WO2013172105A1 - 膵臓癌を検出するためのマーカー - Google Patents
膵臓癌を検出するためのマーカー Download PDFInfo
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- WO2013172105A1 WO2013172105A1 PCT/JP2013/059867 JP2013059867W WO2013172105A1 WO 2013172105 A1 WO2013172105 A1 WO 2013172105A1 JP 2013059867 W JP2013059867 W JP 2013059867W WO 2013172105 A1 WO2013172105 A1 WO 2013172105A1
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- pancreatic cancer
- c4bpa
- pigr
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- G—PHYSICS
- G01—MEASURING; TESTING
- G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
- G01N33/00—Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
- G01N33/48—Biological material, e.g. blood, urine; Haemocytometers
- G01N33/50—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
- G01N33/53—Immunoassay; Biospecific binding assay; Materials therefor
- G01N33/574—Immunoassay; Biospecific binding assay; Materials therefor for cancer
- G01N33/57407—Specifically defined cancers
- G01N33/57438—Specifically defined cancers of liver, pancreas or kidney
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- G—PHYSICS
- G01—MEASURING; TESTING
- G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
- G01N33/00—Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
- G01N33/48—Biological material, e.g. blood, urine; Haemocytometers
- G01N33/50—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
- G01N33/68—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving proteins, peptides or amino acids
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- C—CHEMISTRY; METALLURGY
- C07—ORGANIC CHEMISTRY
- C07K—PEPTIDES
- C07K14/00—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
- C07K14/435—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
- C07K14/46—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans from vertebrates
- C07K14/47—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans from vertebrates from mammals
- C07K14/4701—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans from vertebrates from mammals not used
- C07K14/4748—Tumour specific antigens; Tumour rejection antigen precursors [TRAP], e.g. MAGE
Definitions
- the present invention relates to a marker for detecting pancreatic cancer. More specifically, the present invention relates to a marker for detecting pancreatic cancer in distinction from chronic pancreatitis or healthy subjects, a method for measuring a specific glycoprotein to detect pancreatic cancer, and a method for detecting pancreatic cancer.
- the present invention relates to the use of a specific glycoprotein as a marker for detecting pancreatic cancer, a reagent kit for detecting pancreatic cancer, and the like.
- pancreatic cancer Malignant tumors in the hepatobiliary pancreatic region, especially pancreatic cancer, are known to have the poorest prognosis among gastrointestinal cancers, and the main reason is that they are already advanced cancers when diagnosed because they tend to infiltrate and metastasize to surrounding organs. The resection rate is low, and more effective adjuvant therapy has not been established. Therefore, there is an urgent need to identify a specific diagnostic marker for pancreatic cancer in order to improve the efficiency of surgical excision, which can be expected to be completely cured, and to develop molecular targeted therapeutics targeting that protein, Furthermore, it is important to improve treatment results by performing individualized treatment in order to obtain a higher therapeutic effect.
- CA19-9 is known as a pancreatic cancer marker (Non-patent Document 1).
- pancreatic cancer marker It has also been proposed to use the fucosylated sugar chain of human haptoglobin as a pancreatic cancer marker (Patent Document 1). However, these markers are not necessarily sufficient in terms of sensitivity and specificity, and further development of new pancreatic cancer markers is required.
- an object of the present invention is to provide a marker for detecting pancreatic cancer, particularly a marker for detecting pancreatic cancer in distinction from chronic pancreatitis or healthy individuals. Furthermore, the present invention provides a method for measuring a specific protein in order to detect pancreatic cancer, and a method for detecting pancreatic cancer.
- pancreatic cancer marker excellent in sensitivity and specificity
- the present inventors have identified several cancer-specific proteins in the hepatobiliary pancreatic region by using a proteomic technique so far. I came. Then, using a serum that is a minimally invasive and highly versatile specimen as a sample, specific glycoproteins in the serum for pancreatic cancer are quantitatively identified by using glycoprotein extraction and TMT reagent (tandem mass tag reagent). The inventors have found a new marker for detecting pancreatic cancer as distinguished from chronic pancreatitis or healthy individuals, and have completed the present invention.
- a marker for detecting pancreatic cancer comprising glycoprotein C4BPA or PIGR; [2].
- the marker according to [1] above which is used to detect pancreatic cancer as distinguished from chronic pancreatitis or healthy individuals; [3].
- the method according to [3] above, wherein the measurement of glycoprotein C4BPA or PIGR in a specimen is performed by immunoassay, electrophoresis, mass spectrometry or liquid chromatography; [5].
- a method for detecting pancreatic cancer comprising measuring glycoprotein C4BPA or PIGR in a sample and correlating the amount of C4BPA or PIGR with detection of pancreatic cancer; [6].
- Use of glycoprotein C4BPA or PIGR as a marker for detecting pancreatic cancer; [8].
- the use according to [7] above which is a marker for detecting pancreatic cancer in distinction from chronic pancreatitis or healthy individuals; [9].
- a reagent kit for detecting pancreatic cancer comprising a reagent for measuring glycoprotein C4BPA or PIGR; and [10].
- pancreatic cancer When the glycoprotein C4BPA or PIGR is used as a marker for detecting pancreatic cancer of the present invention, the possibility of pancreatic cancer can be specifically determined by distinguishing from patients with chronic pancreatitis and healthy individuals. In addition, the prognostic status of patients with pancreatic cancer after surgery can be monitored. Furthermore, by using in combination with other pancreatic cancer markers, such as CA19-9, it is possible to distinguish more specifically from patients with chronic pancreatitis and healthy subjects.
- pancreatic cancer markers such as CA19-9
- the test result by SDS-PAGE about the protein from various serum specimens is shown.
- the measurement result of C4BPA by ELISA method about various serum specimens is shown.
- the measurement result of PIGR by ELISA method for various serum samples is shown.
- Figure 7 shows ROC curves for C4BPA, PIGR and CA19-9 in the diagnosis of pancreatic cancer.
- serum samples collected from healthy subjects, patients with chronic pancreatitis and patients with pancreatic cancer are identified with specific glycoproteins in the serum for pancreatic cancer by using glycoprotein extraction and TMT reagent.
- C4BPA which is a glycoprotein
- PIGR was present, and therefore it was found that C4BPA and PIGR could be pancreatic cancer markers.
- the marker for detecting pancreatic cancer of the present invention consists of C4BPA or PIGR.
- C4BPA that is, C4b-binding protein alpha chain, is a glycoprotein whose UniProt accession number is represented by P04003 (http://www.uniprot.org/uniprot/P04003).
- C4BPA regulates the classical pathway of complement activation.
- C4BPA is a cofactor of C3bINA and hydrolyzes the complement fragment C4b. Furthermore, it has a function of promoting degradation of the C4bC2a complex and complement fragment C2a (Barbosa et al., Infection and Immunity, Mr.
- PIGR Polymeric immunoglobulin receptor
- P01833 http://www.uniprot.org/uniprot/P01833
- the bound complex is transported extracellularly from the transmembrane region during its cleavage (Deitcher et al., The Journal of Cell Biology, Volume 102, March 1986, 911-919; Asano et al., Journal of Oral Science, Vol. 53, No. 2, 147-156, 2011).
- the marker for detecting pancreatic cancer of the present invention consists of C4BPA or PIGR.
- the marker of the present invention can detect pancreatic cancer in distinction from chronic pancreatitis or healthy individuals.
- C4BPA or PIGR is measured in order to detect pancreatic cancer based on C4BPA or PIGR in a specimen.
- pancreatic cancer can be detected by measuring C4BPA or PIGR in a specimen and correlating the amount of C4BPA or PIGR with detection of pancreatic cancer.
- C4BPA or PIGR as a glycoprotein may be measured.
- C4BPA or PIGR from which a sugar chain has been removed from a glycoprotein by sample processing or the like may be measured.
- the amino acid sequence portion may be measured.
- the level of C4BPA or PIGR in a sample collected from a patient suspected of pancreatic cancer or a postoperative patient for pancreatic cancer is measured to determine the possibility of pancreatic cancer morbidity or prognosis. be able to.
- the level of C4BPA or PIGR is higher than the level of a healthy person, it can be considered that pancreatic cancer is likely detected, and C4BPA or When the level of PIGR decreases, the prognosis of pancreatic cancer can be improved.
- pancreatic cancer markers such as CA19-9
- Specimens that can be used in the present invention include serum, plasma, blood, urine and the like collected from patients suspected of having pancreatic cancer and postoperative patients with pancreatic cancer.
- C4BPA or PIGR Any currently known method can be used to measure C4BPA or PIGR.
- immunoassay, electrophoresis, mass spectrometry, liquid chromatography and the like can be mentioned.
- the immunoassay examples include an immunoturbidimetric assay and an enzyme immunoassay.
- the immunoassay can be performed by using a polyclonal antibody or a monoclonal antibody that is an anti-C4BPA antibody or an anti-PIGR antibody as an antibody in a conventionally known immunoassay for measuring a protein as an antigen.
- a commercially available antibody can be used, and it can also be produced by a known method.
- These antibodies may specifically recognize the structure of the C4BPA or PIGR amino acid sequence, or may specifically recognize the entire structure including the sugar chain.
- C4BPA or PIGR in a specimen is reacted with an anti-C4BPA antibody or anti-PIGR antibody to cause an antigen-antibody reaction, and as a result, the concentration of C4BPA or PIGR is measured from the degree of turbidity generated. If it is a thing, it will not specifically limit. Examples of such methods include TIA method, latex immunoturbidimetric method, and nephelometry method.
- the TIA method is a method of measuring the degree of turbidity in an immunoturbidimetric assay method, for example, by absorbance at 340 nm to 800 nm.
- the latex immunoturbidimetry is a method in which an anti-C4BPA antibody or an anti-PIGR antibody is bound to latex particles as an antibody in the immunoturbidimetric assay.
- the nepherometry method is a method for measuring the degree of turbidity in the immunoturbidimetric method by collecting light scattered to a magnitude of a certain angle or more and measuring it as scattered light.
- an enzyme immunoassay an EIA method using a plate as a support can be mentioned. Details are described below.
- anti-C4BPA antibody and anti-PIGR antibody are used as primary antibodies using physical bonds, chemical bonds, and affinity directly or indirectly to solid phases such as polystyrene, polypropylene, polycarbonate, polyethylene, nylon, polymethacrylate, etc. Combine.
- the amount of sensitizing antibody is usually in the range of 1 ng to 100 mg / ml, for example.
- a specimen for measuring C4BPA or PIGR is added to and reacted with the primary antibody bound to the solid phase by physical binding, chemical binding, affinity, or the like. After reacting for a certain period of time, the solid phase is washed and a secondary labeled antibody is added to carry out a secondary reaction. The solid phase is washed again and the labeled moiety bound to the solid phase is measured.
- a protein that specifically recognizes a sugar chain of C4BPA or PIGR, and binds / crosslinks with it that is, a lectin that is a specific binding partner.
- a lectin that specifically recognizes fucose is preferable, and examples thereof include a brown bamboo lectin (AAL) that binds to a sugar chain having L-fucose.
- an enzyme such as horseradish peroxidase (HRP) alkaline phosphatase can be used as the labeling substance.
- HRP horseradish peroxidase
- the labeling substance is not only a colloidal metal such as gold colloid or europium, but also various chemical and biological fluorescent substances such as FITC, rhodamine, Texas Red, Alexa, GFP, 32 P, 51 Any material that can be labeled, such as radioactive material such as Cr.
- an avidin-biotin system or a streptavidin-biotin system can also be used.
- an SDS-PAGE method can be generally used.
- the SDS-PAGE method is a method of classifying proteins by allowing proteins to migrate in a gel made of polyacrylamide, so that the mobility in a fixed time and the number of amino acids constituting the protein, that is, the molecular weight is proportional. is there.
- Protein staining includes Coomassie brilliant blue, Ponceau S staining, amide black staining, and a method using direct enzyme activity. For example, a fixed amount of specimen and a general sample buffer are mixed at a fixed ratio of 1: 1 and heated. Generally, it is treated in boiling water for about 5 minutes. The sample is then applied to the gel.
- Polyacrylamide electrophoresis leads to good results when it is run at a low current. Generally, it is about 5 to 100 mA.
- a C4BPA or PIGR band can be confirmed. Depending on the strength of the band, the level of C4BPA or PIGR can be measured.
- the electrophoretic gel is transferred to a nitrocellulose membrane, a PVDF membrane or the like, then reacted with an anti-C4BPA antibody or anti-PIGR antibody as a primary antibody, and further with an HRP-labeled anti-IgG as a secondary labeled antibody, C4BPA or PIGR can be measured based on the degree of color development of a band corresponding to C4BPA or PIGR.
- mass spectrometry examples include analysis methods using mass analyzers that have been rapidly developed recently. For example, surface enhanced laser desorption ionization (Surface Enhanced Laser Desorption / Ionization) time-of-flight mass spectrometer (SELDI-TOF MS method), matrix-assisted laser ionization (Matrix-Assisted Laser Desorption / Ionization) time-of-flight mass spectrometer Examples thereof include a method using MALDI-TOF MS method) and ESI method (Electrospray Ionization).
- the SELDI-TOF MS method is preferable because an ion spectrum with a high reproducible S / N ratio can be obtained because impurities are removed while the target substance is uniformly trapped in the functional group on the chip surface and ionized with laser light. .
- a specimen is usually pretreated, adsorbed on a chip, and attached to a SELDI-TOF MS mass meter.
- the specimen is serum
- the chip to which the protein used in the SELDI-TOF MS method is bound is not particularly limited as long as it is a chip capable of adsorbing C4BPA or PIGR protein. Examples include chips modified with functional groups having affinity for proteins such as hydrophobicity and ion exchange (also referred to as chemical chips), chips immobilized with antibodies against C4BPA or PIGR (biochemical chips), and the like.
- a sample is mixed with a compound that absorbs laser light, and irradiated with a laser beam for a short time of several nanoseconds to ionize and measure the protein in the sample.
- the chip for binding the protein the same chip as that used in the SELDI-TOF MS method can be used.
- the pretreated specimen such as protease treatment
- a mass spectrometer directly connected to a separation means such as high performance liquid chromatography.
- separately detectable isotope-labeled C4BPA or isotope-labeled PIGR is added to the sample as an internal standard.
- all or a portion of both endogenous C4BPA or endogenous PIGR and the internal standard present in the sample are ionized to produce a plurality of ions that can be detected in the mass spectrometer and generated from each.
- One or more ions that have been detected are detected by mass spectrometry.
- the isotopically labeled C4BPA or isotopically labeled PIGR may comprise 13 C and 15 N isotopically labeled valine, arginine, isoleucine, leucine, lysine, phenylalanine, proline subunits, or combinations thereof.
- the isotope-labeled C4BPA or isotope-labeled PIGR has carbon atoms replaced with 13 C isotopes or nitrogen atoms replaced with 15 N isotopes, and endogenous C4BPA or endogenous PIGR is , Resulting in an increase in mass compared to natural C4BPA and PIGR.
- the isotope label has an amino acid subunit in which some or all of the carbon atoms are replaced with 13 C isotopes and some or all of the nitrogen atoms are replaced with 15 N isotopes.
- the mass of this isotope-labeled C4BPA or isotope-labeled PIGR is usually higher than that of nature.
- the presence and / or amount of C4BPA ions or PIGR ions is related to the amount in the sample by comparison with an internal standard.
- the liquid chromatography method is a well-known method for those skilled in the art, and these well-known methods can be employed in the present invention.
- an affinity column using as a support a lectin which is a protein that specifically recognizes C4BPA or PIGR sugar chains and binds to or crosslinks them for example, a brown bamboo lectin (AAL) that binds to sugar chains having L-fucose.
- AAL brown bamboo lectin
- kits for detecting pancreatic cancer including a reagent for measuring glycoprotein C4BPA or PIGR for performing the various measurement methods described above.
- kits can contain various reagents as constituents depending on the measurement method.
- an antibody against glycoprotein C4BPA or PIGR can be included to perform an immunoassay.
- commercially available antibodies can be used, and they can also be produced by known methods. These antibodies may specifically recognize the structure of the amino acid sequence of C4BPA or PIGR, or may specifically recognize the entire structure including the sugar chain.
- the kit can further contain a well-known reagent according to the measurement method to be performed, such as a coloring reagent for the labeling substance.
- Example 1 Identification of Pancreatic Cancer Marker Using a serum sample collected from 45 healthy subjects, 25 chronic pancreatitis patients, and 57 pancreatic cancer patients, a pancreatic cancer marker was searched and further identified.
- Method 1 Serum healthy subjects 45 subjects, chronic pancreatitis 25 patients, the serum samples collected from pancreatic cancer patients 57 patients were used in the serum for the search and identification of pancreatic cancer marker.
- Elute buffer (1.25 ML-fucose; TENT buffer) 20 ⁇ L was added to the remainder, mixed, then incubated at room temperature for 1 hour, centrifuged at 12000 ⁇ g for 1 minute, the supernatant was recovered, and glycoprotein was extracted from each pooled serum. Three types of labeling samples were obtained.
- TMT Mass Tagging Kits and Reagents (Thermo SCIENTIFIC) was used for labeling the sample for labeling the glycoprotein .
- TMT Tandem Mass Tag
- specific glycoproteins in each pool serum can be tagged with the same physical properties but different molecular weights.
- a specific glycoprotein abundance ratio of each sample can be quantified by mixing a plurality of labeled samples. The implementation of specific glycoprotein labeling is shown below.
- each mass of TMT reagent solubilized with 42 ⁇ L of 100% acetonitrile is added to each sample obtained, incubated at room temperature for 1 hour, further added with 8 ⁇ L of 5% Hydroxylamine, and left at room temperature for 15 minutes to stop the reaction. did. Thereafter, each sample was washed with cold acetone and freeze-dried again to obtain a labeled sample of glycoprotein.
- Lane 1 shows a sample of a mixture of labeled glycoproteins pretreated with pooled serum from healthy subjects, pooled serum from chronic pancreatitis patients, and pooled from patients with pancreatic cancer
- lane 2 shows pooled serum from healthy subjects and pancreatic cancer patients (surgery). Before), pancreatic cancer patient (after surgery), a sample mixed with labeled glycoprotein pretreated with pooled serum was run.
- tags of TMT-126, TMT-127, and TMT-128 were used as mass reporters for samples from healthy subjects, chronic pancreatitis patients, and pancreatic cancer patients (before surgery), respectively.
- Lane 2 tags of TMT-126, TMT-127, and TMT-128 were used for samples derived from pooled serum of healthy subjects, pancreatic cancer patients (before surgery), and pancreatic cancer patients (after surgery), respectively.
- the gel after electrophoresis was subjected to Coomassie staining, and a protein band was detected (FIG. 1).
- Each lane was cut from the gel into 18 sections and digested in the gel using trypsin.
- the obtained digested fragments were separated using HPLC and subjected to MS / MS measurement using LTQ Orbitrap XL (Thermo SCIENTIFIC).
- the measurement data was a database search using Mascot search engine (Matrix science) to identify the protein. Quantitative comparison of proteins in each pooled serum was performed with Proteome Discoverer (Thermo SCIENTIFIC).
- Results Table 1 shows the results of quantitative comparison of the amount of protein present in the sample using a mass spectrometer.
- the ratio of pancreatic cancer patient pool serum (before surgery) and healthy person pool serum is 1.5 or more, and the ratio of pancreatic cancer patient pool serum (after surgery) and healthy person pool serum is 1.5.
- a protein having a ratio of chronic pancreatitis patient pool serum to healthy pool serum of 1.5 or less and a ratio of pancreatic cancer patient pool serum to healthy pool serum of 1.5 or more; , C4BPA and PIGR were identified.
- C4BPA and PIGR distinguish pancreatic cancer (preoperative) patients from healthy individuals, chronic pancreatitis patients and pancreatic cancer (postoperative) patients as pancreatic cancer markers, and postoperative pancreatic cancer patients and healthy data Especially good results are obtained in that the difference between the data of the pancreatic cancer patient before the operation and the healthy subject is large, and the difference in the data before and after the operation of the pancreatic cancer patient is large.
- the results revealed that C4BPA and PIGR are suitable as pancreatic cancer markers.
- Matrix metalloproteinase-9 and Inter-alpha-trypsin inhibitor heavy chain H3 there was a difference in data between healthy subjects and pancreatic cancer patients. It was excluded from the marker candidate.
- Example 3 Usefulness of C4BPA and PIGR as pancreatic cancer markers The usefulness of C4BPA and PIGR as pancreatic cancer markers was verified by measuring C4BPA or PIGR in specimens by ELISA using anti-C4BPA antibody or anti-PIGR antibody. . Moreover, the usefulness of C4BPA and PIGR as pancreatic cancer markers was also verified by evaluating the accuracy of diagnostic tests and screening tests, and by evaluation using ROC curves that are usually performed for comparison with conventional methods.
- C4BPA or PIGR were subjected to ELISA measurement on various specimens.
- C4BPA and PIGR were measured using C4 Binding Protein ⁇ ELISA Kit (Usnlife Sciences & Technology, Inc.) and Polymer Immunoglobulin Receptor ELISA Kit (UsnlifenSci), respectively.
- Measurement by ELISA kit was performed according to the manufacturer's protocol. Specifically, anti-C4BPA antibody or anti-PIGR antibody was immobilized on a microtiter plate as a primary antibody, and a diluted specimen was added to the antibody for incubation.
- the plate was washed and then reacted by adding an HRP-labeled anti-C4BPA antibody or anti-PIGR antibody, followed by incubation. Further, after the plate was washed, a color reaction was performed by adding TMB, and after adding a reaction stop solution, measurement was performed at 450 nm using iMark TM Microplat Reader (Bio-Rad). The data was compared with a calibration curve prepared in advance, and C4BPA or PIGR in the sample was measured. IBM SPSS Statistics 18 software (SPSS) was used for statistical processing. The 2-sample test was evaluated using Mann-Whitney U-test and judged to have a significant difference at p ⁇ 0.05.
- SPSS IBM SPSS Statistics 18 software
- C4BPA is useful as a pancreatic cancer marker in that it distinguishes pancreatic cancer (before surgery) patients from healthy subjects and chronic pancreatitis patients.
- PIGR pancreatic cancer marker
- HV healthy subjects
- PT chronic pancreatitis patients
- PaCa pancreatic cancer patients
- the AUROC when combining CA19-9 + C4BPA was 0.929 (not shown). Therefore, the measurement result of C4BPA or PIGR is useful for the diagnosis of pancreatic cancer, and furthermore, in addition to the measurement result of C4BPA or PIGR, it is further determined by combining the measurement result of CA19-9. It was found to be useful in the diagnosis of
- pancreatic cancer when glycoprotein C4BPA or PIGR is used as a marker for detecting pancreatic cancer, the possibility of pancreatic cancer is specifically determined by distinguishing from patients with chronic pancreatitis and healthy subjects Can do. In addition, the prognostic status of patients with pancreatic cancer after surgery can be monitored. Furthermore, by using in combination with other pancreatic cancer markers, such as CA19-9, it is possible to distinguish more specifically from patients with chronic pancreatitis and healthy subjects.
- pancreatic cancer markers such as CA19-9
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Abstract
Description
膵臓癌マーカーとしては、CA19-9が知られている(非特許文献1)。また、ヒトハプトグロビンのフコシル化糖鎖を膵臓癌マーカーとして用いることも提案されている(特許文献1)。しかしながら、これらのマーカーは感度や特異性の点で十分なものとは必ずしも言えず、さらに、新たな膵臓癌マーカーの開発が求められている。
[1].糖蛋白質C4BPAまたはPIGRからなる、膵臓癌を検出するためのマーカー;
[2].慢性膵炎又は健常者と区別して膵臓癌を検出するための上記[1]記載のマーカー;
[3].検体中の糖蛋白質C4BPAまたはPIGRに基づいて膵臓癌を検出するために、C4BPAまたはPIGRを測定する方法;
[4].検体中の糖蛋白質C4BPAまたはPIGRの測定を免疫測定法、電気泳動法、質量分析法または液体クロマトグラフィー法により行う、上記[3]記載の方法;
[5].検体中の糖蛋白質C4BPAまたはPIGRを測定し、C4BPAまたはPIGRの量を膵臓癌の検出に相関させることを含む、膵臓癌を検出するための方法;
[6].C4BPAまたはPIGRに加えてCA19-9の量を膵臓癌の検出に相関させることを含む、上記[5]記載の膵臓癌を検出するための方法;
[7].糖蛋白質C4BPAまたはPIGRの、膵臓癌を検出するためのマーカーとしての使用;
[8].慢性膵炎又は健常者と区別して膵臓癌を検出するためのマーカーである、上記[7]に記載の使用;
[9].糖蛋白質C4BPAまたはPIGRを測定するための試薬を含む、膵臓癌検出用試薬キット;および
[10].糖蛋白質C4BPAまたはPIGRに対する抗体を含む、上記[9]記載の膵臓癌検出用試薬キット
に関する。
本発明により、健常者、慢性膵炎患者および膵臓癌患者(手術前および手術後)から採取した血清検体について、糖蛋白質抽出とTMT試薬を用いることによって膵臓癌に対する血清中の特異的糖蛋白質の同定を定量的に行った結果、健常者、慢性膵炎患者および膵臓癌患者(手術後)からの血清に比べて、膵臓癌患者(手術前)からの血清に、高レベルで、糖蛋白質であるC4BPAまたはPIGRが存在することが明らかとなり、したがって、C4BPAおよびPIGRが膵臓癌マーカーとなり得ることが見出された。
一方、PIGRすなわちPolymeric immunoglobulin receptorは、UniProtのアクセション番号がP01833で表される糖蛋白質である(http://www.uniprot.org/uniprot/P01833)。PIGRは、上皮細胞の基底外側表面で重合体のIgAおよびIgMと結合する。結合した複合体はその切断の過程で膜貫通領域から細胞外に輸送される(Deitcher et al., The Journal of Cell Biology, Volume 102, March 1986, 911-919; Asano et al., Journal of Oral Science, Vol.53, No.2, 147-156, 2011)。
本発明の測定する方法においては、検体中のC4BPAまたはPIGRに基づいて膵臓癌を検出するために、C4BPAまたはPIGRを測定する。
本発明においては、検体中のC4BPAまたはPIGRを測定し、C4BPAまたはPIGRの量を膵臓癌の検出に相関させることにより、膵臓癌を検出することができる。検体中のC4BPAまたはPIGRを実際に測定するに際しては、糖蛋白質としてのC4BPAまたはPIGRを測定してもよく、また、例えば、検体処理などで糖蛋白質から糖鎖が除去された、C4BPAまたはPIGRのアミノ酸配列部分を測定してもよい。
本発明においては、例えば、膵臓癌が疑われる患者や膵臓癌の術後患者から採取された検体中のC4BPAまたはPIGRのレベルを測定して、膵臓癌の罹患可能性や予後の状況を判断することができる。この場合、C4BPAまたはPIGRのレベルが健常者のレベルに比べて高い場合には、膵臓癌を検出した可能性が高いとすることができ、また、術後の膵臓癌患者の検体中においてC4BPAまたはPIGRのレベルが低下した場合には、膵臓癌の予後が良好とすることができる。
本発明では、他の膵臓癌マーカー、例えば、CA19-9などと組み合わせて用いることにより、慢性膵炎患者や健常者とを区別してより特異的に膵臓癌を検出することができる。
免疫比濁測定法においては、検体中のC4BPAまたはPIGRと、抗C4BPA抗体または抗PIGR抗体とを反応させて抗原抗体反応させ、その結果、発生する濁りの度合いからC4BPAまたはPIGRの濃度を測定するものであれば、とくに限定されない。そのような方法として、TIA 法、ラテックス免疫比濁法、ネフェロメトリー法を例示することができる。TIA法は、免疫比濁測定法において濁りの度合いを、例えば、340nmから800nmの吸光度で測定する方法である。また、ラテックス免疫比濁法は、免疫比濁測定法において、抗体として抗C4BPA抗体または抗PIGR抗体をラテックス粒子に結合させたものを用いて測定する方法である。さらに、ネフェロメトリー法は、免疫比濁測定法において濁りの度合いを、一定角度以上の大きさに散乱した光を集めて散乱光として測定する方法である。
酵素免疫測定法としては、プレートを支持体としたEIA法を挙げることが出来る。以下に具体的に記述する。はじめにポリスチレン、ポリプロピレン、ポリカーボネート、ポリエチレン、ナイロン、ポリメタクリレートなどのそれ自体公知である固相に直接または間接的に物理結合や化学結合、アフィニティーを利用して抗C4BPA抗体と抗PIGR抗体を一次抗体として結合させる。感作抗体量は、例えば、通常、1ngから100mg/mlの範囲である。
液体クロマトグラフィー法は、当業者にとって周知の方法であり、本発明では、これら周知の方法を採用することができる。例えば、C4BPAまたはPIGRの糖鎖を特異的に認識しそれらと結合・架橋する蛋白質であるレクチン、例えば、L-フコースを持つ糖鎖と結合するヒイロチャワンタケレクチン(AAL)を支持体とするアフィニティカラムを用いた液体クロマトグラフィー法などが挙げられる。
実施例1
膵臓癌マーカーの同定
健常者45名、慢性膵炎患者25名、膵臓癌患者57名から採取した血清検体を用いて、膵臓癌マーカーの探索し、さらに同定を行った。
1.対象の血清
健常者45名、慢性膵炎患者25名、膵臓癌患者57名から採取した血清検体を、膵臓癌マーカーの探索および同定のための血清に用いた。
3種のプール血清として、健常者、慢性膵炎患者、膵臓癌患者(手術前・手術後)の血清を、それぞれ、ランダムに各5名ずつ抽出しプールして得た。
フコース特異的レクチンで、L-フコースを持つ糖鎖と結合するヒイロチャワンタケレクチン(AAL)を用いた糖蛋白質の検索キットであるVECTREX AAL Binding and Elution Kit (Vector Laboratories社)を使用して、各プール血清から糖蛋白質の抽出を行った。
AALビーズ20μLにプール血清20μLを入れ、1時間インキュベーションした後、12000xgで1分間遠心し、上清を捨てた。残りに、TENT buffer(100mM Tris,pH8.0;10mM EDTA;1.5M NaCl;1.0%(v/v) Tween20)80μLを入れ混合した後、12000xgで1分間遠心し、上清を捨てた。残りにElution buffer(1.25ML-fucose;TENT buffer)20μLを入れ混合した後、室温で1時間インキュベーションし、12000xgで1分間遠心後、上清を回収し、各プール血清から糖蛋白質を抽出し、3種類のラベル化用サンプルを得た。
ラベル化用サンプルのラベル化は、TMT Mass Tagging Kits and Reagents(Thermo SCIENTIFIC社)を使用した。
TMT(Tandem Mass Tag)試薬を用いた、この方法では、各プール血清中の特定の糖蛋白質を、物理的性質は同じで分子量が異なるようにタグをつけることができる。その結果、この方法により、複数のラベル化サンプルを混合することにより各サンプルの特定の糖蛋白質の存在比を定量することができる。具体的な糖蛋白質のラベル化の実施を以下に示す。
上記2で得たラベル化用サンプル20μL(血清 20μL相当)をAAL(Aleuria aurantia Lectin)ビーズ処理し、次いで 50mM TEAB(Triethyl ammonium bicarbonate)60μL、2% SDS5μLと200mM TCEP(Tris(2-carboxyethyl)phosphine)5μLを入れて55℃で1時間インキュベーションし、さらに375mM ヨードアセトアミド5μLを加えて室温で30分間、静置した。その後、得られる各サンプルに100%アセトニトリル42μLで可溶化した各質量のTMT試薬40μLを加え、室温で1時間インキュベーションし、さらに5% Hydroxylamine8μLを加えて、室温で15分静置して反応を停止した。その後、各サンプルを冷アセトンにて洗浄し、再び凍結乾燥をして糖蛋白質のラベル化済みサンプルを得た。
SDS-PAGEとして、10-20%のグラディエントゲル(DRC社)を使用した。レーン1は、健常者プール血清、慢性膵炎患者プール血清、膵臓癌患者プール血清を前処理したラベル化済み糖蛋白質を混合したサンプルを流し、レーン2は、健常者プール血清、膵臓癌患者(手術前)、膵臓癌患者(手術後)プール血清を前処理したラベル化済み糖タンパク質を混合したサンプルを流した。なお、レーン1では、健常者、慢性膵炎患者、膵臓癌患者(手術前)由来のサンプルに対し、マス・レポーターとして、それぞれTMT-126、TMT-127、TMT-128のタグを用いた。また、レーン2では、健常者プール血清、膵臓癌患者(手術前)、膵臓癌患者(手術後)由来のサンプルでは、それぞれTMT-126、TMT-127、TMT-128のタグを用いた。
電気泳動後のゲルは、クーマシー染色を行い、タンパク質バンドを検出した(図1)。各レーンを18分割にゲルから切り出し、トリプシンを用いてゲル内消化を行った。得られた消化断片はHPLCを用いて分離し、LTQ Orbitrap XL(Thermo SCIENTIFIC社)でMS/MS測定した。測定データはMascot search engine (Matrix science社)にてデータベース検索を行い、タンパク質を同定した。各プール血清の蛋白質の定量比較はProteome Discoverer(Thermo SCIENTIFIC社)で行った。
質量分析装置にて検体中のタンパク質存在量を定量比較した結果を表1に示す。
C4BPA、PIGRが、膵臓癌マーカーとして膵臓癌(手術前)患者を健常者や慢性膵炎患者や膵臓癌(手術後)患者と区別するという点、また、手術後の膵臓癌患者と健常者のデータの差が小さい点、さらに手術前の膵臓癌患者と健常者のデータの差が大きい点で、従って膵臓癌患者の手術前後でデータの差が大きい点で特に良好な結果が得られ、これらの結果から、C4BPAおよびPIGRが、膵臓癌マーカーとして好適であることが明らかとなった。
他方、Matrix metalloproteinase-9、Inter-alpha-trypsin inhibitor heavy chain H3については、健常者と膵臓癌患者のデータに差が見られたものの、上記基準によるスクリーニングでは手術前後にてデータの差が見られず、マーカー候補から除外した。
C4BPAおよびPIGRの膵臓癌マーカーとしての有用性
C4BPAおよびPIGRの膵臓癌マーカーとしての有用性を、抗C4BPA抗体または抗PIGR抗体を用いたELISA法により検体中のC4BPAまたはPIGRの測定を行って検証した。また、診断用テストやスクリーニングテストの精度評価や従来法との比較のために通常よく行われているROC曲線による評価によっても、C4BPAおよびPIGRの膵臓癌マーカーとしての有用性を検証した。
(1)方法
特に膵臓癌マーカーとしてのデータが良好だったC4BPAおよびPIGRについて、種々の検体に対しELISA測定を行った。C4BPAおよびPIGRは、それぞれ、C4 Binding Protein α ELISA Kit(Uscnlife Sciences & Technology社)、Polymeric Immunoglobulin Receptor ELISA Kit(Uscnlife Sciences & Technology社)を用いて測定した。
ELISAキットによる測定は、メーカーのプロトコルに従い実施した。詳細には、抗C4BPA抗体、もしくは抗PIGR抗体をマイクロタイタープレートに一次抗体として固相化させ、その抗体に希釈検体を添加してインキュベーションを行なった。次いで、そのプレートを洗浄した後、HRP標識した抗C4BPA抗体または抗PIGR抗体を加えて反応させ、インキュベーションを行なった。さらにプレート洗浄後、TMBを添加して発色反応を行い、反応停止液を添加後にiMarkTM Microplat Reader(Bio-Rad社)を用いて450nmで測定を行った。そのデータを、あらかじめ作成しておいた検量線と比較し、検体中のC4BPAまたはPIGRを測定した。統計処理には、IBM SPSS Statistics 18 software(SPSS社)を使用した。2標本検定はMann-Whitney U-testを用いて評価し、p<0.05で有意な違いがあると判断した。
C4BPAおよびPIGRの結果を、それぞれ図2および図3に示す。
図2に示す結果から、C4BPAでは、健常者(HV)、慢性膵炎患者(PT)、膵臓癌患者(手術前)(PaCa)で、それぞれ308.2±89.3μg/mL、303.3±78.3μg/mL、445.2±124.6μg/mL、であり、健常者、慢性膵炎患者に対して膵臓癌患者で、p<0.001と有意な違いがみられた。従って、C4BPAが、膵臓癌(手術前)患者を、健常者や慢性膵炎患者と区別するという点で、膵臓癌マーカーとして有用であることが示された。
図3に示す結果から、PIGRでは、健常者(HV)、慢性膵炎患者(PT)、膵臓癌患者(PaCa)で、それぞれ3.9±0.9μg/mL、5.4±2.3μg/mL、6.5±3.2μg/mLであり、健常者に対して膵臓癌患者で、p<0.001と有意な違いがみられた。従って、PIGRが、膵臓癌マーカーとして膵臓癌(手術前)患者を、健常者と区別するという点で、有用であることが示された。
膵臓癌の診断におけるC4BPAおよびPIGRのROC曲線を、従来膵臓癌の診断に用いられているCA19-9のROC曲線と共に、図4に示した。ROC曲線はそれぞれのマーカーについて健常者濃度の2SDよりカットオフ値を算出し、統計解析ソフトSPSS ver.18を用いて求めた。ROC曲線から求めたAUROC(area under the receiver operating characteristics curves)はCA19-9が0.843、C4BPAが0.859、PIGRが0.728であった。また、CA19-9+C4BPA+PIGRを組み合わせた際のAUROCは0.939であった。さらに、CA19-9+C4BPAを組み合わせた際のAUROCは0.929であった(図面省略)。したがって、C4BPAまたはPIGRの測定結果は、膵臓癌の診断に有用であること、更には、C4BPAまたはPIGRの測定結果に加えて、CA19-9の測定結果を組み合わせて判定することが、更に膵臓癌の診断に有用であることが判明した。
Claims (10)
- 糖蛋白質C4BPAまたはPIGRからなる、膵臓癌を検出するためのマーカー。
- 慢性膵炎又は健常者と区別して膵臓癌を検出するための請求項1記載のマーカー。
- 検体中の糖蛋白質C4BPAまたはPIGRに基づいて膵臓癌を検出するために、C4BPAまたはPIGRを測定する方法。
- 検体中の糖蛋白質C4BPAまたはPIGRの測定を免疫測定法、電気泳動法、質量分析法または液体クロマトグラフィー法により行う、請求項3記載の方法。
- 検体中の糖蛋白質C4BPAまたはPIGRを測定し、C4BPAまたはPIGRの量を膵臓癌の検出に相関させることを含む、膵臓癌を検出するための方法。
- C4BPAまたはPIGRに加えてCA19-9の量を膵臓癌の検出に相関させることを含む、請求項5記載の膵臓癌を検出するための方法。
- 糖蛋白質C4BPAまたはPIGRの、膵臓癌を検出するためのマーカーとしての使用。
- 慢性膵炎又は健常者と区別して膵臓癌を検出するためのマーカーである、請求項7に記載の使用。
- 糖蛋白質C4BPAまたはPIGRを測定するための試薬を含む、膵臓癌検出用試薬キット。
- 糖蛋白質C4BPAまたはPIGRに対する抗体を含む、請求項9記載の膵臓癌検出用試薬キット。
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WO2020004244A1 (ja) * | 2018-06-26 | 2020-01-02 | 富士フイルム和光純薬株式会社 | 膵臓癌の判定用マーカー |
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EP2851688A1 (en) | 2015-03-25 |
CN104395758A (zh) | 2015-03-04 |
JP5863074B2 (ja) | 2016-02-16 |
JPWO2013172105A1 (ja) | 2016-01-12 |
EP2851688B1 (en) | 2019-06-05 |
US20150104816A1 (en) | 2015-04-16 |
EP2851688A4 (en) | 2016-02-10 |
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