TWI726191B - 偵測癌症之探針組合 - Google Patents
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Abstract
一種用於偵測癌症的探針組合,其包括一組或多組以HBV局部基因體做為標的之探針。其中當每一組該以HBV局部基因體做為標的之探針依該HBV局部基因體之序列排列對齊時,已對齊的該些以HBV局部基因體做為標的之探針於對齊後所組成的一整體序列和一種HBV基因體中之一參考序列或一HBV基因體上的DR序列(direct repeat region)互相匹配。在該些已對齊的多組探針中,每一探針序列的一部分和相鄰的一個或二個探針序列的一部分重疊。該探針組合可進一步包括一組或多組以癌症熱點基因做為標的之探針,例如以CTNNB1、TERT和TP53基因做為標的之探針、一組或多組以外源性基因如一部分λ噬菌體之基因體做為標的之探針以及多組以內源性基因如GAPDH和GdX基因做為標的之探針。
Description
本發明與一種探針組合有關。進一步地,本發明和一種用於偵測癌症且具有序列專一性的探針組合有關。
肝病毒科(Hepadnaviridae)被認為是和肝炎、肝細胞癌(hepatocellular carcinoma;HCC)和肝硬化(cirrhosis)之致病機轉有關的一類病毒。HBV(Hepatitis B Virus,即B型肝炎病毒)為肝病毒科中最常見的病毒,且為一小型DNA病毒,其可被分類為基因型A至J。大部分成人被HBV感染後會康復,然而大約有5%至10%感染HBV的病患無法清除體內的病毒且會成為慢性帶原者。B型肝炎的慢性帶原者演變為肝細胞癌的機率很高,因為HBV能嵌入宿主的基因體中且造成肝細胞在遺傳上或表觀遺傳(epigenetic)上的改變。
目前和偵測HBV嵌入基因體有關的方法,有Jiang等人發表的「The effect of hepatitis B virus integration into the genomes of hepatocellular carcinoma patients」(Genome Res.(2012)22,593-601)和Sung等人發表的「Genome-wide survey of recurrent HBV integration in hepatocellular carcinoma」(Nature Genetics(2012)44,765-769);上述文獻揭露了使用全基因體定序(whole genome sequencing)以偵測肝細胞癌之肝組織樣本中HBV嵌入基因體的狀況。然而,這
些直接定序的偵測方法效率不佳。Jiang提及大約每次定序平均會產生2500萬至3500萬個75bp之核酸片段讀值,但是在Jiang的偵測方法中,可測得的HBV核酸片段讀值為600萬個,且僅有400個嵌合點(junction)讀值。更進一步地,目前沒有任何使用直接定序法的研究能夠從循環系統中的腫瘤DNA(ctDNA)樣本中偵測HBV的嵌入事件。
而後,Li等人所發表的「HIVID:An efficient method to detect HBV integration using low coverage sequencing」(Genomics(2013)102:4,338-344)和Zhao等人所發表的「Genomic and oncogenic preference of HBV integration in hepatocellular carcinoma」(Nature Communications(2016)7:12992)揭露了可捕捉特定序列的探針之使用方法,該些探針是依照HBV基因體中的序列設計的,且能夠偵測HBV嵌入基因體的狀態。然而,Li和Zhao皆沒有提供設計該些探針時更清楚的設計邏輯。更進一步地,Li和Zhao的研究中所揭露的探針效率不佳:在Li和Zhao的研究中,探針對人類基因體的平均對準率為83.7%,而HBV序列的平均對準率和偵測嵌入事件的比率卻分別低到0.08%和0.01%,代表著該些探針無法偵測HBV嵌入人類基因體,或偵測嵌入事件時的低效率。
本發明提供了一組探針組合及分析方法,上述的探針組合和分析方法將可用於高效率和高敏感度地捕捉病毒DNA和病毒-宿主嵌合點(viral-host junction)。
根據以下一個或多個本發明之實施例,本發明提供了一種可偵測癌症之探針組合。該探針組合包括一組或多組以HBV局部基因體做為標的之探針,其中當每一組該以HBV局部基因體做為標的之探針依該HBV局部基因體
序列排列對齊時,已對齊的該些以HBV局部基因體做為標的之探針於對齊後所組成的一整體序列和一種HBV基因型的一基因體中之一DR序列(direct repeat region)的一參考序列互相匹配,且在該些已對齊的多組以HBV局部基因體做為標的之探針中,每一個該以HBV局部基因體做為標的之探針序列的一部分和相鄰的一個或二個以HBV局部基因體做為標的之探針序列的一部分相重疊。
在一實施例中,該些HBV基因型包括基因型A型、基因型B型、基因型C型、基因型D型、基因型E型、基因型F型、基因型G型、基因型H型、基因型I型和基因型J型。
在一實施例中,該些DR序列的參考序列包括SEQ ID NO.1至SEQ ID NO.32。
在一實施例中,該探針組合包括一組或多組以HBV全基因體做為標的之探針,其中當每一組該以HBV全基因體做為標的之探針依該HBV全基因體序列排列對齊時,已對齊的該些以HBV全基因體做為標的之探針於對齊後所組成的一整體序列和一種HBV基因型的該基因體互相匹配,且在該些已對齊的多組以HBV全基因體做為標的之探針中,每一個該以HBV全基因體做為標的之探針序列的一部分和相鄰的一個或二個以HBV全基因體做為標的之探針序列的一部分相重疊。
在一實施例中,該探針組合更包括一組或多組以癌症熱點基因做為標的之探針,其中當每一組該以癌症熱點基因做為標的之探針依該癌症熱點基因序列排列對齊時,已對齊的該些以癌症熱點基因做為標的之探針於對齊後所組成的一整體序列和一癌症熱點基因的一參考序列互相匹配,且在該些已對齊的多組以癌症熱點基因做為標的之探針中,每一個該以癌症熱點基因做為標
的之探針序列的一部分和相鄰的一個或二個以癌症熱點基因做為標的之探針序列的一部分相重疊。
在一實施例中,該癌症熱點基因包括CTNNB1、TERT和TP53。
在一實施例中,該癌症熱點基因之該參考序列包括SEQ ID NOs.33-41。
在一實施例中,該探針組合更包括一組或多組以外源性基因做為標的之探針,其中當該每一組以外源性基因做為標的之探針依該外源性基因序列排列對齊時,已對齊的該些以外源性基因做為標的之探針於對齊後所組成的一整體序列和一外源性基因的一參考序列互相匹配,且在該些已對齊的多組以外源性基因做為標的之探針中,每一個該以外源性基因做為標的之探針序列的一部分和相鄰的一個或二個以外源性基因做為標的之探針序列的一部分相重疊。
在一實施例中,該外源性基因源自於一λ噬菌體。
在一實施例中,該外源性基因的該參考序列包括SEQ ID NOs.42-54。
在一實施例中,該探針組合更包括一組或多組以內源性基因做為標的之探針,其中當該每一組以內源性基因做為標的之探針依該內源性基因序列排列對齊時,已對齊的該些以內源性基因做為標的之探針於對齊後所組成的一整體序列和一內源性基因的一參考序列互相匹配,且在該些已對齊的多組以內源性基因做為標的之探針中,每一個該以內源性基因做為標的之探針序列的一部分和相鄰的一個或二個以內源性基因做為標的之探針序列的一部分相重疊。
在一實施例中,該內源性基因包括GAPDH和GdX。
在一實施例中,該內源性基因的該參考序列包括SEQ ID NO.55和SEQ ID NO.56。
較佳地,各個實施例中的該探針組合可偵測到的癌症包括肝細胞癌。
較佳地,各個實施例中的該探針組合是用於捕捉具有病毒-宿主嵌合點的標的核酸片段,該標的核酸片段是由一感染HBV的對象的一樣本中之DNA所取得。
較佳地,由該樣本中取得之DNA包括基因體DNA和循環系統中的腫瘤DNA。
根據以上實施例,本發明可提供一用來偵測病毒感染或病毒感染所導致之癌症的工具。本發明的眾多實施例能夠應用於偵測各種不同種類的DNA病毒和其病毒嵌入基因體現象。根據眾多實施例所設計的探針組合確保了能夠涵蓋到最佳的病毒/宿主序列,且也考慮到了病毒基因的不穩定性。該探針組合也被證實了具備高敏感度、高效率和可信度。
211:探針
212:全基因體序列
本發明將可由以下之敘述配合附圖以更佳地理解,其中:圖1為一流程圖,該流程圖描繪出在符合本發明的一實施例中,取得一參考序列的流程。
圖2A和圖2B為本發明的一實施例中,該探針的設計概念示意圖。
圖3為本發明的一實驗結果,該實驗結果表現出一實施例中該探針的選擇性雜交(hybridization)。
圖4A和圖4B為本發明的一實施結果,該實驗結果表現出該探針的特異性。
圖5A為本發明的一實施例中,一由熱點圖轉換而來的直方圖,據以呈現本發明之探針組合使用於配對的腫瘤基因體DNA(tumor genomic DNA)樣本時,幾個不同基因位置之次世代定序(next generation sequencing)分析結果圖5B為本發明的一實施例中,一由熱點圖轉換而來的直方圖,據以呈現本發明之探針組合使用於配對的血漿內腫瘤DNA(plasma circulating tumor DNA)樣本時,幾個不同基因位置之次世代定序(next generation sequencing)分析結果
圖6為本發明的一實施例中的另一直方圖,該直方圖由一熱點圖轉換而來,具體呈現本發明之探針組合使用於腫瘤基因體DNA(tumor genomic DNA)樣本時,幾個不同基因位置之次世代定序(next generation sequencing)分析結果
圖7為本發明的一實驗結果,該實驗結果為數個DNA樣本和一探針組合進行雜交後,再以次世代定序技術分析之。
為使圖式簡明清楚,因此不同圖式中代表相對應元件之符號可能會重複。另外為了使實施例可被完整地理解,本說明書也針對各實施例中的諸多細節進行說明。然而,本技術領域中具有通常技藝之人也可不需上述諸多細節就可實施以下各實施例。本發明之圖式並不代表部分元件之尺寸和比例,且有可能會將部分元件誇大表示以更佳地說明該元件相關之細節和特徵。本說明書之目的並非限制以下實施例之內容。
本發明中的各詞彙僅用於描述特定實施例,且並非限制本發明之內容。「和/或」以及「至少一」係包括了任何和所有列出的元件、區域。同
時,雖然本發明中會出現「第一」、「第二」和「第三」一類的詞彙,然而該些詞彙僅用於區別一元件和另一元件、一區域和另一區域,以及一部件和另一部件時。因此,以不偏離本發明的教示做為前提,一第一元件、第一區域或第一部件也可被命名為第二元件、第二區域或第二部件。另外,除非有另行定義,否則本發明中的所有詞彙(包括專有名詞)皆為本技術領域中具有通常技藝之人所認知的詞彙。
本發明的其中一個面向提供了一探針組合,該探針組合包括了一組或多組以特定序列做為標的之多個探針。該些探針可包括單股寡核苷酸(single stranded oligonucleotides)和單股聚核苷酸(single stranded polynucleotide),例如單股去氧核醣核酸(ssDNA;single stranded deoxyribonucleic acids)、單股核醣核酸(single stranded ribonucleic acids)和單股人造核苷酸(single stranded artificial nucleotides)。該探針組合可用於偵測病毒感染或病毒感染所引起的癌症,特別是DNA病毒所引起的癌症。在某些實施例中,該探針組合可用於偵測HBV、人類乳突病毒(HPV)、艾司坦-巴爾病毒(EBV;Epstein-Barr Virus)、第8型疱疹病毒(HHV-8;Herpes Virus-8)、人類嗜T淋巴球病毒(HTLV;Human T-lymphotropic Virus)、Merkel氏多瘤病毒(MCV;Merkel Cell Polyomavirus)或其他DNA病毒。在其他實施例中,該探針組合可用於偵測肝細胞癌(hepatocellular carcinoma)、肝癌(liver cancer)、子宮頸癌(cervical cancer)、陰莖癌(penile cancer)、肛門癌(anal cancer)、陰道癌(vaginal cancer)、外陰癌(vulvar cancer)、口腔癌(oral cancer)、口咽癌(oropharyngeal cancer)、鼻咽癌(nasopharyngeal cancer)、頭頸癌(head and neck cancer)、淋巴癌(lymphoma)、原發性積液淋巴癌(primary effusion lymphoma)、胃癌(stomach
cancer)、卡波西氏肉瘤(Kaposi sarcoma)、Merkel氏細胞癌(Merkel cell carcinoma)或其他由DNA病毒感染所引起的癌症。
根據本發明的一種實施例,該探針組合包括一組或多組以特定病毒全基因體做為標的之探針。當每一該以特定病毒全基因體做為標的之探針依該特定病毒全基因體序列對齊時,已對齊的該些以特定病毒全基因體做為標的之探針之於對齊後所組成的一整體序列和一種特定病毒基因型的該基因體的一參考序列互相匹配。該特定病毒得標的基因型可包括前述DNA病毒的不同基因型。例如若該特定病毒為HBV,則其標的基因型就可包括基因型A型、基因型B型、基因型C型、基因型D型、基因型E型、基因型F型、基因型G型、基因型H型、基因型I型和基因型J型。該特定病毒基因體的該參考序列可由NCBIGenBank(https://www.ncbi.nlm.nih.gov/genbank/)或自臨床樣本中所獲得的序列取得。例如HBV基因型A型的參考序列可由NCBI GenBank Accession No.AP007263、HE974383或HE974381取得;HBV基因型B型的參考序列可由GenBank Accession No.AB981581、AB602818或AB554017取得;HBV基因型C型的參考序列可由GenBank Accession No.LC360507、AB644287或AB113879取得;HBVD型的參考序列可由GenBank Accession No.HE815465、HE974382或AB554024取得;HBV基因型E型的參考序列可由GenBank Accession No.HE974380、HE974384或AP007262取得;HBV基因型F型的參考序列可由GenBank Accession No.DQ823095、AB036909或AB036920取得;HBV基因型G型的參考序列可由GenBank Accession No.AB625342、HE981176或GU563559取得;HBV基因型H型的參考序列可由GenBank Accession No.AB298362、AB846650或AB516395取得;HBV基因型I型的參考序列可由GenBank Accession
No.EU833891、KF214680或KU950741取得;HBV基因型J型的參考序列可由GenBank Accession No.AB486012取得。
在一實施例中,該探針組合包括二組以HBV全基因體做為標的之探針。當一組以HBV全基因體做為標的之探針依該HBV全基因體序列排列對齊時,已對齊的該些以HBV全基因體做為標的之探針於對齊後所組成的一整體序列和HBV基因型B型的一基因體的一參考序列(SEQ ID NO.1)互相匹配。同樣的,當其他組以HBV全基因體做為標的之探針依該HBV全基因體序列排列對齊時,已對齊的該些以HBV全基因體做為標的之探針於對齊後所組成的一整體序列和HBV基因型C型的一基因體的一參考序列(SEQ ID NO.2)互相匹配。在此實施例中,該HBV參考序列取得的方法如圖1所示。如步驟S1中所示,DNA由樣本中萃取而來,該樣本可為被HBV慢性感染的病人之生物性液體,例如:血液、淋巴液、尿液、汗液、唾液、眼淚或胃腸液(interstinal fluid);或為其組織,例如肝組織。該萃取出的DNA包括了病人的基因體DNA(gDNA)和/或循環系統中的腫瘤DNA(ctDNA)。如步驟S2中所示,該萃取出的DNA依據NCBI GenBank中已知的各種HBV基因型而定序且分類。在此實施例中,選擇HBV基因型B型和基因型C型的原因,是由於此二種基因型盛行於台灣肝細胞癌病人之中;然而本發明的實施例並不限於HBV基因型B型和基因型C型,而是可包含各種能造成持續性感染之DNA病毒的不同基因型。如步驟S3中所示,以Clustal演算法對齊並計算每一所選基因型之序列,並根據每一位置所共同擁有之對偶片段序列,得到該病毒基因型的一共通序列(consensus sequence)。最後,該共通序列被用來當做該病毒基因型的一參考序列。在此實施例中,該些參考序列包括HBV基因型B型和基因型C型的多個共通序列,其中該些參考序列可分別
涵蓋HBV基因型B型的基因體中的全部3,191bp序列,或HBV基因型C型基因體中的全部3,191bp序列。
在此實施例中,該以病毒序列做為標的之探針被設計為:當該些以病毒全基因體做為標的之探針依該病毒全基因體序列排列對齊時,每一以病毒全基因體做為標的之探針的一部分會直接和相鄰的以病毒全基因體做為標的之探針的一部分相重疊。如圖2A所示,在此實施例中,每一以HBV全基因體序列211做為標的之探針212的一部分會直接和一個或二個相鄰的以HBV全基因體序列211做為標的之探針212的一部分重疊。該序列重疊部分的長度不等,較佳地為50%(在此以2X重疊密度表示)或75%(在此以4X重疊密度表示),如圖2B所示。在一實施例中,該探針被設計為具有120bp的長度和2X重疊密度,每一探針會直接和相鄰的探針重疊60bp。同樣的,若該些探針的長度分別為120bp和4X重疊密度,則每一探針將會直接和相鄰的探針重疊90bp。
進一步地,在設計該些探針時,該病毒的基因體結構也是考量因素之一。在以HBV基因體做為標的之實施例中,由於HBV基因體為環形,因此該些以HBV全基因體做為標的之探針中,其最後的探針將超過該HBV基因體之該參考序列的第3191bp,且會在該參考序列的起始鹼基處(即第1bp)繼續下去。例如一探針之長度為120bp,且起始於該HBV全基因體的參考序列的第3,121bp;該探針將包括一個71bp長的區域以對應該參考序列的第3,121至第3,191bp,緊接在後的是一個49bp長的區域,以對應該參考序列的第1至第49bp。
在公式1中L代表該參考序列的長度,而P代表該些探針的長度,P之範圍可為一最小長度(以min表示)至一最大長度(以max表示)。例如基於一長度為3191bp的HBV基因型B型或C型參考序列,如其探針序列長度為50至120bp之間,則可設計出220,597種探針。
根據本發明的一實施例,該探針組和可以包括一組或多組以特定病毒局部基因體做為標的之探針。當每一組該以特定病毒局部基因體做為標的之探針依該特定病毒局部基因體序列排列對齊時,已對齊的該些以特定病毒局部基因體做為標的之探針於對齊後所組成的一整體序列和一特定病毒局部基因體之一特別區上的一參考序列互相匹配。在該些已對齊的多組以特定病毒局部基因體做為標的的探針中,每一個以特定病毒局部基因體做為標的的探針的一部分和相鄰的一個或二個以該特定病毒局部基因體做為標的的探針的一部分相重疊。在某些實施例中,上述的特別區包括一在HBV基因體中且介於DR序列1(direct repeat 1)和DR序列2(direct repeat 2)之間的區域。在其他實施例中,該特別區可為一介於DR序列1和DR序列2之間的區域,再加上兩個自上述區域延伸出的延展區,以使其長度達到一指定長度。例如:為了定義一長度為960bp,位於DR序列上的參考序列,可以假設DR序列1和DR序列2分別位於病毒基因體上的第360至第370bp和第594至604bp,該參考序列可以定義為DR序列1和DR序列2之間的區域且再加上由兩端起算360bp的延展區。同時,該HBV基因型A型基因體上的一DR序列上的該參考序列可為SEQ ID NOs.3-5;該HBV基因型B型基因體上的一DR序列上的該參考序列可為SEQ ID NOs.6-9;該HBV基因型C型基因體上的一DR序列上的該參考序列可為SEQ ID NOs 10-13;該HBV基因型D型基因體上的一DR序列上的該參考序列可為SEQ ID NOs.14-16;該HBV
基因型E型基因體上的一DR序列上的該參考序列可為SEQ ID NOs.17-19;該HBV基因型F型基因體上的一DR序列上的該參考序列可為SEQ ID NOs.20-22;該HBV基因型G型基因體上的一DR序列上的該參考序列可為SEQ ID NOs.23-25;該HBV基因型H型基因體上的一DR序列上的該參考序列可為SEQ ID NOs.26-28;該HBV基因型I型基因體上的一DR序列上的該參考序列可為SEQ ID NOs.29-31;該HBV基因型J型基因體上的一DR序列上的該參考序列可為SEQ ID NOs.32。
在一實施例中,該探針組合可包括二組以HBV局部基因體做為標的之探針。當中當每一組該以HBV局部基因體做為標的之探針依該HBV局部基因體序列之序列排列對齊時,已對齊的該些以HBV局部基因體做為標的之探針於對齊後所組成的一整體序列和HBV基因型B型的一基因體中之一DR序列的一參考序列(SEQ ID NO.9),或HBV基因型C型的一基因體中之一DR序列的一參考序列(SEQ ID NO.13)互相匹配。該些DR序列可被定義為位於第1190至第2234bp、第1231至第2190bp或其他在HBV基因體中的特別區。和前述類似的是,每一個該以HBV局部基因體做為標的之探針的一部分和相鄰的一個或二個以HBV局部基因體做為標的之探針序列的一部分相重疊。該些重疊序列的長度可為但不限於50%(即為2X重疊密度)或75%(即為4X重疊密度)。
可使用前述的公式1計算該些以HBV局部基因體中該DR序列的參考序列(SEQ ID NOs.9和13)做為標的之探針的可能數量。例如基於一長度為960bp的HBV DR序列中之參考序列,在探針序列總長為50至120bp之間的前提下,則可設計出62,196種探針。
根據本發明的一實施例,該探針組合包括一組以病毒全基因體序
列做為標的之探針和一組以病毒局部基因體做為標的之序列探針。以該病毒全基因體序列做為標的之探針和以病毒局部基因體序列做為標的之探針可合併使用,以提升該探針組合所能涵蓋的該病毒基因體中之參考序列範圍。在一實施例中,該以HBV局部基因體做為標的之探針可被設計為覆蓋該基因體中的DR序列。例如,假設該以HBV全基因體做為標的之探針的長度為120bp並起始於HBV基因體的第1、第61和第121bp(該探針重疊序列設計為2X重疊密度),該以HBV局部基因體做為標的之探針的重疊序列則設計為2X重疊密度且起始於HBV基因體的第31、第91和第151bp。亦即,該DR序列即可被二組探針所涵蓋(即上述的以HBV全基因體做為標的之探針和以HBV局部基因體做為標的之探針)且探針的重疊序列為4X重疊密度(即每一探針和其直接相鄰之探針有75%的序列重疊)。
根據本發明的一實施例,該探針組合更進一步包括一組或多組以癌症熱點基因(hotspot genes)做為標的之探針。其中當每一組該以癌症熱點基因做為標的之探針依該癌症熱點基因序列排列對齊時,已對齊的該些以癌症熱點基因做為標的之探針於對齊後所組成的一整體序列和一癌症熱點基因的一參考序列互相匹配。在該些已對齊的多組以癌症熱點基因做為標的之探針中,每一個該以癌症熱點基因做為標的之探針序列的一部分和相鄰的一個或二個以癌症熱點基因做為標的之探針序列的一部分相重疊。該些重疊序列的長度可為但不限於50%(即為2X重疊密度)或75%(即為4X重疊密度)。
該些癌症熱點基因的參考序列可由NCBI基因資料庫(www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=gene,以下並以該資料庫中的「Entrez Gene ID」表示)取得。該些癌症熱點基因可包括但不限於以下至少一種基因:ABL1(Entrez Gene ID:25)、ABL2(Entrez Gene ID:27)、ACSL3(Entrez Gene ID:2181)、AF15Q14(Entrez Gene ID:57082)、AF1Q(Entrez Gene
ID:10962)、AF3p21(Entrez Gene ID:51517)、AF5q31(Entrez Gene ID:27125)、AKAP9(Entrez Gene ID:10142)、AKT1(Entrez Gene ID:207)、AKT2(Entrez Gene ID:208)、ALDH2(Entrez Gene ID:217)、ALK(Entrez Gene ID:238)、ALO17(Entrez Gene ID:57674)、APC(Entrez Gene ID:11789)、ARHGEF12(Entrez Gene ID:23365)、ARHH(Entrez Gene ID:399)、ARID1A(Entrez Gene ID:8289)、ARID2(Entrez Gene ID:196528)、ARNT(Entrez Gene ID:405)、ASPSCR1(Entrez Gene ID:79058)、ASXL1(Entrez Gene ID:171023)、ATF1(Entrez Gene ID:466)、ATIC(Entrez Gene ID:471)、ATM(Entrez Gene ID:472)、ATRX(Entrez Gene ID:546)、BAP1(Entrez Gene ID:8314)、BCL10(Entrez Gene ID:8915)、BCL11A(Entrez Gene ID:53335)、BCL11B(Entrez Gene ID:64919)、BCL2(Entrez Gene ID:596)、BCL3(Entrez Gene ID:602)、BCL5(Entrez Gene ID:603)、BCL6(Entrez Gene ID:604)、BCL7A(Entrez Gene ID:605)、BCL9(Entrez Gene ID:607)、BCOR(Entrez Gene ID:54880)、BCR(Entrez Gene ID:613)、BHD(Entrez Gene ID:50947)、BIRC3(Entrez Gene ID:330)、BLM(Entrez Gene ID:641)、BMPRIA(Entrez Gene ID:12166)、BRAF(Entrez Gene ID:673)、BRCA1(Entrez Gene ID:672)、BRCA2(Entrez Gene ID:675)、BRD3(Entrez Gene ID:8019)、BRD4(Entrez Gene ID:23476)、BRIP1(Entrez Gene ID:83990)、BTG1(Entrez Gene ID:694)、BUB1B(Entrez Gene ID:701)、C15orf55(Entrez Gene ID:144535)、C16orf75(Entrez Gene ID:387882)、CANT1(Entrez Gene ID:124583)、CARD11(Entrez Gene ID:84433)、CARs(Entrez Gene ID:833)、CBFB(Entrez Gene ID:865)、CBL(Entrez Gene ID:867)、CBLB(Entrez Gene ID:868)、CBLC(Entrez Gene ID:23624)、CCNB1IP1
(Entrez Gene ID:57820)、CCND1(Entrez Gene ID:595)、CCND2(Entrez Gene ID:894)、CCND3(Entrez Gene ID:896)、CCNE1(Entrez Gene ID:898)、CD273(Entrez Gene ID:80380)、CD274(Entrez Gene ID:29126)、CD74(Entrez Gene ID:972)、CD79A(Entrez Gene ID:973)、CD79B(Entrez Gene ID:974)、CDH1(Entrez Gene ID:999)、CDH11(Entrez Gene ID:1009)、CDK12(Entrez Gene ID:51755)、CDK4(Entrez Gene ID:1019)、CDK6(Entrez Gene ID:1021)、CDKN2A(Entrez Gene ID:1029)、CDKN2C(Entrez Gene ID:1031)、CDX2(Entrez Gene ID:1045)、CEBPA(Entrez Gene ID:1050)、CEP1(Entrez Gene ID:11064)、CHCHD7(Entrez Gene ID:79145)、CHEK2(Entrez Gene ID:11200)、CHIC2(Entrez Gene ID:26511)、CHN1(Entrez Gene ID:1123)、CIC(Entrez Gene ID:23152)、CIITA(Entrez Gene ID:4261)、CLTC(Entrez Gene ID:1213)、CLTCL1(Entrez Gene ID:8218)、CMKOR1(Entrez Gene ID:57007)、CoL1A1(Entrez Gene ID:1277)、CPBP(Entrez Gene ID:1316)、COX6C(Entrez Gene ID:1345)、CREB1(Entrez Gene ID:1385)、CREB3L1(Entrez Gene ID:90993)、CREB3L2(Entrez Gene ID:64764)、CREBBP(Entrez Gene ID:1387)、CRLF2(Entrez Gene ID:64109)、CRTC3(Entrez Gene ID:64784)、CTNNB1(catenin beta 1;Entrez Gene ID:1499)、CYLD(Entrez Gene ID:1540)、D10S170(Entrez Gene ID:8030)、DAXX(Entrez Gene ID:1616)、DDB2(Entrez Gene ID:1643)、DDX10(Entrez Gene ID:1662)、DDX5(Entrez Gene ID:1655)、DDX6(Entrez Gene ID:1656)、DEK(Entrez Gene ID:7913)、DICER1(Entrez Gene ID:23405)、DNMT3A(Entrez Gene ID:1788)、DUX4(Entrez Gene ID:100288687)、EBF1(Entrez Gene ID:1879)、EGFR(Entrez Gene ID:1956)、
EIF4A2(Entrez Gene ID:1974)、ELF4(Entrez Gene ID:2000)、ELK4(Entrez Gene ID:2005)、ELKS(Entrez Gene ID:23085)、ELL(Entrez Gene ID:8178)、ELN(Entrez Gene ID:2006)、EML4(Entrez Gene ID:27436)、EP300(Entrez Gene ID:2033)、EPS15(Entrez Gene ID:2060)、ERBB2(Entrez Gene ID:2064)、ERCC2(Entrez Gene ID:2068)、ERCC3(Entrez Gene ID:2071)、ERCC4(Entrez Gene ID:2072)、ERCC5(Entrez Gene ID:2073)、ERG(Entrez Gene ID:2078)、ETV1(Entrez Gene ID:2115)、ETV4(Entrez Gene ID:2118)、ETV5(Entrez Gene ID:2119)、ETV6(Entrez Gene ID:2120)、EVI1(Entrez Gene ID:2122)、EWsR1(Entrez Gene ID:2130)、EXT1(Entrez Gene ID:2131)、EXT2(Entrez Gene ID:2132)、EZH2(Entrez Gene ID:2146)、FACL6(Entrez Gene ID:23305)、FAM22A(Entrez Gene ID:728118)、FAM22B(Entrez Gene ID:729262)、FAM46C(Entrez Gene ID:54855)、FANCA(Entrez Gene ID:2175)、FANCC(Entrez Gene ID:2176)、FANCD2(Entrez Gene ID:2177)、FANCE(Entrez Gene ID:2178)、FANCF(Entrez Gene ID:2188)、FANCG(Entrez Gene ID:2189)、FBXO11(Entrez Gene ID:80204)、FBXW7(Entrez Gene ID:55294)、FCGR2B(Entrez Gene ID:2213)、FEV(Entrez Gene ID:54738)、FGFR1(Entrez Gene ID:2260)、FGFRIOP(Entrez Gene ID:11116)、FGFR2(Entrez Gene ID:2263)、FGFR3(Entrez Gene ID:2261)、FH(Entrez Gene ID:2271)、FHIT(Entrez Gene ID:2272)、FIP1L1(Entrez Gene ID:81608)、FLI1(Entrez Gene ID:2313)、FLT3(Entrez Gene ID:2322)、FNBP1(Entrez Gene ID:23048)、FOXL2(Entrez Gene ID:668)、FOXO1(Entrez Gene ID:2308)、FOXO3A(Entrez Gene ID:2309)、FOXP1(Entrez Gene ID:27086)、FSTL3(Entrez Gene ID:10272)、
FUBP1(Entrez Gene ID:8880)、FUS(Entrez Gene ID:2521)、FVT1(Entrez Gene ID:2531)、GAS7(Entrez Gene ID:8522)、GATA1(Entrez Gene ID:2623)、GATA2(Entrez Gene ID:2624)、GATA3(Entrez Gene ID:2625)、GMPS(Entrez Gene ID:8833)、GNA11(Entrez Gene ID:2767)、GNAQ(Entrez Gene ID:2776)、GNAS(Entrez Gene ID:2778)、GOLGA5(Entrez Gene ID:9950)、GOPC(Entrez Gene ID:57120)、GPC3(Entrez Gene ID:2719)、GPHN(Entrez Gene ID:10243)、GRAF(Entrez Gene ID:23092)、HCMOGT-1(Entrez Gene ID:92521)、HEAB(Entrez Gene ID:10978)、HERPUD1(Entrez Gene ID:9709)、HEY1(Entrez Gene ID:23462)、HIP1(Entrez Gene ID:3092)、HIST1H4I(Entrez Gene ID:8294)、HLF(Entrez Gene ID:3131)、HLXB9(Entrez Gene ID:3110)、HMGA1(Entrez Gene ID:3159)、HMGA2(Entrez Gene ID:8091)、HNRNPA2B1(Entrez Gene ID:3181)、HOOK3(Entrez Gene ID:84376)、HOXA11(Entrez Gene ID:3207)、HOXA13(Entrez Gene ID:3209)、HOXA9(Entrez Gene ID:3205)、HOXC11(Entrez Gene ID:3227)、HOXC13(Entrez Gene ID:3229)、HOXD11(Entrez Gene ID:3237)、HOXD13(Entrez Gene ID:3239)、HRAS(Entrez Gene ID:3265)、HRPT2(Entrez Gene ID:79577)、HSPCA(Entrez Gene ID:3320)、HSPCB(Entrez Gene ID:3326)、IDH1(Entrez Gene ID:3417)、IDH2(Entrez Gene ID:3418)、IGH@(Entrez Gene ID:3492)、IGK@(Entrez Gene ID:50802)、IGL@(Entrez Gene ID:3535)、IKZF1(Entrez Gene ID:10320)、IL2(Entrez Gene ID:3558)、IL21R(Entrez Gene ID:50615)、IL6ST(Entrez Gene ID:3572)、IL7R(Entrez Gene ID:3575)、IRF4(Entrez Gene ID:3662)、IRTA1(Entrez Gene ID:83417)、ITK(Entrez Gene ID:3702)、JAK1(Entrez Gene ID:
3716)、JAK2(Entrez Gene ID:3717)、JAK3(Entrez Gene ID:3718)、JAZF1(Entrez Gene ID:221895)、JUN(Entrez Gene ID:3725)、KDR(Entrez Gene ID:3791)、KIAA1549(Entrez Gene ID:57670)、KIT(Entrez Gene ID:3815)、KLK2(Entrez Gene ID:3817)、KRAS(Entrez Gene ID:3845)、KTN1(Entrez Gene ID:3895)、LAF4(Entrez Gene ID:3899)、LASP1(Entrez Gene ID:3927)、LCK(Entrez Gene ID:3932)、LCP1(Entrez Gene ID:3936)、LCX(Entrez Gene ID:80312)、LHFP(Entrez Gene ID:10186)、LIFR(Entrez Gene ID:3977)、LMO1(Entrez Gene ID:4004)、LMO2(Entrez Gene ID:4005)、LPP(Entrez Gene ID:4026)、LYL1(Entrez Gene ID:4066)、MADH4(Entrez Gene ID:4089)、MAF(Entrez Gene ID:4094)、MAFB(Entrez Gene ID:9935)、MALT1(Entrez Gene ID:10892)、MAML2(Entrez Gene ID:84441)、MAP2K4(Entrez Gene ID:6416)、MDM2(Entrez Gene ID:4193)、MDM4(Entrez Gene ID:4194)、MDS1(Entrez Gene ID:2122)、MDS2(Entrez Gene ID:259283)、MECT1(Entrez Gene ID:23373)、MED12(Entrez Gene ID:9968)、MEN1(Entrez Gene ID:4221)、MET(Entrez Gene ID:4233)、MITF(Entrez Gene ID:4286)、MKL1(Entrez Gene ID:57591)、MLF1(Entrez Gene ID:4291)、MLH1(Entrez Gene ID:4292)、MLL(Entrez Gene ID:4297)、MLL2(Entrez Gene ID:8085)、MLL3(Entrez Gene ID:58508)、MLLT1(Entrez Gene ID:4298)、MLLT10(Entrez Gene ID:8028)、MLLT2(Entrez Gene ID:4299)、MLLT3(Entrez Gene ID:4300)、MLLT4(Entrez Gene ID:4301)、MLLT6(Entrez Gene ID:4302)、MLLT7(Entrez Gene ID:4303)、MN1(Entrez Gene ID:4330)、MPL(Entrez Gene ID:4352)、MSF(Entrez Gene ID:10801)、MSH2(Entrez Gene ID:4436)、MSH6(Entrez Gene ID:
2956)、MsI2(Entrez Gene ID:124540)、MSN(Entrez Gene ID:4478)、MTCP1(Entrez Gene ID:4515)、MUC1(Entrez Gene ID:4582)、MUTYH(Entrez Gene ID:4595)、MYB(Entrez Gene ID:4602)、MYC(Entrez Gene ID:4609)、MYCL1(Entrez Gene ID:4610)、MYCN(Entrez Gene ID:4613)、MYD88(Entrez Gene ID:4615)、MYH11(Entrez Gene ID:4629)、MYH9(Entrez Gene ID:4627)、MYST4(Entrez Gene ID:23522)、NACA(Entrez Gene ID:4666)、NBS1(Entrez Gene ID:4683)、NCOA1(Entrez Gene ID:8648)、NCOA2(Entrez Gene ID:10499)、NCOA4(Entrez Gene ID:8031)、NDRG1(Entrez Gene ID:10397)、NF1(Entrez Gene ID:4763)、NF2(Entrez Gene ID:4771)、NFE2L2(Entrez Gene ID:4780)、NFIB(Entrez Gene ID:4781)、NFKB2(Entrez Gene ID:4791)、NIN(Entrez Gene ID:51199)、NKX2-1(Entrez Gene ID:7080)、NONO(Entrez Gene ID:4841)、NOTCH1(Entrez Gene ID:4851)、NOTCH2(Entrez Gene ID:4853)、NPM1(Entrez Gene ID:4869)、NR4A3(Entrez Gene ID:8013)、NRAS(Entrez Gene ID:4893)、NSD1(Entrez Gene ID:64324)、NTRK1(Entrez Gene ID:4914)、NTRK3(Entrez Gene ID:4916)、NUMA1(Entrez Gene ID:4926)、NUP214(Entrez Gene ID:8021)、NUP98(Entrez Gene ID:4928)、OLIG2(Entrez Gene ID:10215)、OMD(Entrez Gene ID:4958)、PAFAHIB2(Entrez Gene ID:5049)、PALB2(Entrez Gene ID:79728)、PAX3(Entrez Gene ID:5077)、PAX5(Entrez Gene ID:5079)、PAX7(Entrez Gene ID:5081)、PAX8(Entrez Gene ID:7849)、PBRM1(Entrez Gene ID:55193)、PBX1(Entrez Gene ID:5087)、PCM1(Entrez Gene ID:5108)、PCSK7(Entrez Gene ID:9159)、PDE4DIP(Entrez Gene ID:9659)、PDGFB(Entrez Gene ID:5155)、PDGFRA(Entrez Gene ID:5156)、
PDGFRB(Entrez Gene ID:5159)、PER1(Entrez Gene ID:5187)、PHOX2B(Entrez Gene ID:8929)、PICALM(Entrez Gene ID:8301)、PIK3CA(Entrez Gene ID:5290)、PIK3R1(Entrez Gene ID:5295)、PIM1(Entrez Gene ID:5292)、PLAG1(Entrez Gene ID:5324)、PML(Entrez Gene ID:5371)、PMS1(Entrez Gene ID:5378)、PMS2(Entrez Gene ID:5395)、PMX1(Entrez Gene ID:5396)、PNUTL1(Entrez Gene ID:5413)、POU2AFI(Entrez Gene ID:5450)、POU5F1(Entrez Gene ID:5460)、PPARG(Entrez Gene ID:5468)、PPP2R1A(Entrez Gene ID:5518)、PRCC(Entrez Gene ID:5546)、PRDM1(Entrez Gene ID:639)、PRDM16(Entrez Gene ID:63976)、PRF1(Entrez Gene ID:5551)、PRKAR1A(Entrez Gene ID:5573)、PRO1073(Entrez Gene ID:57018)、PSIP2(Entrez Gene ID:11168)、PTCH(Entrez Gene ID:5727)、PTEN(Entrez Gene ID:5728)、PTPN11(Entrez Gene ID:5781)、RAB5EP(Entrez Gene ID:9135)、RAD51L1(Entrez Gene ID:5890)、RAF1(Entrez Gene ID:5894)、RALGDS(Entrez Gene ID:5900)、RANBP17(Entrez Gene ID:64901)、RAP1GDS1(Entrez Gene ID:5910)、RARA(Entrez Gene ID:5914)、RB1(Entrez Gene ID:5925)、RBM15(Entrez Gene ID:64783)、RECQL4(Entrez Gene ID:9401)、REL(Entrez Gene ID:5966)、RET(Entrez Gene ID:5979)、ROS1(Entrez Gene ID:6098)、RPL22(Entrez Gene ID:6146)、RPN1(Entrez Gene ID:6184)、RuNDC2A(Entrez Gene ID:92017)、RUNX1(Entrez Gene ID:861)、RUNXBP2(Entrez Gene ID:7994)、SBDS(Entrez Gene ID:51119)、SDH5(Entrez Gene ID:54949)、SDHB(Entrez Gene ID:6390)、SDHC(Entrez Gene ID:6391)、SDHD(Entrez Gene ID:6392)、SEPT6(Entrez Gene ID:23157)、SET(Entrez Gene ID:6418)、SETD2(Entrez
Gene ID:29072)、SF3B1(Entrez Gene ID:23451)、SFPQ(Entrez Gene ID:6421)、SFRS3(Entrez Gene ID:6428)、SH3GL1(Entrez Gene ID:6455)、SIL(Entrez Gene ID:6491)、SLC45A3(Entrez Gene ID:85414)、SMARCA4(Entrez Gene ID:6597)、SMARCB1(Entrez Gene ID:6598)、SMO(Entrez Gene ID:6608)、SOCS1(Entrez Gene ID:8651)、SOX2(Entrez Gene ID:6657)、SRGAP3(Entrez Gene ID:9901)、SRSF2(Entrez Gene ID:6427)、SS18L1(Entrez Gene ID:26039)、SSH3BP1(Entrez Gene ID:10006)、SSX1(Entrez Gene ID:6756)、SSX2(Entrez Gene ID:6757)、SSX4(Entrez Gene ID:6759)、STK11(Entrez Gene ID:6794)、STL(Entrez Gene ID:7955)、SUFU(Entrez Gene ID:51684)、SUZ12(Entrez Gene ID:23512)、SYK(Entrez Gene ID:6850)、TAF15(Entrez Gene ID:8148)、TAL1(Entrez Gene ID:6886)、TAL2(Entrez Gene ID:6887)、TCEA1(Entrez Gene ID:6917)、TCF1(Entrez Gene ID:6927)、TCF12(Entrez Gene ID:6938)、TCF3(Entrez Gene ID:6929)、TCF7L2(Entrez Gene ID:6934)、TCL1A(Entrez Gene ID:8115)、TCL6(Entrez Gene ID:27004)、TET2(Entrez Gene ID:54790)、TERT(telomerase reverse transcriptase;Entrez Gene ID:7015)、TFE3(Entrez Gene ID:7030)、TFEB(Entrez Gene ID:7942)、TFG(Entrez Gene ID:10342)、TFPT(Entrez Gene ID:29844)、TFRC(Entrez Gene ID:7037)、THRAP3(Entrez Gene ID:9967)、TIF1(Entrez Gene ID:8805)、TLX1(Entrez Gene ID:3195)、TLX3(Entrez Gene ID:30012)、TMPRSS2(Entrez Gene ID:7113)、TNFAIP3(Entrez Gene ID:7128)、TNFRSF14(Entrez Gene ID:8764)、TNFRSF17(Entrez Gene ID:608)、TNFRSF6(Entrez Gene ID:355)、TOP1(Entrez Gene ID:7150)、TP53(tumor protein p53;Entrez Gene ID:7157)、
TPM3(Entrez Gene ID:7170)、TPM4(Entrez Gene ID:7171)、TPR(Entrez Gene ID:7175)、TRA@(Entrez Gene ID:6955)、TRB@(Entrez Gene ID:6957)、TRD@(Entrez Gene ID:6964)、TRIM27(Entrez Gene ID:5987)、TRIM33(Entrez Gene ID:51592)、TRIP11(Entrez Gene ID:9321)、TSC1(Entrez Gene ID:7248)、TSC2(Entrez Gene ID:7249)、TSHR(Entrez Gene ID:7253)、TTL(Entrez Gene ID:150465)、U2AF1(Entrez Gene ID:7307)、USP6(Entrez Gene ID:9098)、VHL(Entrez Gene ID:7428)、WAS(Entrez Gene ID:7454)、WHSC1(Entrez Gene ID:7468)、WHSC1L1(Entrez Gene ID:54904)、WIF1(Entrez Gene ID:11197)、WRN(Entrez Gene ID:7486)、WT1(Entrez Gene ID:7490)、WTX(Entrez Gene ID:139285)、XPA(Entrez Gene ID:7507)、XPC(Entrez Gene ID:7508)、XPO1(Entrez Gene ID:7514)、YWHAE(Entrez Gene ID:7531)、ZNF145(Entrez Gene ID:7704)、ZNF198(Entrez Gene ID:7750)、ZNF278(Entrez Gene ID:23598)、ZNF331(Entrez Gene ID:55422)、ZNF384(Entrez Gene ID:171017)、ZNF521(Entrez Gene ID:25925)、ZNF9(Entrez Gene ID:7555)、and ZRSR2(Entrez Gene ID:8233)。
在該實施例中,考慮到該些癌症熱點基因之該參考序列的終端區域(terminal regions;即起始的60bp和最後的60bp)僅會被一探針所涵蓋,相比之下該參考序列的非終端區域在探針重疊序列為2X重疊密度的前提下則會被二個探針所涵蓋,如此該僅被一探針涵蓋之終端區域的捕捉效率將較低。該癌症熱點基因的參考序列可以延展超過該參考序列的兩端,例如:CTNNB1基因的外顯子3(exon 3)之長度為228bp,若從兩端延展75bp則會得到一條378bp長的CTNNB1基因外顯子3參考序列(SEQ ID NO.33)。其他癌症熱點基因的參考序列
也可以類似方式設計。另外,若一外顯子延展出之序列和一相鄰外顯子延展出之序列重疊,該二條經延展的參考序列也可彙整為一條能涵蓋所有外顯子和所有延展序列的單一條參考序列。
該以癌症熱點基因做為標的之探針的可能數量可使用前述的公式1進行計算。例如針對一條長度為378bp的CTNNB1外顯子3(exon 3)參考序列(SEQ ID NO.33),在探針序列長度介於50至120bp之間的前提下,總共可有20,874種探針設計。同樣的,針對一條長度為673bp的TERT啟動子(promoter)之參考序列(SEQ ID NO.34),在探針序列長度介於50至120bp之間的前提下,總共可有41,819種探針設計。針對一條長度為779bp的TP53外顯子2/3/4(exons 2/3/4)之參考序列(SEQ ID NO.35),在探針序列長度介於50至120bp之間的前提下,總共可有49,345種探針設計。針對一條長度為528bp的TP53外顯子5/6(exon 5/6)之參考序列(SEQ ID NO.36),在探針序列長度介於50至120bp之間的前提下,總共可有31,524種探針設計。針對一條長度為260bp的TP53外顯子7(exon 7)之參考序列(SEQ ID NO.37),在探針序列長度介於50至120bp之間的前提下,總共可有12,496種探針設計。針對一條長度為453bp的TP53外顯子8/9(exon 8)之參考序列(SEQ ID NO.39),在探針序列長度介於50至120bp之間的前提下,總共可有26,199種探針設計。針對一條長度為257bp的TP53外顯子10(exon 10)之參考序列(SEQ ID NO.40),在探針序列長度介於50至120bp之間的前提下,總共可有12,283種探針設計。針對一條長度為232bp的TP53外顯子11(exon 11)之參考序列(SEQ ID NO.41),在探針序列長度介於50至120bp之間的前提下,總共可有10,508種探針設計。
根據本發明的一實施例,該探針組合更進一步包括一組或多組以外源性基因(exogenous gene)做為標的之探針,以做為定量和陰性對照組之用。當每一組該以外源性基因做為標的之探針依該外源性基因序列排列對齊時,已
對齊的該些以外源性基因做為標的之探針於對齊後所組成的一整體序列和一外源性基因的一參考序列互相匹配。在該些已對齊的多組以外源性基因做為標的之探針中,每一個該以外源性基因做為標的之探針序列的一部分和相鄰的一個或二個以外源性基因做為標的之探針序列的一部分相重疊。該些重疊序列的長度可為但不限於50%(即為2X重疊密度)或75%(即為4X重疊密度)。
該些外源性基因的參考序列可由NCBI基因資料庫中取得。該外源性基因可源自λ噬菌體(lambda phage)、大腸桿菌(E.coli)、酵母菌、φX174病毒或其他常見微生物。該以外源性基因做為標的之探針的可能數量可使用前述的公式1進行計算。例如針對長度為48,502bp的λ噬菌體基因體之參考序列(GenBank Accession No.NC_001416),在探針序列長度介於50至120bp之間的前提下,總共可有478,682種探針設計。
該實施例將需要額外加入一來自外部之核苷酸片段(如spike-in DNA)且其序列需相對應於該以外源性基因做為標的之探針。亦即,無論在受HBV感染或罹患肝細胞癌的情況下,人類基因體都不會含有類似於該以外源性基因做為標的之探針的序列,所以若在以該實施例偵測癌症的過程之中沒有額外加入與該以外源性基因做為標的之探針相對應的核苷酸片段,則該以外源性基因做為標的之探針理論上無法於基因體DNA或循環系統中的腫瘤DNA之中捕捉到任何核苷酸片段。另一方面,因為理論上能被該以外源性基因做為標的之探針所捕捉的所有核苷酸片段都是額外加入的核苷酸片段,在該實施例偵測癌症的過程中也可以另外加入核苷酸片段,更可以調整該另外加入的核苷酸片段的數量或性質,以確保絕對定量之結果可靠。
在一實施例中,可挑選4個120bp長且位於λ噬菌體基因體中的序列,以設計以λ噬菌體基因體做為標的之探針。挑選的標準包括:a)所選擇的序列和人類基因體或HBV基因體沒有同源性(homology);b)所選擇的序列在
整個λ噬菌體基因體中是獨特的序列;c)所選擇的序列的GC鹼基含量在一定範圍之內;d)不是長的單體鹼基(monomer)序列,例如:AAAAA;和/或e)在primer 3、netprimer或其他引子設計演算法的推算結果中,其DNA序列不容易形成二級結構。如表1所示,該些以HBV全基因體做為標的之探針、該些以HBV局部基因體做為標的之探針、該些以熱點基因做為標的之探針,和該些以外源性基因做為標的之探針之組合可用於捕捉特定HBV DNA片段,無論該特定HBV DNA片段是否具備病毒-宿主嵌合點。
在表2所示的另一實施例中,可以設計額外的以λ噬菌體做為標的之探針組,以涵蓋由前述的4個120bp區域(SEQ ID NOs.46-49)之下游所延展出的序列,並且該些探針具有2X或4X重疊密度.另外,以λ噬菌體做為標的之探針組(或探針套數)也可用於模擬2套(2N)以HBV做為標的之探針(其中一套探針之標的為基因型B型,另一套探針之標的為基因型C型)和1套(1N)以熱點基因做為標的之探針組,因此可產生一組2X/1N、2X/2N、4X/1N和4X/2N的以λ噬菌體之基因體所延展出的序列做為標的之探針組。
另外,目前已知序列中的GC鹼基會影響定序所涵蓋的範圍,約在GC鹼基比率低(GC=0.3,定序涵蓋範圍=0.6X)的樣本、GC鹼基比率最佳(GC=0.48,定序涵蓋範圍=1.3X)的樣本和GC鹼基比率高(GC=0.7,定序涵蓋範圍=0.4X)的樣本之中造成定序涵蓋範圍約3倍的不同。因此,如表2所述,額外的以λ噬菌體做為標的之探針組也可設計做為探針中GC鹼基的內部控制機制。在λ噬菌體基因體中5個120對鹼基長的序列(SED ID NOs.50-54)是依照下列的標準而被選擇做為參考序列:a)所選擇的序列和人類基因體或HBV基因體沒有同源性;b)所選擇的序列在整個λ噬菌體中是獨特的序列;c)所選擇的序列的GC鹼基含量在一定範圍之內;d)不是長的單體鹼基序列,例如:AAAAA;和/或e)在primer 3、netprimer或其他引子設計演算法的推測結果中,其DNA序列不容易形成二級結構。此5個長度為120bp、GC鹼基含量分別為0.3、0.4、0.5、0.6和0.68的區域被選定為參考序列,用以設計5組額外的以λ噬菌體做為標的之探針
(1X/1N)。
根據本發明的一實施例,該探針組合更進一步包括一組或多組以內源性基因(endogenous gene)做為標的之探針,以做為相對定量和陽性對照組之用。當每一組該以內源性基因做為標的之探針依該內源性基因序列排列對齊時,已對齊的該些以內源性基因做為標的之探針於對齊後所組成的一整體序列和一內源性基因的一參考序列互相匹配。在該些已對齊的多組以內源性基因做為標的之探針中,每一個該以內源性基因做為標的之探針序列的一部分和相鄰的一個或二個以內源性基因做為標的之探針序列的一部分相重疊。該些重疊序列的長度可為但不限於50%(即為2X重疊密度)或75%(即為4X重疊密度)。
該些內源性基因的參考序列可由NCBI基因資料庫中取得。在該實施例中,該內源性基因源於人類基因體內,且可由NCBI基因資料庫(www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=gene,以下並以該資料庫中的「Entrez Gene ID」表示)取得。該些內源性基因可包括但不限於以下至少一種基因:GAPDH(glyceraldehyde-3-phosphate dehydrogenase;Entrez Gene ID:2597)、UBL4A(ubiquitin like 4A;GdX;Entrez Gene ID:8266)、HPRT1(Entrez Gene ID:3251)、TBP(Entrez Gene ID:6908)、B2M(Entrez Gene ID:567)、RPL13A(Entrez Gene ID:23521)、RN18S1(Entrez Gene ID:100008588)、C1orf43(Entrez Gene ID:25912)、CHMP2A(Entrez Gene ID:27243)、EMC7(Entrez Gene ID:56851)、GPI(Entrez Gene ID:2821)、PSMB2(Entrez Gene ID:5690)、PSMB4(Entrez Gene ID:5692)、RAB7A(Entrez Gene ID:7879)、REEP5(Entrez Gene ID:7905)、SNRPD3(Entrez Gene ID:6634)、VCP(Entrez Gene ID:7415)、VPS29(Entrez Gene ID:51699)、ACTB(Entrez Gene ID:60)、PPIA(Entrez Gene ID:5478)、GUSB(Entrez Gene ID:2990)、HSP90AB1(Entrez Gene ID:3326)、RPLP0(Entrez Gene ID:6175)
、TFRC(Entrez Gene ID:7037)、UBC(Entrez Gene ID:7316)。
該以內源性基因做為標的之探針的可能數量可使用前述的公式1進行計算。例如針對長度為1,682bp的GAPDH基因之參考序列,在探針序列長度介於50至120bp之間的前提下,總共可有113,458種探針設計。同樣的,針對長度為3,583bp的GdX基因之參考序列,在探針序列長度介於50至120bp之間的前提下,總共可有248,429種探針設計。
在該實施例中,該些內源性基因是用來增加偵測序列之可靠度;也就是說,該些內源性基因可以做為穩定表現且在腫瘤中表現量不會變化的一般性持家基因(housekeeping gene)。由於癌症熱點基因的結構變異;如CTNNB、TP53、TERT和其他前述與癌症有關之基因已被發現出現在腫瘤樣本中,且上述與癌症有關之基因的套數(copy number)在腫瘤形成(tumorgenesis)之中可能由於基因缺失(deletion)、複製(duplication)或其他結構上的變異而有所改變,因此僅根據癌症熱點基因進行定量可能並不可靠。在表2所述的實施例中有二組探針被納入探針組合中作為內部控制組:一組以GAPDH基因(SEQ ID NO.55)上240bp長的區域做為標的、重疊密度為2X之探針和一組以GdX基因(SEQ ID NO.56)上240bp長的區域做為標的、重疊密度為2X之探針。此二個240bp長、分別位於GdX基因和GAPDH基因上的標的序列皆不具備以下特徵:和HBV基因體之同源性、長的單體鹼基序列、明顯的DNA二級結構或超出一定範圍的GC鹼基含量。使用GdX基因做為參考序列的另一優點是,GdX基因也可以用來辨識檢測對象的性別。
在本發明的部分實施例中,每一個該些探針都以一標記分子標記之,以做為偵測和定量之用。該些標記分子可包括但不限於:生物素(biotin)、螢光蛋白(fluorescent protein)、冷光蛋白(luminescent protein)、抗體、放射性化合物或其組合。
本發明的另一方面也提供了一偵測DNA病毒感染(如:HBV、人類乳突病毒、艾司坦-巴爾病毒、第8型疱疹病毒、人類嗜T淋巴球病毒、Merkel氏多瘤病毒或其他DNA病毒)或偵測和病毒感染有關的癌症(如:肝細胞肝癌、子宮頸癌、鼻咽癌、淋巴癌、Merkel氏細胞癌或其他和DNA病毒感染有關之癌症)之方法。在一實施例中,該方法包括以下步驟:由一對象的一樣本萃取核酸;增幅該核酸;將該核酸和各實施例中所提及之該探針組合進行雜交以捕捉標的核酸片段;定序該些被捕獲之標的核酸片段;且分析該些被捕獲之標的核酸片段。
在該實施例中,該核酸可包括病毒核酸、宿主的基因體核酸和具有病毒-宿主嵌合點的核酸,且可為DNA、RNA或其他聚核苷酸(polynucleotides)。萃取該些核酸的方法可為沈澱法、色層分析法(chromatography)和/或磁珠捕捉分析法。該用來萃取核酸的樣本可為生物性液體(如:血液、汗液、唾液、淚液、尿液、淋巴液或組織間液(interstitial fluid))或組織(如:肝組織)。可使用DNA選殖(DNA cloning)、聚合酶鏈鎖反應(polymerase chain reaction;PCR)、反轉錄酶-聚合酶連鎖反應(reverse transcription PCR;RT-PCR)、巢式PCR(nested-PCR)、定量PCR(qPCR)和/或數位式PCR(digital PCR)增幅該些被萃取出的核酸。該標的核酸片段可被該探針組合以雜交的方式捕捉(如:南方墨點轉漬(Southern blot)雜交法、原位雜交法(in-situ hybridization)或北方墨點轉漬(Northern blog)雜交法)和/或被鎖定在特定位置(如:和微粒有關的捕捉法或和晶片有關的捕捉法)。該被捕捉的標的核酸片段以次世代定序技術執行定序(如:大量平行定序(massively parallel sequencing)、單分子定序(single molecule sequencing)或NanoString定序)、馬克薩姆-吉爾伯特定序法(Maxam-Gilbert sequencing)、桑格氏定序法(Sanger seuqencing)、焦磷酸根定序法(pyrosequencing)和/或DNA微陣列(DNA microarray)。
在另一實施例中,該增幅步驟和該雜交步驟可互相調換。即根據本發明之另一實施例的方法包括以下步驟:由一對象的一樣本萃取核酸;將該核酸和各實施例中所提及之該探針組合進行雜交以捕捉標的核酸片段;增幅該核酸;定序該些標的核酸片段;且分析該些標的核酸片段。
分析和定量被該探針組合標的核酸可依以下方式執行:原始讀值(Raw reads;RR)直接由該次世代定序儀器所產生。該些原始讀值中的低品質讀值被排除以取得高品質讀值(high quality reads;HQR)。該些高品質讀值再壓縮為特別讀值(unique reads;UR);換句話說,具有一模一樣序列的高品質讀值被壓縮為一單一特別讀值,同時和其套數或冗餘性(redundancy)有關的資訊也被保留下來。最後,該些具有低冗餘性的特別讀值進一步被排除,保留下高冗餘性特別讀值(high redundancy unique reads;HRUR)。再利用壓縮時被保留下來的冗餘性資訊,可再計算出高冗餘性特別讀值之讀值總數(RiHRUR)。
在一實施例中,該用來分析該次世代定序數據的生物資訊分析方法彙總於表3中。
表3同時也比較該較佳實施例中的方法和Zhao所提到的方法。如表3中所示,兩者之間主要不同處包括:Zhao合併位置相近的嵌合點,而本實施例的方法則是基於序列之間的相似度而合併嵌合點。同時,Zhao會移除重複計算的讀值,且僅考慮特別嵌合點(unique junction);而本實施例的方法則是排除冗餘性小於5的讀值,保留冗餘性資訊,且對嵌合點的定量是基於單一特別嵌合點的總數。
驗證探針的特異性
基於本發明之一實施例,設計以TP53外顯子2-11(SEQ ID NOs 35-38,40-41)做為標的之探針,該探針和一肝細胞癌病人的肝細胞腫瘤基因體DNA、非腫瘤基因體DNA和循環系統中的腫瘤DNA進行雜交,且該雜交結果以定量PCR進行定量。在脊椎動物中普遍存在且在肝中表現量高的Micro RNA miR-122也被定量以做為陰性對照組。
如上表4中所述,在三種不同樣本中,TP53較miR-122具有顯著較高的雜交後留存率,這代表以TP53做為標的的探針和TP53成功雜交、捕捉且回收。相反地,miR-122因為缺乏與TP53標的探針的特異性,所以會被洗去。表4同時也顯示了在基因體DNA中被以TP53做為標的的探針所捕捉之TP53的量為miR-122量的250倍,且由循環系統中的腫瘤DNA捕捉的TP53的量為miR-122量的10倍。上述結果顯示了以TP53做為標的的探針具有序列特異性且能夠選擇性地在DNA樣本中捕捉TP53基因片段。
同時,如表5中所示,以表1中所列出的探針增幅共26組肝細胞腫瘤基因體DNA樣本,且以次世代定序技術執行定序以分析HBV基因體、HBV-人之嵌合點(以下以「嵌合點」表示)和癌症熱點基因(包括CTNNB1、TERT和TP53)是否存在。該HBV-人之嵌合點代表著HBV嵌入人類基因體。表5中的該宿主基因體序列比率(host genome ratio)為被捕捉到之序列和人類基因體之序列的序列長度比率。如表5中所示,該宿主基因體序列長度比率和該已觀測的次世代定序讀值比率在樣本之間有顯著的不同,此代表著該HBV基因體、癌症熱點基因和HBV-人嵌合點皆被該探針組合成功地增幅。
由於單一的嵌合點估計會有150bp長的偵測範圍,因而可估算宿主基因體中的嵌合點長度(junction length)為3kb。因此,單一嵌入事件會形成
二個嵌合點,可以300bp長的嵌合點區(junction region)表示之。若大致估計每一位病人有10個可偵測的嵌合點,則一位個別病人的估計嵌合點長度則應在3kb(即300bp x 10)。該嵌入的HBV長度(排除未嵌入的自由態HBV)就可被估計為32.15kb(即為3,215kb x 10)。此處所述之在人類基因體中該嵌合點和該HBV的比率,為非常粗略且高估的估計值,因此可能會造成低估該嵌合點和該HBV之增幅效率。
如圖3所示,基於本發明之一實施例,以嵌合點做為標的的探針能夠選擇性地捕捉具有特定病毒-宿主嵌合點的DNA片段。三位肝細胞癌病人(由「pt3」、「pt11」和「pt15」表示)由腫瘤中取得之肝細胞癌的基因體DNA樣本(以「T」表示)和由非腫瘤組織取得之DNA樣本(以「N」表示)皆和探針1(以「pt3 junction」表示)及探針2(以「pt11 junction」表示)進行雜交。該探針1和該探針2皆分別根據pt3和pt11中之HBV-人嵌合點之序列而進行設計。圖3中的聚合酶鏈鎖反應(Polymerase Chain Reaction)實驗結果代表該探針1選擇性地和pt3之腫瘤基因體DNA雜交且該探針2選擇性地和pt11之腫瘤基因體DNA雜交。「NTC」代表「無樣本對照組」且做為此實驗之陰性對照組,而「PBGD」(即紫質膽素原去胺酶基因(porphobilinogen deaminase gene))和miR-122做為陽性對照組。
見圖4A和圖4B,該探針1(以「pt3 junction」表示)被用來偵測在病人pt3的基因體DNA和血清DNA中是否存在HBV-人嵌合點。如圖4A所示,可觀察到一病人pt3特有的HBV-人嵌合點存在於病人pt3的腫瘤基因體DNA、術前血清DNA(pre-OP serum DNA)和術後血清DNA(post-OP serum DNA)之中。上述病人pt3特有的嵌合點並沒有在病人pt11和非肝細胞癌但為HBV陽性病人(non-HCC HBV positive,以「Normal」表示)之樣本中被觀察到。同樣地,如圖4B中所示,當探針2(以「pt11 junction」表示)被用來偵測在病人pt11的基因體DNA和
血清DNA中是否存在HBV-人嵌合點,一病人pt11特有的HBV-人嵌合點存在於病人pt11的腫瘤基因體DNA、術前血清DNA和術後血清DNA之中。上述病人pt11特有的嵌合點並沒有在病人pt15和非肝細胞癌但為HBV陽性病人(以「Normal」表示)之樣本中被觀察到。
確認探針之捕捉效率
表2中的該探針組合被用來分析一對腫瘤基因體DNA和血漿內循環系統中的腫瘤DNA(plasma ctDNA)樣本(上述DNA樣本皆由同一位肝細胞癌病人取得),以決定該探針組合在不同種樣本中的捕捉效率。如表6中次世代定序統計資訊所示,腫瘤基因體DNA的讀值在HBV全基因體、HBV局部基因體和HBV-人嵌合點中,高於血漿內循環系統中的腫瘤DNA;該探針組合在腫瘤基因體DNA樣本中展現出高捕捉效率。另外、在腫瘤基因體DNA中被辨識之10個嵌合點中的8個嵌合點具有顯著且大量的讀值(>947),這代表了嵌合點取得率(junction recovery rate)為75%。
圖5A和圖5B為熱點圖轉換成的直方圖,該直方圖顯示了被次世代定序技術預測到且被探針捕捉到之讀值的比率。同時,圖6顯示了以同樣的該探針組合(表2中的探針組合)與另一肝細胞癌病人之腫瘤基因體DNA樣本雜交並執行次世代定序分析之分析結果。
請見圖7,該探針組合除了有偵測HBV DNA和HBV嵌入人基因體的功能外,本發明中的該探針組合也能夠偵測和基因突變有關的癌症。如圖8中所示,由次世代定序技術分析被基因型B型之HBV感染的男性和女性肝細胞癌病
人之DNA樣本,可得到在不同病人中有不同類型的HBV-人嵌合點,且不同的嵌合點也具有不同的讀值:在TERT和MLL4區中具有特別的嵌合點(以「TERT/MLL4 integration」表示),且有數個已知的癌症熱點突變位於CTNNB1基因的外顯子3之TERT啟動子中(以「TERT/CTNNB1 mutations」表示)。
優點與益處
根據本發明中的實施例所提出之該探針組合和分析方法較先前技藝展現了明顯更佳的敏感度和效率。如表7所示,和Li等人之分析法的比較中,可以得到被本發明中之較佳實施例的該探針組合捕捉到的該核酸片段具有顯著較高HBV比率、較高的嵌合點讀值和較低的人類基因體讀值。
另外,根據本揭露中的實施例之生物資訊分析方法,分析先前Zhao的次世代定序結果,也可以得知Zhao的分析結果中有97.5%的讀值來自於人類基因體,僅有1.49%來自於HBV基因體,1.43%來自於局部HBV基因體和1%來自於嵌合點,再次證明了目前已知的捕捉HBV之探針在增幅HBV片段和HBV-嵌合點上的效率並不好。再者,Zhao的研究中僅提及辨識出157個嵌合點,然而以本發明實施例中所使用的之生物資訊分析方法,分析與Zhao研究中相同一組次世代定序原始資料,則可揭露出469個嵌合點。其中,將近80%由Zhao所揭露的嵌合點亦出現在這469個嵌合點中。這些結果展現出本發明中的實施例之生物資
訊分析方法在偵測病毒嵌入事件中具高敏感度,且較先前技藝能夠辨識顯著地較多的病毒-宿主嵌合點。
再者,和Jiang和Sung所提出的直接定序法相比,本發明中的實施例所提出的該探針組合和分析方法僅在典型的次世代定序結果中產生5百萬個150bp長之讀值(較Jiang的分析結果少了80%讀值,或少了60%總核酸量);然而本發明之實施例仍能夠在5百萬個讀值之中辨識出307,101個HBV讀值和69,198個嵌合點讀值。上述結果展現了本發明中的實施例不僅對病毒嵌入事件敏感且效率高。
本發明的諸多前述實施例提供了一有力且多功能的分析工具,以偵測病毒感染和病毒感染所引起之癌症。本發明中的實施例可用來偵測各種不同DNA病毒和病毒嵌入事件。該根據實施例所設計的探針組合可確保最適病毒/宿主序列涵蓋率,且也考慮到基因穩定性,並因此而展現了高敏感度、效率和可靠度。
綜上所述,本發明符合發明專利要件,爰依法提出專利申請。惟,以上所述者僅為本發明之較佳實施例,本發明之範圍並不以上述實施例為限,舉凡熟習本案技藝之人士爰依本創作之精神所作之等效修飾或變化,皆應涵蓋於以下申請專利範圍內。
<110> 泰宗生物科技股份有限公司
<120> 偵測癌症之探針組合
<150> US 62/456,087
<151> 2017-02-07
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Claims (14)
- 一種用於偵測癌症的探針組合,包括:一組或多組以HBV局部基因體做為標的之探針,一組或多組以HBV全基因體做為標的之探針,其中,當每一組該以HBV局部基因體做為標的之探針依該HBV局部基因體序列排列對齊時,已對齊的該些以HBV局部基因體做為標的之探針於對齊後所組成的一整體序列和一種HBV基因型的一基因體中之一DR序列(direct repeat region)的一參考序列互相匹配,該DR序列的該參考序列是SEQ ID NOs.3-32其中之一;當每一組該以HBV全基因體做為標的之探針依該HBV全基因體序列排列對齊時,已對齊的該些以HBV全基因體做為標的之探針於對齊後所組成的一整體序列和該種HBV基因型的該基因體互相匹配;在該些已對齊的多組以HBV局部基因體做為標的之探針中,每一個該以HBV局部基因體做為標的之探針序列的一部分和相鄰的一個或二個以HBV局部基因體做為標的之探針序列的一部分相重疊;在該些已對齊的多組以HBV全基因體做為標的之探針中,每一個該以HBV全基因體做為標的之探針序列的一部分和相鄰的一個或二個以HBV全基因體做為標的之探針序列的一部分相重疊;且該癌症為肝細胞癌。
- 如請求項1所述之探針組合,其中該HBV基因型為基因型A型、基因型B型、基因型C型、基因型D型、基因型E型、基因型F型、基因型G型、基因型H型、基因型I型或基因型J型。
- 如請求項1所述之探針組合,更進一步包括:一組或多組以癌症熱點基因做為標的之探針,其中當每一組該以癌症熱點基因做為標的之探針依該癌症熱點基因序列排列對齊時,已對齊的該些以癌症熱點基因做為標的之探針於對齊後所組成的一整體序列和一癌症熱點基因的一參考序列互相匹配,且在該些已對齊的多組以癌症熱點基因做為標的之探針中,每一個該以癌症熱點基因做為標的之探針序列的一部分和相鄰的一個或二個以癌 症熱點基因做為標的之探針序列的一部分相重疊;其中該癌熱點基因的該參考序列是該癌熱點基因的外顯子或啟動子。
- 如請求項3所述之探針組合,其中該癌症熱點基因為CTNNB1、TERT或TP53。
- 如請求項3所述之探針組合,其中該癌症熱點基因之該參考序列是SEQ ID NOs.33-41其中之一。
- 如請求項3所述之探針組合,更進一步包括:一組或多組以外源性基因做為標的之探針,其中當該每一組以外源性基因做為標的之探針依該外源性基因序列排列對齊時,已對齊的該些以外源性基因做為標的之探針於對齊後所組成的一整體序列和一外源性基因的一參考序列互相匹配,且在該些已對齊的多組以外源性基因做為標的之探針中,每一個該以外源性基因做為標的之探針序列的一部分和相鄰的一個或二個以外源性基因做為標的之探針序列的一部分相重疊;其中該外源基因的該参考序列满足以下要求a)~e):a1)與人類基因體或HBV基因體缺乏同源性;b)在該外源基因基因體中是獨特的序列;c)序列中的GC鹼基含量為0.3~0.7;d)沒有5個以上相同鹼基排列的序列;e)沒有根據引子設計演算法預測的二級結構。
- 如請求項6所述之探針組合,其中該外源性基因源自於一λ噬菌體。
- 如請求項6所述之探針組合,其中該外源性基因的該參考序列是SEQ ID NOs.42-54其中之一。
- 如請求項6所述之探針組合,更進一步包括:一組或多組以內源性基因做為標的之探針,其中當該每一組以內源性基因做為標的之探針依該內源性基因序列排列對齊時,已對齊的該些以內源性基因做為標的之探針於對齊後所組成的一整體序列和一內源性基因的一參考序列互相匹配,且 在該些已對齊的多組以內源性基因做為標的之探針中,每一個該以內源性基因做為標的之探針序列的一部分和相鄰的一個或二個以內源性基因做為標的之探針序列的一部分相重疊;其中該內源基因的該参考序列满足如下f)~h)的要求:f)與HBV基因體缺乏同源性;g)沒有5個以上相同鹼基排列的序列;h)沒有由引子設計演算法預測的二級結構。
- 如請求項9所述之探針組合,其中該內源性基因為GAPDH或GdX。
- 如請求項9所述之探針組合,其中該內源性基因的該參考序列為SEQ ID NO.55或SEQ ID NO.56。
- 如請求項1所述之探針組合,該探針組合是用於捕捉具有病毒-宿主嵌合點的標的核酸片段,該標的核酸片段是由一感染HBV的對象的一樣本中之DNA所取得。
- 如請求項12所述之探針組合,其中該DNA為宿主的基因體DNA或循環系統中的腫瘤DNA。
- 如請求項12所述之探針組合,其中該樣本為生物性液體或肝組織。
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ES2961464T3 (es) | 2024-03-12 |
JP6799175B2 (ja) | 2020-12-09 |
CN110573628B (zh) | 2023-12-22 |
WO2018145627A1 (en) | 2018-08-16 |
TW201833332A (zh) | 2018-09-16 |
JP2020503067A (ja) | 2020-01-30 |
KR20190114989A (ko) | 2019-10-10 |
KR102327119B1 (ko) | 2021-11-16 |
EP3580353A1 (en) | 2019-12-18 |
US20180223380A1 (en) | 2018-08-09 |
EP3580353A4 (en) | 2020-03-04 |
SG11201907220UA (en) | 2019-09-27 |
EP3580353B1 (en) | 2023-09-13 |
CN110573628A (zh) | 2019-12-13 |
US11319602B2 (en) | 2022-05-03 |
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