亦可被用於產生一噬菌體或酵母菌scFv庫及scFv聚落,其對於切割的C3具專一性,且可藉由常規方式從該資料庫中找出來。陽性聚落可接著進一步篩選以找出該等與切割C3結合者。 A single-chain antibody can be prepared by recombinant technology by linking a nucleotide sequence encoding the variable region of the heavy chain to a nucleotide sequence encoding the variable region of the light chain. Preferably, a flexible linker can be added between the two variable regions. Alternatively, the single-stranded antibody production technology described in (US Patent Nos. 4,946,778 and 4,704,692) can also be used to generate a phage or yeast scFv library and scFv colonies, which are specific for cleaved C3 and can be used Find out from the database by conventional means. The positive colonies can then be further screened to identify those that bind to cleaved C3.

從該領域所習知方法、及本文所述之方法以製得之抗體,可藉由該領域所習知方法以確認其特性。例如,一種方法係用於辨識與抗原結合之抗原決定基,或「抗原決定基圖譜」。於該領域中有著許多不同已知方法可用於定位及分析蛋白上抗原決定基之位置,包含將抗體抗原複合體結晶結構之解析、競爭式分析、基因片段表現分析、及合成胜肽分析,例如,如Harlow and Lane,Using Antibodies,a Laboratory Manual,Cold Spring Harbor Laboratory Press,Cold Spring Harbor,N.Y.,1999第11章所述者。於另一樣本中,抗原決定基圖譜可被用於決定抗體結合之序列。該抗原決定基可為一線性抗原決定基,例如,包含於一單股延伸之胺基酸中、或藉由三維的胺基酸交互作用以形成之構型抗原決定 基,其可能不需包含於單股延伸支中(線性序列之主要結構)。可分離或合成(如重組地)不同長度之胜肽(如至少4-6個胺基酸長度),及可用一抗體以進行結合分析。於另一實例中,該可被抗體結合之抗原決定基,可藉由使用重疊之胜肽(衍生自標的抗原序列),於一系統性篩選中以判定,以決定抗體結合位置。根據基因片段表現分析,該開放式閱讀框架編碼標的抗原係經隨機片段化,或藉由特定基因構築以片段化,且所表現之抗原片段的反應性可使用抗體以測試判定之。該基因片段可能,例如,藉由PCR以製備之,接著於放射性胺基酸環境中,進行體外轉錄及轉譯成蛋白。抗體與已被放射性標記之抗原片段之結合與否,可藉由免疫沉澱法及膠體電泳判定。部分抗原決定基亦可使用展現於噬菌體顆粒表面之隨機胜肽序列之大型資料庫(噬菌體庫)中以辨識。此外,一個已分析之重疊胜肽片段資料庫,可於一簡單的結合試驗中,用於測試該測試抗體之結合情形。於另一實例中,抗原結合域之突變,可施行功能區切換試驗及丙胺酸篩選突變法以辨識所需、足夠、即/或必須之殘基,以供抗原決定基結合。例如,功能區切換試驗可使用標的抗原之一個突變以施行,其中一切割的C3多胜肽之各種片段,係以一相近、但非抗原性不同之蛋白序列以取代(置換)之。藉由分析與該突變C3結合之抗體,則可評估與特定抗原片段結合之抗體的重要性。與所欲之抗原決定基結合之抗體可藉由抗原決定基定位圖譜以辨識。 The properties of antibodies prepared from methods known in the field and the methods described herein can be confirmed by methods known in the field. For example, a method is used to identify the epitope that binds to the antigen, or "epitope map". There are many different known methods in this field that can be used to locate and analyze the position of epitopes on proteins, including analysis of the crystal structure of antibody-antigen complexes, competitive analysis, gene fragment expression analysis, and synthetic peptide analysis, such as , As described in Chapter 11 of Harlow and Lane, Using Antibodies, a Laboratory Manual, Cold Spring Harbor Laboratory Press, Cold Spring Harbor, NY, 1999. In another sample, the epitope map can be used to determine the sequence of antibody binding. The epitope can be a linear epitope, for example, contained in a single-stranded amino acid, or a conformational epitope formed by three-dimensional amino acid interaction Base, which may not need to be included in a single-strand extended branch (the main structure of a linear sequence). Peptides of different lengths (such as at least 4-6 amino acids in length) can be isolated or synthesized (eg recombinantly), and an antibody can be used for binding analysis. In another example, the antigenic determinant that can be bound by the antibody can be determined in a systematic screening by using overlapping peptides (derived from the target antigen sequence) to determine the antibody binding position. According to gene fragment performance analysis, the open reading frame encoding target antigen system is randomly fragmented, or fragmented by specific gene construction, and the reactivity of the expressed antigen fragment can be determined by testing using antibodies. The gene fragment may, for example, be prepared by PCR, and then transcribed and translated into protein in vitro in a radioactive amino acid environment. Whether the antibody binds to the radioactively labeled antigen fragment can be determined by immunoprecipitation and gel electrophoresis. Part of the epitope can also be identified in a large database (phage library) of random peptide sequences displayed on the surface of phage particles. In addition, an analyzed database of overlapping peptide fragments can be used to test the binding of the test antibody in a simple binding test. In another example, for the mutation of the antigen binding domain, functional region switching test and alanine screening mutation method can be performed to identify the required, sufficient, or necessary residues for epitope binding. For example, the functional region switching test can be performed using a mutation of the target antigen, in which various fragments of a cleaved C3 polypeptide are replaced (replaced) with a similar but non-antigenic protein sequence. By analyzing antibodies that bind to the mutant C3, the importance of antibodies that bind to specific antigen fragments can be evaluated. The antibody that binds to the desired epitope can be identified by the epitope mapping map.

Ⅲ.新穎卵巢癌標記於診斷及預後之應用Ⅲ. Application of novel ovarian cancer markers in diagnosis and prognosis

如本文所述,經蛋白酶分解後之切割型C3多胜肽,被發現與卵巢癌之出現及進展有關係。因此,本文所述之用於篩檢卵巢癌病患的方法、監控卵巢癌進展、及評估卵巢癌治療效果之方法,可使用切割型C3多胜肽作為一可 信賴之生物標記。如上所述,本文所述之偵測方法可被用作一種初步的篩檢方法,供任何女性個體以檢測其是否可能患有卵巢癌(尤其是早期卵巢癌)。 As described in this article, the cleaved C3 multipeptide after protease decomposition was found to be related to the appearance and progression of ovarian cancer. Therefore, the methods described herein for screening patients with ovarian cancer, monitoring the progress of ovarian cancer, and methods for evaluating the therapeutic effect of ovarian cancer can use the cleaved C3 multipeptide as a possible Biomarker of trust. As mentioned above, the detection method described herein can be used as a preliminary screening method for any female individual to detect whether they may have ovarian cancer (especially early stage ovarian cancer).

藉由該方法所分析之個體,可為任何女性哺乳動物個體,像是人類個體。於部分實例,該個體可具有一種或多種與卵巢癌相關之症狀。於其他實例中,該個體可能具有患有發展成卵巢癌之風險。於另一實例中,該個體為無症狀的。於再一實例中,本文所述之診斷方法可被用作常規篩檢方法,以供健康女性個體,如超過20、35、40、45、50或55歲之女性檢測,以監控潛在之卵巢癌風險或發展。 The individual analyzed by this method can be any female mammalian individual, such as a human individual. In some examples, the individual may have one or more symptoms associated with ovarian cancer. In other instances, the individual may be at risk of developing ovarian cancer. In another example, the individual is asymptomatic. In another example, the diagnostic method described herein can be used as a routine screening method for healthy female individuals, such as women over 20, 35, 40, 45, 50 or 55 years old, to detect potential ovaries Cancer risk or development.

為了進行本文所述之方法,將取自一有需要之個體之生物樣本(如一人類病患其不具有任何卵巢癌之症狀、或一人類病患具有、疑似有、或患有卵巢癌之風險)偵測、或測量該樣本中切割型C3多胜肽,或其之量,係透過任何該領域所習知方法,像是該等本文所述者,如質譜分析及免疫分析。生物樣本可為生物性液體樣本,像是血液樣本,如血漿或血清樣本。切割的C3可為量化的或質化的方式偵測。任何該領域之有效方法,以測量標記之存在與否、量、或活性,皆包含於本發明中。對於該領域具有通常技藝者具有能力可判定何種方法最適用於測量特定標記。 In order to perform the method described herein, a biological sample taken from an individual in need (such as a human patient who does not have any symptoms of ovarian cancer, or a human patient who has, is suspected of, or is at risk of having ovarian cancer ) Detecting or measuring the cleaved C3 polypeptide, or the amount thereof, in the sample by any method known in the art, such as those described herein, such as mass spectrometry and immunoassay. The biological sample may be a biological liquid sample, such as a blood sample, such as a plasma or serum sample. The cut C3 can be detected quantitatively or qualitatively. Any effective method in this field to measure the presence, amount, or activity of the marker is included in the present invention. Those skilled in the field have the ability to determine which method is most suitable for measuring a particular mark.

於一具體實施例中,從須進行測試之個體中取得之樣本,測試切割型C3多胜肽之存在與否。若切割型C3多胜肽可於源自須測試之個體之樣本中測得,則代表該個體被診斷為罹患卵巢癌或具有罹患卵巢癌之風險。 In a specific embodiment, a sample obtained from an individual to be tested is tested for the presence or absence of the cleaved C3 polypeptide. If the cleaved C3 polypeptide can be detected in a sample derived from an individual to be tested, it means that the individual has been diagnosed with ovarian cancer or has a risk of ovarian cancer.

於部分具體實施例中,源自候選個體之樣本中切割型C3多胜肽之量,可藉由與一標準值比較,以判斷是否該候選個體具有或患有卵巢癌之風險。該標準值代表對照組樣本中切割型C3多胜肽之量。該對照樣本可取自一個體(如 一女性個體),其不具有卵巢癌。此外,該對照組樣本可取自多個該等個體之混合物。可選擇地,該等對照組個體與候選個體於,如年齡、性別、及/或種族背景相符。較佳地,該對照組樣本及該候選個體之生物樣本為同一種類之樣本。於部分具體實施例中,若該切割型C3多胜肽被測得、或切割型C3多胜肽之量較標準值高(如高於標準值約10%或更多),則該候選個體可能被診斷為具有、疑似有、或患有卵巢癌之風險。於部分實例中,使用常規方法,如該等本文所述者,於對照組樣本之切割型C3多胜肽的量係於對照組樣本中無法測得的(標準值係為0,低於偵測極限)。於此例子中,使用相同方法偵測源自一個體之生物樣本中,具有切割型C3多胜肽,係指該個體具有、疑似有、或患有卵巢癌之風險。 In some embodiments, the amount of cleaved C3 polypeptide in a sample derived from a candidate individual can be compared with a standard value to determine whether the candidate individual has or is at risk of ovarian cancer. The standard value represents the amount of cleaved C3 polypeptide in the control sample. The control sample can be taken from an individual (e.g. A female individual) who does not have ovarian cancer. In addition, the control sample can be taken from a mixture of multiple individuals. Optionally, the control group individuals match the candidate individuals, such as age, gender, and/or ethnic background. Preferably, the control sample and the biological sample of the candidate individual are samples of the same type. In some specific embodiments, if the cleaved C3 polypeptide is measured, or the amount of cleaved C3 polypeptide is higher than the standard value (for example, about 10% or more higher than the standard value), the candidate individual May be diagnosed with, suspected, or at risk of ovarian cancer. In some examples, using conventional methods, such as those described herein, the amount of cleaved C3 polypeptide in the control sample is undetectable in the control sample (the standard value is 0, which is lower than the detection Test limit). In this example, the same method is used to detect the presence of the cleaved C3 polypeptide in a biological sample derived from an individual, which means that the individual has, is suspected of having, or is at risk of ovarian cancer.

本發明之方法專一性且廣泛性辨識多種型態的卵巢癌,以及不同階段的卵巢癌,但患有其它癌症種類或其他疾病的個體之血液樣本,則未檢出此生物標記;且可以血液樣本進行檢測,無須複雜儀器,對受測者接受度高,適合用於大規模篩檢,有助於早期診斷及持續追蹤病況。 The method of the present invention specifically and extensively identifies various types of ovarian cancer and different stages of ovarian cancer, but blood samples of individuals suffering from other cancer types or other diseases do not detect this biomarker; and blood The sample is tested without complicated equipment, and it is highly acceptable to the subjects. It is suitable for large-scale screening, which is helpful for early diagnosis and continuous tracking of the disease.

本文所述之卵巢癌包括但不限於子宮內膜型(endometrioid)卵巢癌、亮細胞型(clear cell)卵巢癌、漿液型(serous)卵巢癌、黏液型(mucinous)卵巢、及其他類型卵巢癌,例如,卵巢癌肉瘤(ovarian carcinosarcoma)、卵巢未成熟畸胎瘤(Immature teratoma)、卵巢黏液及顆粒型癌(ovarian mucinous and granulosa tumor)及轉移性卵巢癌(Krukenberg,卵巢克魯根勃氏瘤)。 Ovarian cancer as described herein includes but is not limited to endometrioid ovarian cancer, clear cell ovarian cancer, serous ovarian cancer, mucinous ovarian, and other types of ovarian cancer , For example, ovarian carcinosarcoma (ovarian carcinosarcoma), ovarian immature teratoma (Immature teratoma), ovarian mucinous and granulosa tumor (ovarian mucinous and granulosa tumor) and metastatic ovarian cancer (Krukenberg, ovarian Krukenberg tumor ).

本文所述之卵巢癌包括第I期卵巢癌、第II期卵巢癌、第III期卵巢癌及第IV期卵巢癌。各階段卵巢癌的症狀如表1所述。 The ovarian cancer described herein includes stage I ovarian cancer, stage II ovarian cancer, stage III ovarian cancer, and stage IV ovarian cancer. The symptoms of each stage of ovarian cancer are shown in Table 1.

表1:各階段卵巢癌的症狀。

Figure 106132298-A0304-12-0022-1
Table 1: Symptoms of various stages of ovarian cancer.
Figure 106132298-A0304-12-0022-1

於部分具體實施例中,源自候選個體(如卵巢癌病患)之多個樣本中,其切割型C3多胜肽的量可藉由測量,以判定疾病之進展。例如,至少兩個生物樣本(如血清樣本或血漿樣本)可自候選個體中,於不同時間點取得。切割型C3多胜肽的量,於該至少兩個生物樣本中,可藉由本文所述進行測量。若觀察到該切割型C3多胜肽的趨勢,隨著時間(如於較晚獲得之樣本中之切割型C3多胜肽的量,相較於較早獲得之樣本為高時)呈現增加的,該個體係被診斷具有、疑似有或有罹患卵巢癌之風險。若該個體為卵巢癌病患,則切割型C3多胜肽的量呈現增加的趨勢時,則代表卵巢癌進展(惡化)中。 In some embodiments, the amount of cleaved C3 polypeptide in multiple samples from candidate individuals (such as ovarian cancer patients) can be measured to determine the progression of the disease. For example, at least two biological samples (such as serum samples or plasma samples) can be obtained from candidate individuals at different time points. The amount of cleaved C3 polypeptide in the at least two biological samples can be measured as described herein. If the trend of the cleaved C3 polypeptide is observed, it will increase with time (for example, the amount of cleaved C3 polypeptide in the sample obtained later is higher than that of the sample obtained earlier) , The system is diagnosed with, suspected or at risk of ovarian cancer. If the individual is a patient with ovarian cancer, when the amount of cleaved C3 polypeptide shows an increasing trend, it means that ovarian cancer is progressing (deteriorating).

當一個體如人類病患,被診斷為具有、疑似有或患有卵巢癌風險後,該個體可進行進一步之檢驗(如常規物理檢測,包含影像法,如X光攝像、核磁共振成像(MRI)、或超音波或以手術進行活組織檢驗)以確認疾病之發生及/或判定卵巢癌之時期及種類。 When an individual, such as a human patient, is diagnosed as having, suspected, or at risk of ovarian cancer, the individual can undergo further tests (such as routine physical testing, including imaging methods, such as X-ray photography, magnetic resonance imaging (MRI) ), or ultrasound or biopsy with surgery) to confirm the occurrence of the disease and/or determine the time and type of ovarian cancer.

於部分具體實施例中,本文所述之方法可進一步包含治療該卵巢癌病患達到至少舒緩與該疾病有關之症狀。該治療可為任何傳統抗卵巢癌療 法,包含放射療法、化學療法及外科手術。示例性抗卵巢癌化學療法藥劑包含但不限於,阿糖胞苷(ARA-C)、思停(bevacizumab)、撲類惡(bleomycin)、卡鉑(carboplatinum)、順鉑(cisplatin)、佳鉑帝(carboplatin)、癌德星(cyclophosphamide)、醫百幸(etoposide,VP-16)、剋癌易(docetaxel)、艾黴素(doxorubicin)、健擇(gemcitabine)、5-氟尿嘧啶(5-FU)、好克癌(ifosfamide)、尼拉帕尼(Niraparib)、奧拉帕尼(Olaparib)、汰癌勝(paclitaxel)、磷酸瑞卡帕布(Rucaparib)、太莫西芬(Tamoxifene)、癌康定(topotecan)、敏畢瘤(vinblastine)及敏克瘤(vincristine)。 In some embodiments, the method described herein may further comprise treating the ovarian cancer patient to at least relieve the symptoms related to the disease. The treatment can be any traditional anti-ovarian cancer treatment Methods include radiotherapy, chemotherapy and surgery. Exemplary anti-ovarian cancer chemotherapy agents include, but are not limited to, cytarabine (ARA-C), bevacizumab, bleomycin, carboplatinum, cisplatin, Jiaplatin Carboplatin, cyclophosphamide, etoposide (VP-16), docetaxel, doxorubicin, gemcitabine, 5-fluorouracil (5-FU) ), ifosfamide, niraparib, olaparib, paclitaxel, rucaparib phosphate, Tamoxifene, cancer Topotecan, vinblastine and vincristine.

於另一具體實施例中,於此提供之方法,用於評估於卵巢癌病患中所施予之卵巢癌治療之效力。例如,可從進行卵巢癌治療之卵巢癌病患,於治療期間,收集多個生物樣本。若經治療期間,該切割型C3多胜肽的量呈現減少的趨勢,即切割型C3多胜肽的量於較晚獲得之生物樣本中之量,相較於較早獲得之生物樣本之切割型C3多胜肽的量低的話,則代表該治療對於卵巢癌病患是有效的。相反的,若該切割型C3多胜肽的量,經治療期間,仍維持或甚至增加,則代表該治療對於該病患無效或病情惡化。 In another embodiment, the method provided herein is used to evaluate the efficacy of ovarian cancer treatment administered to patients with ovarian cancer. For example, multiple biological samples can be collected from ovarian cancer patients undergoing ovarian cancer treatment during the treatment period. If during the treatment period, the amount of the cleaved C3 multi-peptide shows a decreasing trend, that is, the amount of cleaved C3 multi-peptide in the biological sample obtained later is compared with the amount of the biological sample obtained earlier. If the amount of type C3 polypeptide is low, it means that the treatment is effective for ovarian cancer patients. On the contrary, if the amount of the cleaved C3 multipeptide remains maintained or even increased during the treatment period, it means that the treatment is ineffective for the patient or the condition deteriorates.

此處所使用的「較低」、「減少的」、「降低的」的量或類似用語,是指低於所欲比較的量(如治療前的標記檢測量),其降低的程度具有一般此領域所認可之統計上之意義。在特定具體實施例中,此降低程度可以是相較於治療前的標記檢測量達20%或以上的降低,30%或以上的降低,40%或以上的降低,50%或以上的降低,60%或以上的降低,70%或以上的降低,80%或以上的降低,或90%或以上的降低。 The "lower", "reduced", "reduced" amount or similar terms used here refer to the amount lower than the desired comparison (such as the amount of label detection before treatment), and the degree of reduction is generally The statistical significance recognized by the field. In certain embodiments, the degree of reduction may be a reduction of 20% or more, a reduction of 30% or more, a reduction of 40% or more, and a reduction of 50% or more compared to the amount of label detected before treatment. 60% or more reduction, 70% or more reduction, 80% or more reduction, or 90% or more reduction.

此處所使用的「較高」、「增加的」、「提高的」的量或類似用 語,是指高於所欲比較的量(如治療前的標記檢測量),其提高的程度具有一般此領域所認可之統計上之意義。在特定具體實施例中,此提高程度可以是相較於所欲比較的量達20%或以上的增加,30%或以上的增加,40%或以上的增加,50%或以上的增加,60%或以上的增加,70%或以上的增加,80%或以上的增加,或90%或以上的增加。 The amount of "higher", "increased", "increased" or similar used here The term refers to an amount higher than the desired comparison (such as the amount of label detection before treatment), and the degree of improvement has a statistical significance generally recognized in this field. In a specific embodiment, the degree of improvement can be an increase of 20% or more, an increase of 30% or more, an increase of 40% or more, an increase of 50% or more, compared to the amount to be compared. % Or more increase, 70% or more increase, 80% or more increase, or 90% or more increase.

若一卵巢癌療法被認為對於一卵巢癌病患無效時,則可調整治療策略,如增加藥劑量、治療頻率、或改變更適合之療法。 If an ovarian cancer therapy is deemed to be ineffective for an ovarian cancer patient, the treatment strategy can be adjusted, such as increasing the dose of the drug, the frequency of treatment, or changing a more suitable therapy.

Ⅳ.活體外診斷套組Ⅳ. In Vitro Diagnostic Kit

本發明亦提供施行該方法之套組,其包含本文所述之可專一性辨識切割型C3多胜肽的試劑(如抗體)。該套組可進一步包含供使用該套組之說明,偵測此處所述之切割型態C3多胜肽之存在或含量,藉此偵測卵巢癌,及亦可用於監控卵巢癌進展、或評估於卵巢癌病患所施用之治療效果。 The present invention also provides a kit for performing the method, which includes the reagent (such as an antibody) capable of specifically identifying the cleaved C3 polypeptide described herein. The set may further include instructions for using the set to detect the presence or content of the cleaved C3 polypeptide described herein, thereby detecting ovarian cancer, and can also be used to monitor the progress of ovarian cancer, or To evaluate the effects of treatments administered to patients with ovarian cancer.

V.抗切割型態C3多胜肽之抗體於偵測卵巢癌之用途V. Use of antibodies against cleavage type C3 multipeptides in the detection of ovarian cancer

本文所述之任何抗體,其可專一地辨認切割型態C3多胜肽,用於偵測卵巢癌。例如,該抗體可共軛於可測得之標記(如該領域所習知之體內顯像劑)結合,用於診斷之目的。較佳地,該抗體係用於活體外分析來自待測個體的樣本,以免疫分析方法,如西方墨點分析、酵素連結免疫吸附法(ELISA)、放射免疫法(RIA)、放射免疫沉澱法(RIPA)、免疫螢光法(IFA)及電化學螢光法(ECL),測定樣本中是否存在切割型C3多胜肽或測定其含量判定。 Any of the antibodies described herein can specifically recognize the cleavage pattern C3 polypeptide for detecting ovarian cancer. For example, the antibody can be conjugated to a detectable label (such as an in vivo imaging agent known in the art) and used for diagnostic purposes. Preferably, the antibody system is used for in vitro analysis of samples from individuals to be tested by immunoassay methods, such as Western blot analysis, enzyme-linked immunosorbent assay (ELISA), radioimmunoassay (RIA), radioimmunoassay (RIPA), immunofluorescence method (IFA) and electrochemical fluorescence method (ECL) to determine whether there is a cleaved C3 multipeptide in the sample or determine its content.

以本文所述之診斷方法或治療方法所治療之個體可為一女性哺乳動物,較佳地為一人類女性個體。哺乳動物包含,但不限於農場動物、運動動物、寵物、靈長類、馬、狗、貓、小鼠及大鼠。一個需要該治療之人類個體, 可能為一患有卵巢癌之人類病患、疑似患有卵巢癌之人類病患、或患有卵巢癌風險之人類病患。該病患可藉由常規醫療方式或本文所述之診斷方法以辨識。 The subject to be treated by the diagnostic method or the treatment method described herein may be a female mammal, preferably a human female subject. Mammals include, but are not limited to farm animals, sports animals, pets, primates, horses, dogs, cats, mice, and rats. A human individual in need of this treatment, It may be a human patient with ovarian cancer, a human patient suspected of having ovarian cancer, or a human patient at risk of ovarian cancer. The patient can be identified by conventional medical treatment or the diagnostic methods described herein.

本文所用之「有效量」係指每一個活性物質之量,可於該個體上賦予療效,無論是單獨使用或與一種或多種其他活性物質合併使用。有效量可能會有所不同,須由該領域具有技藝者判斷,根據需施予時之特定情況、情況之嚴重性、個別病患參數,包含年齡、生理狀況、大小、性別及重量、治療時程、(如果有的話)併行療法的本質、特定施予路徑及其他醫療人員之知識及專業內判斷之可能因素。該等因素對於該領域具有通常技藝者而言為習知的,且可引入而無須進一步常規實驗。一般較佳地為,使用個別組成或其組合物之最大劑量,即為根據明智的醫學判斷之最高安全劑量。應可理解的是,該領域中具有通常技藝者,然而,一病患可能基於醫療理由、生理反應或其他可能的理由,堅持使用較低劑量或可忍受劑量。 As used herein, "effective amount" refers to the amount of each active substance that can impart a therapeutic effect on the individual, whether used alone or in combination with one or more other active substances. The effective amount may vary and must be judged by those skilled in the field, based on the specific conditions at the time of administration, the severity of the situation, individual patient parameters, including age, physical condition, size, gender and weight, and treatment time The process, (if any) the nature of concurrent therapy, the specific delivery route, and the possible factors of the knowledge and professional judgment of other medical personnel. These factors are well known to those with ordinary skills in the field, and can be introduced without further routine experimentation. It is generally preferable to use the maximum dose of the individual composition or its composition, which is the highest safe dose based on wise medical judgment. It should be understood that those with ordinary skills in this field, however, a patient may insist on using a lower dose or a tolerable dose based on medical reasons, physiological reactions or other possible reasons.

根據經驗考量,像是半衰期,一般認為影響劑量之決定。例如,與人類免疫系統相容的抗體,像是人化的抗體、或完全的人類抗體,可以延長抗體之半衰期,及避免該抗體被宿主免疫系統所攻擊。施予的頻率可根據治療期間判定及調整,一般而言,如非必須,可根據治療及/或抑制,及/或改善卵巢癌以調整施予頻率。此外,持續性釋放之抗切割的C3配方亦可適用之。用於維持釋放之各種不同配方及裝置,皆為該領域所習知的。 Based on empirical considerations, such as half-life, it is generally believed that it affects the dose decision. For example, antibodies compatible with the human immune system, such as humanized antibodies or fully human antibodies, can extend the half-life of the antibody and prevent the antibody from being attacked by the host immune system. The frequency of administration can be determined and adjusted according to the treatment period. Generally speaking, if not necessary, the frequency of administration can be adjusted according to treatment and/or suppression, and/or improvement of ovarian cancer. In addition, the continuous release of anti-cutting C3 formula can also be applied. Various formulations and devices for sustained release are all known in the field.

根據施予路徑,結合的抗體可與適用之醫藥可接受載劑混合,以形成適合的配方。可注射型之組合物可能含有不同的載劑,像是植物油、二甲基乙醯胺、二甲基甲醯胺、乳酸乙酯、碳酸乙酯、肉豆蔻酸異丙酯、乙醇、及多元醇(甘油、丙二醇、液態聚乙二醇及其類似物)。為了靜脈注射,可藉由 點滴方式施予水溶的抗體,係藉由注入含有抗體及生理可接受賦形劑之醫藥配方。生理可接受之賦形劑可包含,例如5%葡萄糖、0.9%生理食鹽水、Ringer’s溶液或其他適用之賦形劑。肌肉內用之配方,如一滅菌配方,其抗體為適用可溶之鹽類,可藉由施予醫藥賦形劑(如供注射用水、0.9%生理食鹽水、或5%葡萄糖溶液)以溶解。 Depending on the route of administration, the bound antibody can be mixed with a suitable pharmaceutically acceptable carrier to form a suitable formulation. The injectable composition may contain different carriers, such as vegetable oil, dimethylacetamide, dimethylformamide, ethyl lactate, ethyl carbonate, isopropyl myristate, ethanol, and multiple Alcohol (glycerin, propylene glycol, liquid polyethylene glycol and the like). For intravenous injection, you can use The water-soluble antibody is administered by drip method by injecting a pharmaceutical formula containing the antibody and physiologically acceptable excipients. Physiologically acceptable excipients may include, for example, 5% dextrose, 0.9% physiological saline, Ringer's solution or other suitable excipients. For intramuscular formulations, such as a sterile formulation, the antibody is a suitable soluble salt, which can be dissolved by administering pharmaceutical excipients (such as water for injection, 0.9% saline, or 5% glucose solution).

不須進一步詳述,吾人相信該領域具有通常技藝者,可基於以上說明,可應用本發明至其最完整之延伸範圍。因此,以下特定具體實施例僅用於闡述,而非意欲以任何方式來限制本發明之可用範圍。所有本文所引用之文獻,皆以引用之目的或參考文獻方式引用於本文中。 Without further elaboration, we believe that those with ordinary skills in this field can apply the present invention to its most complete extension based on the above description. Therefore, the following specific embodiments are only for illustration, and are not intended to limit the applicable scope of the present invention in any way. All documents cited in this article are cited in this article for the purpose of citation or by reference.

實施例:卵巢癌病患中之補體成分3之特定的蛋白分解片段Example: Specific proteolytic fragments of complement component 3 in patients with ovarian cancer

首先,透過修飾的二維膠體電泳系統,吾人發現來自部分卵巢癌病患之血漿中,檢測出補體成分3(C3蛋白)之特定片段。透過LC-MS/MS分析其胰蛋白酶水解產物,我們發現該片段具分子量約40kDa。該等數據顯示該C3蛋白的特定片段可能為蛋白分解過程之產物。進一步分析胺基酸序列,得知該C3蛋白的特定片段是人類C3 α鏈片段2,是一段在相對於全長人類C3蛋白SEQ ID NO:1的1320位置與1321位置之間切出的C端片段,具有SEQ ID NO:2之胺基酸序列。 First, through a modified two-dimensional colloidal electrophoresis system, we found that certain fragments of complement component 3 (C3 protein) were detected in the plasma of some patients with ovarian cancer. By LC-MS/MS analysis of its trypsin hydrolysate, we found that the fragment has a molecular weight of about 40kDa. These data indicate that the specific fragment of the C3 protein may be the product of the proteolysis process. Further analysis of the amino acid sequence revealed that the specific fragment of the C3 protein is human C3 α chain fragment 2, which is a C-terminal fragment cut between positions 1320 and 1321 relative to the full-length human C3 protein SEQ ID NO:1 , Has the amino acid sequence of SEQ ID NO: 2.

接著,進行西方墨點法,以進一步瞭解該等蛋白片段之特性。 Then, perform the Western blot method to further understand the characteristics of these protein fragments.

抗體製備Antibody preparation

本發明多株抗體製備方式包含下列步驟:將純化的人類切割型C3多胜肽片段或重組蛋白作為抗原,抗原純度達95%以上。為增加抗原之免疫原性,可將胜肽交聯到適當的載體蛋白上,通常為牛血清白蛋白(bovine serum albumin,BSA)或鑰孔蟲戚血藍蛋白(keyhole limpet hemocyanin,KLH)。將抗原注入一兔子體內誘發免疫反應,使不同的抗原表位(epitopes)分別誘導B細胞分泌很多不同的免疫球蛋白(抗體,antibodies)。每兩周免疫一次,共免疫5次。後續先以酵素免疫分析法檢測,確保免疫後血清效價大於1:4000即可進行全部採血。待血液凝固後,離心取上清液,即得抗血清。隨後此正確抗體分子之純化,即利用親和性層析法(蛋白A/G)進行免疫球蛋白(Ig)的純化,以硫酸銨沉澱即可得到含有目標專一性的抗體。可搭配結合離子交換管柱層析去除沉澱中的雜質。 The preparation method of the multi-strain antibody of the present invention includes the following steps: the purified human cleavage C3 multi-peptide fragment or recombinant protein is used as the antigen, and the antigen purity is more than 95%. To increase the immunogenicity of the antigen, the peptide can be cross-linked to an appropriate carrier protein, usually bovine serum albumin (bovine serum albumin). albumin, BSA) or keyhole limpet hemocyanin (KLH). Injecting antigen into a rabbit body induces an immune response, and different epitopes (epitopes) induce B cells to secrete many different immunoglobulins (antibodies). Immunization is once every two weeks for a total of 5 immunizations. Subsequent detection is performed by enzyme immunoassay to ensure that the serum titer after immunization is greater than 1:4000 before all blood sampling can be performed. After the blood is coagulated, the supernatant is centrifuged to obtain the antiserum. The subsequent purification of the correct antibody molecule is the purification of immunoglobulin (Ig) by affinity chromatography (protein A/G) and precipitation with ammonium sulfate to obtain the antibody containing the target specificity. It can be combined with ion exchange column chromatography to remove impurities in the precipitate.

西方墨點分析Western ink dot analysis

將收集自人類個體之血漿樣本中之蛋白與6X Laemmli樣本緩衝液混合,該緩衝液含有120mM Tris-HCl、pH 6.8、2% SDS(w/v)及10%蔗糖(w/v)。於部分樣本,另外加入1%之2-巰基乙醇。經過電泳分離,使用標準技術將蛋白轉移至Immobilon PVDF膜(Millipore Corp.)上。將點墨後之膜以阻斷緩衝液(含有1%山羊血清)進行阻斷,於室溫作用1小時,接著以兔抗補體成分3抗體作用。經三次以Tris緩衝之生理食鹽水(含有0.1% Tween 20)清洗後,將膜以過氧化酶結合之山羊抗兔IgG(Sigma-Aldrich)作用。化學螢光係使用LAS-4000(Fujifilm,日本)偵測。 The protein in the plasma sample collected from a human individual was mixed with 6X Laemmli sample buffer containing 120mM Tris-HCl, pH 6.8, 2% SDS ( w/v ) and 10% sucrose ( w/v ). Add 1% 2-mercaptoethanol to some samples. After electrophoretic separation, the protein was transferred to Immobilon PVDF membrane (Millipore Corp.) using standard techniques. The membrane after spotting was blocked with a blocking buffer (containing 1% goat serum), and allowed to act at room temperature for 1 hour, followed by rabbit anti-complement component 3 antibody. After three times of washing with Tris buffered saline (containing 0.1% Tween 20), the membrane was treated with peroxidase-conjugated goat anti-rabbit IgG (Sigma-Aldrich). The chemical fluorescence system uses LAS-4000 (Fujifilm, Japan) for detection.

結果result

西方墨點分析顯示,於卵巢癌病患樣本中偵測到一特定的補體成分3之片段(切割型C3多胜肽片段),約40kDa大小。如圖1所示,來自卵巢癌病患之樣本可檢測到切割型C3多胜肽片段,但來自正常個體之樣本則未測出。因此,該切割型C3多胜肽片段可被作為一卵巢癌之診斷指標(特異性地出現在卵 巢癌患者血漿樣本中,但在正常個體的血漿中則未檢出)。 Western blot analysis showed that a specific complement component 3 fragment (cleaved C3 multipeptide fragment) was detected in samples from patients with ovarian cancer, about 40kDa in size. As shown in Figure 1, the cleaved C3 multipeptide fragments can be detected in samples from ovarian cancer patients, but not in samples from normal individuals. Therefore, the cleaved C3 multi-peptide fragment can be used as a diagnostic indicator for ovarian cancer (specifically appear in egg It is not detected in the plasma samples of patients with nest cancer, but not in the plasma of normal individuals).

為確認此切割型C3多胜肽片段對於卵巢癌之專一性,取用患有其它癌症種類或其他疾病的人類個體之血漿樣本,進行西方墨點分析。結果如表2所示。 In order to confirm the specificity of this cleaved C3 multi-peptide fragment for ovarian cancer, plasma samples from human individuals with other cancer types or other diseases were taken for Western blot analysis. The results are shown in Table 2.

Figure 106132298-A0304-12-0028-2
Figure 106132298-A0304-12-0028-2

結果顯示,其它癌症種類或其他疾病的人類個體之血漿樣本,均未檢出切割型C3多胜肽片段之存在(檢出率為零)。 The results showed that plasma samples of human individuals with other cancer types or other diseases did not detect the presence of cleaved C3 multipeptide fragments (the detection rate was zero).

相較之下,取用患有不同卵巢癌期別的人類個體之血漿樣本,進行西方墨點分析。結果如表3所示。 In contrast, plasma samples from human individuals with different stages of ovarian cancer were taken for Western blot analysis. The results are shown in Table 3.

Figure 106132298-A0304-12-0028-3
Figure 106132298-A0304-12-0028-3

結果顯示,切割型C3多胜肽片段與卵巢癌有顯著關聯性,在不區 分卵巢癌期數的病患中,總數28名病患中有22名病患檢出切割型C3多胜肽片段,陽性百分比高達78.6%,檢出率將近八成,故可作為卵巢癌的指標;特別是初期(I期)陽性百分比高達86.7%,檢出率接近九成,這是現有檢測技術都無法達到的高檢出率,對於卵巢癌的早期診斷及篩檢有極大助益。 The results show that the cleaved C3 multi-peptide fragment is significantly associated with ovarian cancer, Among the patients classified by stage of ovarian cancer, 22 of the 28 patients were detected with cleaved C3 multipeptide fragments, the positive percentage was as high as 78.6%, and the detection rate was nearly 80%, so it can be used as an indicator of ovarian cancer ; Especially in the initial stage (Phase I) the positive percentage is as high as 86.7%, and the detection rate is close to 90%. This is a high detection rate that cannot be achieved by existing detection technologies. It is of great help to the early diagnosis and screening of ovarian cancer.

我們進一步分析卵巢癌病患的型態,分析切割型C3多胜肽片段之生物標記是否廣泛性地存在於不同型態的卵巢癌病患中。結果如表4所示。 We further analyzed the types of ovarian cancer patients, and analyzed whether the biomarkers of cleaved C3 multipeptide fragments are widely present in different types of ovarian cancer patients. The results are shown in Table 4.

Figure 106132298-A0304-12-0029-4
Figure 106132298-A0304-12-0029-4

結果顯示,切割型C3多胜肽片段對於不同型態的卵巢癌有顯著關聯性,表示可經由檢測切割型C3多胜肽片段,廣泛地篩檢出多種型態的卵巢癌,尤其對於目前檢測率極低的亮細胞型卵巢癌,高達100.0%的檢出率,對於卵巢癌的早期診斷及篩檢有極大助益。 The results show that the cleaved C3 multi-peptide fragments are significantly related to different types of ovarian cancer, which means that the detection of cleaved C3 multi-peptide fragments can be used to screen for multiple types of ovarian cancer, especially for the current test The extremely low rate of bright cell ovarian cancer, with a detection rate of 100.0%, is of great help to the early diagnosis and screening of ovarian cancer.

此外,圖2顯示卵巢癌病患在不同時間點之血漿樣本之西方墨點分析,其中編號1是卵巢癌病患在第一時間點的血漿樣本分析結果,編號2是同一名病患在接受化療後約一年回診的血漿樣本分析結果,顯示切割型C3蛋白含量增加,該病患經進一步確認病情惡化,已發生癌症轉移;編號3是正常個體的血漿樣本分析結果,顯示未測得切割型C3蛋白。結果顯示,切割型C3多胜肽片段可作為監測卵巢癌治療效果的指標,含量增加表示卵巢癌可能惡化。 In addition, Figure 2 shows the Western blot analysis of plasma samples of patients with ovarian cancer at different time points. Number 1 is the analysis result of plasma samples from patients with ovarian cancer at the first time point, and Number 2 is the same patient receiving The analysis of plasma samples returned to the clinic about one year after chemotherapy showed that the content of cleaved C3 protein increased. The patient was further confirmed that his condition had deteriorated and cancer metastasis had occurred; number 3 is the analysis result of plasma samples of normal individuals, showing that no cleave was detected Type C3 protein. The results show that the cleaved C3 multi-peptide fragment can be used as an indicator to monitor the therapeutic effect of ovarian cancer, and the increase in content indicates that ovarian cancer may worsen.

吾人證實約40kDa之切割型C3多胜肽片段係特異性地存在於卵巢癌病患中,可作為篩檢卵巢癌之生物標記,也可作為監測卵巢癌治療效果的指標。因此,本發明首次提出一種卵巢癌篩檢技術,其可專一性地辨識患有卵巢癌、疑似患有卵巢癌、或可能患有卵巢癌風險之病患,可作為於早期(即於任何症狀發生前)或經治療後的預後指標。本發明之技術可發展出針對卵巢癌的檢驗試劑,以切割型C3蛋白作為卵巢癌之篩檢及追蹤治療後病況之生物標記。相較於先前技術,本發明之技術大幅提高卵巢癌檢出率,不但可廣泛性辨識各種類型的卵巢癌,也可辨識各種期別的卵巢癌,特別是早期檢出率相當高(可接近九成),且偽陽性低(其他種類的癌症或病症的病患樣本未檢出切割型C3多胜肽片段之存在),是卵巢癌篩檢的重大突破,又可從個體之血液樣本以簡單的蛋白測量方式完成檢測,屬於非侵入式的檢驗,病患接受度高,適合發展大規模的早期篩檢;另一方面,亦可作為監測卵巢癌治療效果的指標,可持續追蹤患者病況,以便對治療效果不佳的患者,能及時調整治療方案,避免或延緩惡化。 We have confirmed that the cleaved C3 multi-peptide fragment of about 40kDa specifically exists in patients with ovarian cancer, and can be used as a biomarker for ovarian cancer screening and as an indicator for monitoring the therapeutic effect of ovarian cancer. Therefore, the present invention proposes for the first time an ovarian cancer screening technology, which can specifically identify patients with ovarian cancer, suspected ovarian cancer, or who may be at risk of ovarian cancer, and can be used as an early stage (that is, in any symptoms). Prognostic indicators before occurrence) or after treatment. The technology of the present invention can develop a test reagent for ovarian cancer, using cleaved C3 protein as a biomarker for ovarian cancer screening and tracking the condition after treatment. Compared with the prior art, the technology of the present invention greatly improves the detection rate of ovarian cancer. It can not only identify various types of ovarian cancer, but also identify various stages of ovarian cancer, especially the early detection rate is quite high (approximately 90%) and low false positives (the presence of cleaved C3 multi-peptide fragments are not detected in patient samples from other types of cancers or diseases). This is a major breakthrough in screening for ovarian cancer. The simple protein measurement method completes the test, which is a non-invasive test, which is highly accepted by patients and is suitable for the development of large-scale early screening; on the other hand, it can also be used as an indicator to monitor the effect of ovarian cancer treatment and continuously track the patient's condition , So that the treatment plan can be adjusted in time for patients with poor treatment effect to avoid or delay the deterioration.

序列資訊 Sequence Information

補體成分3(智人)-全長(SEQ ID NO:1)

Figure 106132298-A0304-12-0031-5
Complement component 3 (Homo sapiens)-full length (SEQ ID NO: 1)
Figure 106132298-A0304-12-0031-5

補體成分3(智人)C3α鏈片段2(1321-1663 a.a.)(SEQ ID NO:2)

Figure 106132298-A0304-12-0032-6
Complement component 3 (Homo sapiens) C3α chain fragment 2 (1321-1663 aa) (SEQ ID NO: 2)
Figure 106132298-A0304-12-0032-6

補體成分3(智人)C3α鏈片段1(749-954 a.a.)(SEQ ID NO:3)

Figure 106132298-A0304-12-0032-7
Complement component 3 (Homo sapiens) C3α chain fragment 1 (749-954 aa) (SEQ ID NO: 3)
Figure 106132298-A0304-12-0032-7

補體成分3(智人)C3β片段(23-667 a.a.)(SEQ ID NO:4)

Figure 106132298-A0304-12-0032-8
Complement component 3 (Homo sapiens) C3β fragment (23-667 aa) (SEQ ID NO: 4)
Figure 106132298-A0304-12-0032-8

Claims (26)

一種偵測卵巢癌之方法,包含:(a)提供來自待測個體之生物樣本;(b)檢測該來自待測個體之生物樣本之切割型補體成分3(C3)多胜肽的含量,獲得切割型C3多胜肽檢測量;(c)比較該切割型C3多胜肽檢測量與來自正常個體之切割型C3多胜肽正常量,獲得比較結果;以及(d)根據該比較結果判斷該待測個體罹患卵巢癌之可能性,其中如該比較結果顯示切割型C3多胜肽檢測量高於切割型C3多胜肽正常量,則判斷該待測個體患有卵巢癌或有罹患卵巢癌之風險,其中該切割型C3多胜肽為人類C3 α鏈片段2。 A method for detecting ovarian cancer, comprising: (a) providing a biological sample from an individual to be tested; (b) detecting the content of the cleaved complement component 3 (C3) multipeptide in the biological sample from the individual to be tested to obtain The detected amount of cleaved C3 multipeptide; (c) compare the detected amount of cleaved C3 multipeptide with the normal amount of cleaved C3 multipeptide from a normal individual to obtain a comparison result; and (d) judge the amount based on the comparison result The possibility of the individual to be tested suffering from ovarian cancer, where if the comparison result shows that the detected amount of cleaved C3 multipeptide is higher than the normal amount of cleaved C3 multipeptide, then it is determined that the subject has ovarian cancer or has ovarian cancer The risk of the cleavage type C3 multipeptide is human C3 α chain fragment 2. 如請求項1之方法,其中該切割型C3多胜肽具有對應於SEQ ID NO:1的位置1321至位置1663的胺基酸序列。 The method of claim 1, wherein the cleaved C3 polypeptide has an amino acid sequence corresponding to position 1321 to position 1663 of SEQ ID NO:1. 如請求項1之方法,其中該切割型C3多胜肽具有SEQ ID NO:2的胺基酸序列。 The method of claim 1, wherein the cleavage type C3 polypeptide has the amino acid sequence of SEQ ID NO: 2. 如請求項1之方法,其中步驟(b)之檢測係由質譜分析或免疫分析法進行。 Such as the method of claim 1, wherein the detection in step (b) is performed by mass spectrometry or immunoassay. 如請求項1之方法,其中步驟(b)之檢測係由免疫分析法進行,該免疫分析法使用專一性結合至具有SEQ ID NO:2的切割型C3多胜肽之抗體。 The method of claim 1, wherein the detection of step (b) is performed by an immunoassay method that uses an antibody that specifically binds to the cleavage C3 polypeptide of SEQ ID NO: 2. 如請求項1之方法,其中該生物樣本為體液樣本、組織樣本、或生物檢體樣本。 Such as the method of claim 1, wherein the biological sample is a body fluid sample, a tissue sample, or a biological specimen sample. 如請求項6之方法,其中該生物樣本為血液樣本、尿液樣本、或腹水樣本。 Such as the method of claim 6, wherein the biological sample is a blood sample, a urine sample, or an ascites sample. 如請求項1至7中任一項之方法,其中該卵巢癌係選自由子宮內膜型(endometrioid)卵巢癌、亮細胞型(clear cell)卵巢癌、漿液型(serous)卵巢癌、及黏液型(mucinous)卵巢癌所組成之群組,或選自由卵巢癌肉瘤(ovarian carcinosarcoma)、卵巢未成熟畸胎瘤(Immature teratoma)、卵巢黏液及顆粒型癌(ovarian mucinous and granulosa tumor)、及轉移性卵巢癌(Krukenberg,卵巢克魯根勃氏瘤)所組成之群組。 The method according to any one of claims 1 to 7, wherein the ovarian cancer is selected from the group consisting of endometrioid ovarian cancer, clear cell ovarian cancer, serous ovarian cancer, and mucus Type (mucinous) ovarian cancer, or selected from ovarian carcinosarcoma (ovarian carcinosarcoma), ovarian immature teratoma (Immature teratoma), ovarian mucinous and granulosa tumor (ovarian mucinous and granulosa tumor), and metastasis Sexual ovarian cancer (Krukenberg, ovarian Krugenberg tumor). 如請求項1至7中任一項之方法,其中該卵巢癌係選自由第I期卵巢癌、第II期卵巢癌、第III期卵巢癌及第IV期卵巢癌所組成之群組。 The method according to any one of claims 1 to 7, wherein the ovarian cancer is selected from the group consisting of stage I ovarian cancer, stage II ovarian cancer, stage III ovarian cancer, and stage IV ovarian cancer. 如請求項9之方法,其中該卵巢癌係選自由子宮內膜型(endometrioid)卵巢癌、亮細胞型(clear cell)卵巢癌、漿液型(serous)卵巢癌、及黏液型(mucinous)卵巢癌所組成之群組,或選自由卵巢癌肉瘤(ovarian carcinosarcoma)、卵巢未成熟畸胎瘤(Immature teratoma)、卵巢黏液及顆粒型癌(ovarian mucinous and granulosa tumor)、及轉移性卵巢癌(Krukenberg,卵巢克魯根勃氏瘤)所組成之群組。 The method of claim 9, wherein the ovarian cancer is selected from the group consisting of endometrioid ovarian cancer, clear cell ovarian cancer, serous ovarian cancer, and mucinous ovarian cancer Group consisting of ovarian carcinosarcoma (ovarian carcinosarcoma), ovarian immature teratoma (Immature teratoma), ovarian mucinous and granulosa tumor (ovarian mucinous and granulosa tumor), and metastatic ovarian cancer (Krukenberg, Klugenberg tumor of the ovary). 一種監控卵巢癌病患之卵巢癌發展之方法,該方法包含:(a)於第一時間點,提供源自該病患之第一生物樣本;(b)於第二時間點,提供源自該病患之第二生物樣本,其中該第二時間點係晚於第一時間點; (c)檢測第一生物樣本中之切割型C3多胜肽的含量,獲得切割型C3多胜肽第一檢測量,以及檢測第二生物樣本中之切割型C3多胜肽的含量,獲得切割型C3多胜肽第二檢測量;(d)比較切割型C3多胜肽第一檢測量與切割型C3多胜肽第二檢測量,獲得比較結果;以及(e)基於該比較結果,判斷該病患中之卵巢癌進程,其中如該比較結果顯示切割型C3多胜肽第二檢測量高於切割型C3多胜肽第一檢測量,則表示卵巢癌發展中,其中該切割型C3多胜肽為人類C3 α鏈片段2。 A method for monitoring the development of ovarian cancer in patients with ovarian cancer, the method comprising: (a) at a first time point, providing a first biological sample derived from the patient; (b) at a second time point, providing a first biological sample derived from the patient A second biological sample of the patient, wherein the second time point is later than the first time point; (c) Detect the content of cleaved C3 multipeptide in the first biological sample to obtain the first detection amount of cleaved C3 multipeptide, and detect the content of cleaved C3 multipeptide in the second biological sample to obtain the cut The second detection amount of type C3 multipeptide; (d) compare the first detection amount of cleaved C3 multipeptide with the second detection amount of cleaved C3 multipeptide to obtain a comparison result; and (e) judge based on the comparison result For the progression of ovarian cancer in the patient, if the comparison result shows that the second detected amount of cleaved C3 multipeptide is higher than the first detected amount of cleaved C3 multipeptide, it means that ovarian cancer is developing, and the cleaved C3 The multipeptide is human C3 α chain fragment 2. 如請求項11之方法,其中該病患係接受卵巢癌治療,以及該第一生物樣本及第二生物樣本係取自於治療之前或治療之後,或治療期間。 The method of claim 11, wherein the patient is treated for ovarian cancer, and the first biological sample and the second biological sample are taken before or after treatment, or during treatment. 如請求項11之方法,其進一步包含評估該卵巢癌治療對於該病患之療效,其中如經治療後、或於療程期間,該切割型C3多胜肽的含量呈現降低趨勢,則代表該療法對於該病患有效。 The method of claim 11, which further comprises evaluating the therapeutic effect of the ovarian cancer treatment on the patient, wherein if the content of the cleaved C3 polypeptide shows a decreasing trend after treatment or during the course of treatment, it represents the treatment It is effective for this patient. 如請求項11之方法,其中該切割型C3多胜肽具有對應於SEQ ID NO:1的位置1321至位置1663的胺基酸序列。 The method of claim 11, wherein the cleaved C3 polypeptide has an amino acid sequence corresponding to position 1321 to position 1663 of SEQ ID NO:1. 如請求項11之方法,其中該切割型C3多胜肽具有SEQ ID NO:2的胺基酸序列。 The method of claim 11, wherein the cleaved C3 polypeptide has an amino acid sequence of SEQ ID NO: 2. 如請求項11之方法,其中步驟(c)之檢測係由質譜分析或免疫分析法進行。 Such as the method of claim 11, wherein the detection in step (c) is performed by mass spectrometry or immunoassay. 如請求項11之方法,其中步驟(c)之檢測係由免疫分析法進行,該免疫分析法使用專一性結合至具有SEQ ID NO:2的切割型C3多胜肽之抗體。 The method of claim 11, wherein the detection of step (c) is performed by an immunoassay method that uses an antibody that specifically binds to the cleavage C3 polypeptide of SEQ ID NO: 2. 如請求項11之方法,其中該生物樣本為體液樣本、組織樣本、或生物檢體樣本。 Such as the method of claim 11, wherein the biological sample is a body fluid sample, a tissue sample, or a biological specimen sample. 如請求項18之方法,其中該生物樣本為血液樣本、尿液樣本、或腹水樣本。 Such as the method of claim 18, wherein the biological sample is a blood sample, a urine sample, or an ascites sample. 如請求項11至19中任一項之方法,其中該卵巢癌係選自由子宮內膜型(endometrioid)卵巢癌、亮細胞型(clear cell)卵巢癌、漿液型(serous)卵巢癌、及黏液型(mucinous)卵巢癌所組成之群組,或選自由卵巢癌肉瘤(ovarian carcinosarcoma)、卵巢未成熟畸胎瘤(Immature teratoma)、卵巢黏液及顆粒型癌(ovarian mucinous and granulosa tumor)、及轉移性卵巢癌(Krukenberg,卵巢克魯根勃氏瘤)所組成之群組。 The method according to any one of claims 11 to 19, wherein the ovarian cancer is selected from the group consisting of endometrioid ovarian cancer, clear cell ovarian cancer, serous ovarian cancer, and mucus Type (mucinous) ovarian cancer, or selected from ovarian carcinosarcoma (ovarian carcinosarcoma), ovarian immature teratoma (Immature teratoma), ovarian mucinous and granulosa tumor (ovarian mucinous and granulosa tumor), and metastasis Sexual ovarian cancer (Krukenberg, ovarian Krugenberg tumor). 如請求項11至19中任一項之方法,其中該卵巢癌係選自由第I期卵巢癌、第II期卵巢癌、第III期卵巢癌及第IV期卵巢癌所組成之群組。 The method according to any one of claims 11 to 19, wherein the ovarian cancer is selected from the group consisting of stage I ovarian cancer, stage II ovarian cancer, stage III ovarian cancer, and stage IV ovarian cancer. 如請求項21之方法,其中該卵巢癌係選自由子宮內膜型(endometrioid)卵巢癌、亮細胞型(clear cell)卵巢癌、漿液型(serous)卵巢癌、及黏液型(mucinous)卵巢癌所組成之群組,或選自由卵巢癌肉瘤(ovarian carcinosarcoma)、卵巢未成熟畸胎瘤(Immature teratoma)、卵巢黏液及顆粒型癌(ovarian mucinous and granulosa tumor)、及轉移性卵巢癌(Krukenberg,卵巢克魯根勃氏瘤)所組成之群組。 The method of claim 21, wherein the ovarian cancer is selected from the group consisting of endometrioid ovarian cancer, clear cell ovarian cancer, serous ovarian cancer, and mucinous ovarian cancer Group consisting of ovarian carcinosarcoma (ovarian carcinosarcoma), ovarian immature teratoma (Immature teratoma), ovarian mucinous and granulosa tumor (ovarian mucinous and granulosa tumor), and metastatic ovarian cancer (Krukenberg, Klugenberg tumor of the ovary). 一種可辨識切割型C3多胜肽之試劑的用途,其係用於診斷卵巢癌或監控卵巢癌發展,或用於製備供診斷卵巢癌或監控卵巢癌發展之試劑或套組,其中該切割型C3多胜肽為人類C3 α鏈片段2。 The use of a reagent capable of identifying cleavage type C3 multipeptides, which is used to diagnose ovarian cancer or monitor the development of ovarian cancer, or to prepare reagents or kits for diagnosing or monitoring the development of ovarian cancer, wherein the cleavage type The C3 multipeptide is human C3 α chain fragment 2. 如請求項23之用途,其中該切割型C3多胜肽具有對應於SEQ ID NO:1的位置1321至位置1663的胺基酸序列。 Such as the use of claim 23, wherein the cleaved C3 polypeptide has an amino acid sequence corresponding to position 1321 to position 1663 of SEQ ID NO:1. 如請求項23之用途,其中該切割型C3多胜肽具有SEQ ID NO:2的胺基酸序列。 Such as the use of claim 23, wherein the cleaved C3 polypeptide has the amino acid sequence of SEQ ID NO: 2. 如請求項23之用途,其中該試劑為抗體。 Such as the use of claim 23, wherein the reagent is an antibody.
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Citations (3)

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WO2004103941A2 (en) * 2003-05-16 2004-12-02 Wyeth Aryl-carbaldehyde oxime derivatives and their use as estrogenic agents
US20090258002A1 (en) * 2005-02-01 2009-10-15 Government Of The Us, As Represented By The Secretary, Department Of Health And Human Services Biomarkers for Tissue Status
TW201608239A (en) * 2013-10-01 2016-03-01 豐宥科技股份有限公司 Biomarkers for breast cancer

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2004103941A2 (en) * 2003-05-16 2004-12-02 Wyeth Aryl-carbaldehyde oxime derivatives and their use as estrogenic agents
US20090258002A1 (en) * 2005-02-01 2009-10-15 Government Of The Us, As Represented By The Secretary, Department Of Health And Human Services Biomarkers for Tissue Status
TW201608239A (en) * 2013-10-01 2016-03-01 豐宥科技股份有限公司 Biomarkers for breast cancer

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