WO2015097863A1 - 診断用情報の分析方法およびそのためのキット - Google Patents
診断用情報の分析方法およびそのためのキット Download PDFInfo
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- WO2015097863A1 WO2015097863A1 PCT/JP2013/085116 JP2013085116W WO2015097863A1 WO 2015097863 A1 WO2015097863 A1 WO 2015097863A1 JP 2013085116 W JP2013085116 W JP 2013085116W WO 2015097863 A1 WO2015097863 A1 WO 2015097863A1
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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
- G01N33/6893—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving proteins, peptides or amino acids related to diseases not provided for elsewhere
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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
- G01N33/57434—Specifically defined cancers of prostate
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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
- G01N33/573—Immunoassay; Biospecific binding assay; Materials therefor for enzymes or isoenzymes
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- G—PHYSICS
- G01—MEASURING; TESTING
- G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
- G01N2333/00—Assays involving biological materials from specific organisms or of a specific nature
- G01N2333/435—Assays involving biological materials from specific organisms or of a specific nature from animals; from humans
- G01N2333/46—Assays involving biological materials from specific organisms or of a specific nature from animals; from humans from vertebrates
- G01N2333/47—Assays involving proteins of known structure or function as defined in the subgroups
- G01N2333/4701—Details
- G01N2333/4725—Mucins, e.g. human intestinal mucin
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- G—PHYSICS
- G01—MEASURING; TESTING
- G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
- G01N2333/00—Assays involving biological materials from specific organisms or of a specific nature
- G01N2333/435—Assays involving biological materials from specific organisms or of a specific nature from animals; from humans
- G01N2333/705—Assays involving receptors, cell surface antigens or cell surface determinants
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- G—PHYSICS
- G01—MEASURING; TESTING
- G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
- G01N2333/00—Assays involving biological materials from specific organisms or of a specific nature
- G01N2333/90—Enzymes; Proenzymes
- G01N2333/914—Hydrolases (3)
- G01N2333/948—Hydrolases (3) acting on peptide bonds (3.4)
- G01N2333/95—Proteinases, i.e. endopeptidases (3.4.21-3.4.99)
- G01N2333/964—Proteinases, i.e. endopeptidases (3.4.21-3.4.99) derived from animal tissue
- G01N2333/96425—Proteinases, i.e. endopeptidases (3.4.21-3.4.99) derived from animal tissue from mammals
- G01N2333/96427—Proteinases, i.e. endopeptidases (3.4.21-3.4.99) derived from animal tissue from mammals in general
- G01N2333/9643—Proteinases, i.e. endopeptidases (3.4.21-3.4.99) derived from animal tissue from mammals in general with EC number
- G01N2333/96433—Serine endopeptidases (3.4.21)
- G01N2333/96441—Serine endopeptidases (3.4.21) with definite EC number
- G01N2333/96455—Kallikrein (3.4.21.34; 3.4.21.35)
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- G—PHYSICS
- G01—MEASURING; TESTING
- G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
- G01N2800/00—Detection or diagnosis of diseases
- G01N2800/34—Genitourinary disorders
- G01N2800/342—Prostate diseases, e.g. BPH, prostatitis
Definitions
- the present invention relates to a method for analyzing diagnostic information related to benign prostate disease and prostate cancer.
- the present invention also relates to a method for analyzing diagnostic information based on the concentration of mucin-1 in blood.
- Post-translational modifications such as glycosylation play an extremely important role in order for proteins, which are the main players responsible for vital functions of living organisms, to exhibit their functions in an orderly manner in the living body.
- post-translational modifications the following has been revealed in recent years.
- Most proteins in the body are modified by sugar chains, and the sugar chain added to the protein is protein stability, binding to hormones, binding to toxins, virus infection, mycoplasma infection, bacterial infection It plays an important role in various life phenomena such as protozoan parasitism, fertilization, developmental differentiation, cancer cell metastasis, and apoptosis.
- Even proteins with the same amino acid sequence and the same name have a variety of modified sugar chains, and the structure of the sugar chain varies depending on the state of the cell that produces the protein, and the role in vivo is different. .
- Patent Document 1 describes the following for a prostate-specific antigen (hereinafter referred to as PSA) indicating that it is suffering from a prostate disease. That is, in a blood sample derived from a patient with prostate cancer, a prostate-specific antigen having a specific sugar residue, N-acetyl-D-galactosamine ⁇ 1-4N acetylglucosamine (hereinafter referred to as LacdiNAc) residue in the sugar chain.
- PSA prostate-specific antigen
- LacdiNAc N-acetyl-D-galactosamine ⁇ 1-4N acetylglucosamine
- LacdiNAc-PSA LacdiNAc-PSA
- PSA sugar chains are changed due to the onset of prostate cancer, and PSA having the specific sugar residue increases, and the concentration of PSA having the specific sugar residue is high in the blood sample of prostate cancer patients. It is observed.
- the change of the sugar chain does not occur even when prostatic hypertrophy develops, no change is observed in the concentration of PSA having the specific sugar residue in the prostatic hypertrophy patient.
- Patent Document 1 it is possible to discriminate between a patient with prostate cancer and a patient with benign prostatic hypertrophy by measuring the concentration of PSA having the specific sugar residue in the blood sample.
- a method for distinguishing prostate cancer by sugar chain fraction measurement is disclosed.
- a method for identifying liver cancer by measuring ⁇ -fetoprotein (AFP) sugar chain fraction, a method for identifying adenocarcinoma by measuring carcinoembryonic antigen (CEA) sugar chain fraction, and the like have been proposed.
- AFP ⁇ -fetoprotein
- CEA carcinoembryonic antigen
- MUC1 mucin-1
- MUC1 mucin-1
- Patent Document 2 and Patent Document 3 describe an aptamer ligand and an anti-MUC1 antibody that can be used for such MUC1 quantification, respectively.
- Patent Document 4 describes that MUC1 or the like can be used as a biomarker for prostate cancer and colorectal cancer.
- lectin having the ability to specifically recognize and bind to the sugar residue is widely used. ing. This is because an antibody having a sugar chain as an epitope, particularly an antibody having a specific sugar residue as an epitope, is very difficult to produce and is difficult to obtain. Lectins are inexpensive and can be obtained in large quantities, and are excellent in protein stability and can be stored for a long time.
- nodafuji lectin (Wisteria floribunda Agglutinin: hereinafter referred to as WFA) is known to have N-acetylgalactosamine as the main linking sugar residue.
- WFA Wisteria floribunda Agglutinin: hereinafter referred to as WFA
- WFA having such characteristics is bound to a carrier, packed in a column, fractionated PSA having a LacdiNAc residue in the side chain of an asparagine-linked sugar chain, and then subjected to ELISA or the like.
- a method for quantifying minutes is described.
- Patent Document 5 using a solid-phased anti-PSA antibody and fluorescently labeled WFA, a PSA having a LacdiNAc residue in the side chain of a sugar chain and a sandwich-type complex are formed, and SPFS ( A method of quantifying PSA having this specific sugar residue by Surface Plasmon-field enhanced Fluorescence Spectroscopy (surface plasmon excitation enhanced fluorescence spectroscopy) is described.
- Prostate cancer mainly affects men over the age of 60. In Western countries, it is the cause of death after lung cancer among male cancers, and early detection is desired.
- a method for diagnosing prostate cancer a method widely used in the past is a method in which all PSA contained in a blood sample or the like is quantified to obtain a total PSA value, and that value is used as a determination index.
- free PSA that does not bind to ⁇ 1-antichymotrypsin contained in a blood sample or the like is quantified as free PSA, and the ratio of the amount of free PSA to the total amount of PSA (free PSA / total PSA ratio) is used as a judgment index It is.
- the total PSA value is 10 ng / mL or more, it is determined that there is a high possibility of prostate cancer, or (2) the total PSA value is 4 to 10 ng / mL (gray zone) and free A technique is adopted in which it is determined that the possibility of prostate cancer is high when the PSA / total PSA ratio is 25% or less.
- a biopsy of the prostate is performed for a definitive diagnosis.
- it is relatively often determined that a patient with benign disease such as benign prostatic hyperplasia is not likely to have prostate cancer but prostate cancer. Since patients with such benign diseases have undergone prostate biopsy and are overburdened, there has been a need for a diagnostic method that can easily distinguish prostate cancer from benign diseases with high accuracy.
- a lectin having an affinity for an N-acetylgalactosamine residue, such as WFA, is brought into contact with a sample that may contain PSA,
- the amount of PSA having affinity with the lectin that is, the amount of PSA having an N-acetylgalactosamine residue in the sugar chain is quantified, and the absolute amount of the specific PSA, that is, the concentration in the blood sample, or the total PSA or free PSA
- a method for discriminating between prostate cancer and benign prostatic hyperplasia by the ratio of the amount of a specific PSA to the amount of PSA is described. If this method is based solely on the amount of total PSA or free PSA, patients with benign prostatic hyperplasia that may be determined to be prostate cancer will be correctly diagnosed with prostatic hypertrophy rather than prostate cancer Leads to.
- An object of the present invention is to provide an analysis method capable of accurately discriminating between prostate cancer and benign prostate disease and obtaining new diagnostic information.
- the present inventors have found that the amount of MUC1 contained in a blood sample derived from a prostate benign disease patient is larger than that in a blood sample derived from a prostate cancer patient or a healthy person.
- all MUC1 having reactivity with an anti-MUC1 antibody, preferably an anti-KL-6 monoclonal antibody, which is a kind thereof, in a blood sample is quantified, and the information is used to determine whether prostate benign disease and prostate cancer.
- the present invention has been completed by discovering that it is possible to accurately determine and diagnose the above. That is, the present invention makes it possible to prevent a patient with benign prostatic disease from being erroneously diagnosed as a prostate cancer patient and receiving unnecessary medical care.
- the present invention provides a method for analyzing diagnostic information according to the following [1] to [6].
- [1] Measure the concentration of all mucin-1 (total MUC1) in a blood sample derived from a diagnostic object, compare the measured value with a threshold value, and the measured value of the total MUC1 concentration is greater than the threshold value
- a method for analyzing diagnostic information that presumes that the disease affected by the diagnostic object is not a prostate cancer but a prostate benign disease.
- [2] Measure the concentration of all mucin-1 (total MUC1) in a blood sample derived from a diagnostic object, compare the measured value with a threshold value, and that the concentration of total MUC1 is greater than the threshold value, A diagnostic information analysis method for estimating that the disease affected by the diagnostic object is not a prostate cancer but a prostate benign disease, and diagnostic information relating to a prostate-specific antigen indicating that the diagnostic object is affected by the prostate disease; A diagnostic information analysis method that estimates whether the subject to be diagnosed is suffering from benign prostate disease or prostate cancer.
- [3] Measure the concentration of all mucin-1 (total MUC1) in the blood sample derived from the diagnosis object, compare the measured value with the threshold value, and the measured value of the total MUC1 concentration is greater than the threshold value
- the method of analyzing diagnostic information for presuming that the disease affected by the diagnostic object is not a prostate cancer but a prostate benign disease, and N-acetyl-D-galactosamine ⁇ 1 in a blood sample derived from the diagnostic object The concentration of prostate specific antigen (LacdiNAc-PSA) having reactivity with a lectin that recognizes and binds to -4N acetylglucosamine residue is measured, and the obtained measurement value is compared with a threshold value to determine the concentration of LacdiNAc-PSA.
- LacdiNAc-PSA prostate specific antigen having reactivity with a lectin that recognizes and binds to -4N acetylglucosamine residue
- the diagnostic information that estimates that the disease affected by the diagnosis is prostate cancer rather than benign prostate disease.
- the method for obtaining diagnostic information for estimating whether the diagnosis target is suffering from either of prostate benign and prostate cancer is more than the threshold value according to [3]. If the measured value of the LacdiNAc-PSA concentration is larger than another large threshold value and larger than the other threshold value larger than the threshold value described in [3], the prostate cancer affected by the diagnosis subject is metastasized.
- a method for analyzing diagnostic information that is presumed to be highly prostatic prostate cancer, prostate cancer with prostate benign disease, or hormone resistant prostate cancer.
- the present invention provides a diagnostic kit according to the following [7] to [10].
- [7] A kit for carrying out the method for analyzing diagnostic information according to [1], comprising an anti-mucin-1 antibody for quantifying total MUC1.
- [8] A kit for carrying out the diagnostic information analysis method according to [2], comprising an anti-mucin-1 antibody for quantifying total MUC1 and an anti-prostate for quantifying an anti-prostate specific antigen
- a diagnostic kit comprising a specific antigen antibody.
- a kit for carrying out the diagnostic information analysis method according to [3] or [4], wherein an anti-mucin-1 antibody for quantifying total MUC1 and an anti-prostate specific antigen are quantified A diagnostic kit comprising an anti-prostate specific antigen antibody and a lectin that recognizes and binds to N-acetyl-D-galactosamine ⁇ 1-4N acetylglucosamine residues. [10] The diagnostic kit according to any one of [7] to [9], wherein the anti-mucin-1 antibody is an anti-KL-6 monoclonal antibody. [11] The diagnostic kit according to any one of [7] to [10], further comprising an instruction manual describing information necessary for performing the diagnostic information analysis method.
- the diagnostic information obtained by the analysis method of the present invention makes it possible to determine a benign prostatic disease with high accuracy even when used alone, it is erroneously estimated that a prostatic benign disease patient is a prostate cancer patient. By combining with diagnostic information regarding prostate cancer, it is possible to significantly reduce the possibility of misdiagnosis of conventional diagnostic methods.
- FIG. 1 is a scatter diagram showing the result of quantification of the quantification step (1): total MUC1 (KL6) of the example.
- PC represents a sample of a prostate cancer patient
- BPH represents a sample of a prostatic hypertrophy patient.
- FIG. 2 is a scatter diagram showing in combination the quantitative process (1): total MUC1 (KL6) quantitative result (horizontal axis) and quantitative process (2): total PSA quantitative result (vertical axis) in the examples. It is.
- PC represents a sample of a prostate cancer patient
- BPH represents a sample of a prostatic hypertrophy patient.
- FIG. 1 is a scatter diagram showing the result of quantification of the quantification step (1): total MUC1 (KL6) of the example.
- PC represents a sample of a prostate cancer patient
- BPH represents a sample of a prostatic hypertrophy patient.
- FIG. PC represents a sample of a patient with prostate cancer
- BPH represents a sample of a patient with benign prostatic hyperplasia
- the sample surrounded by a dotted circle is derived from a patient whose prostate cancer has spread to other sites.
- N-acetyl-D-galactosamine ⁇ 1-4N acetylglucosamine is abbreviated as LacdiNAc, mucin-1 as MUC1, and nodafuji lectin as WFA.
- LacdiNAc-PSA A PSA having reactivity with a lectin that recognizes a LacdiNAc residue typified by WFA used in the present invention is referred to as LacdiNAc-PSA. Called.
- the concentration of all MUC1, that is, the total MUC1 in the blood sample derived from the diagnosis object is measured, and the obtained measurement value is compared with a threshold value.
- This is a diagnostic information analysis method for estimating that the disease affected by the diagnostic object is not a prostate cancer but a benign prostatic disease when the measured value of the MUC1 concentration is larger than a threshold value.
- the diagnostic information based on the concentration of total MUC1 in the blood sample obtained by the first embodiment of the analysis method according to the present invention described above is a prior art that cannot clearly distinguish benign prostate disease from prostate cancer. In combination with diagnostic information relating to prostate cancer, it can be used to more clearly determine whether the diagnostic object is suffering from prostate benign disease or prostate cancer.
- any of the prior arts may erroneously estimate prostate benign disease as prostate cancer, and the diagnostic information about prostate cancer in the prior art is not particularly limited, and analysis of any known diagnostic information Can be obtained by the method.
- diagnostic information based on the concentration of all PSA in a blood sample International Publication WO2010 / 090264 (Patent Document 1) and JP2013-76666A (Patent Document 5)
- the diagnostic information based on the concentration of PSA having a specific sugar residue in the blood sample described in 1) can be used.
- the second embodiment of the diagnostic information analysis method of the present invention includes, for example, the diagnostic information analysis method obtained in the first embodiment and the concentration of all PSA in the blood sample derived from the diagnostic object. That is, the concentration of total PSA is measured, and the measured value obtained is compared with a threshold value. If the measured value of the total PSA concentration is larger than the threshold value, the disease affected by the diagnosis object is not a benign prostatic disease. It can be combined with a diagnostic information analysis method for estimating prostate cancer to provide a diagnostic information analysis method for estimating whether the diagnosis target suffers from a benign prostate disease or prostate cancer.
- the method using total PSA is exemplified as the diagnostic information analysis method used in combination with the diagnostic information analysis method obtained in the first embodiment.
- the amount of free PSA relative to the total amount of PSA As described above, it is possible to use the diagnostic information analysis method using the ratio (free PSA / total PSA ratio) and other known diagnostic information analysis methods.
- the third embodiment of the diagnostic information analysis method of the present invention recognizes and binds to the diagnostic information analysis method obtained in the first embodiment and a LacdiNAc residue in a blood sample derived from the diagnostic object. Measure the concentration of PSA having reactivity with lectin, that is, LacdiNAc-PSA, compare the measured value with a threshold value, and the measured value of LacdiNAc-PSA concentration is greater than the threshold value.
- a diagnostic information analysis method that presumes that the disease is prostate cancer, not prostate benign disease, for diagnostic purposes to estimate whether the subject is diagnosed with prostate benign disease or prostate cancer It is an information analysis method.
- the fourth embodiment of the diagnostic information analysis method of the present invention is further characterized in that, in the diagnostic information analysis method of the third embodiment, when it is estimated that the diagnosis target suffers from prostate cancer, The measured value of the total MUC1 concentration is larger than another threshold value (second threshold value for total MUC1) larger than the threshold value (first threshold value for total MUC1) described in the third embodiment, and the concentration of LacdiNAc-PSA If the measured value is larger than another threshold value (second threshold value for LacdiNAc-PSA) larger than the threshold value (first threshold value for LacdiNAc-PSA) described in the third embodiment, the diagnosis subject is affected.
- Presumed prostate cancer is highly metastatic prostate cancer, prostate cancer with prostate benign disease or hormone resistant prostate cancer It is an analysis method of diagnostic information that.
- total MUC1 in the present invention is preferably one having reactivity with “anti-KL-6 monoclonal antibody”. That is, when measuring the concentration of total MUC1, an anti-MUC1 antibody is usually used as an antibody for immobilization or labeling, but an anti-KL-6 monoclonal antibody is preferably used as the anti-MUC1 antibody.
- anti-MUC1 antibodies also include monoclonal antibodies that recognize and bind sites common to all or many variants as epitopes.
- Anti-KL-6 monoclonal antibody that recognizes as an epitope glycated glycan antigen KL-6 (antigen consisting of Neu5Ac ⁇ 2,3Gal ⁇ 1,3GalNAc ⁇ glycan, which is a sialylated glycan linked to amino acid sequence PDTRPAP and threonine (T))
- monoclonal antibodies that bind to some variants, such as anti-CA15-3 monoclonal antibodies.
- diagnostic information can be analyzed using various anti-MUC1 antibodies.
- an anti-KL-6 monoclonal antibody when used, a highly reliable analysis can be performed. . Also in the description of the following specification, as a preferred embodiment, the anti-MUC1 antibody can be read as an anti-KL-6 monoclonal antibody.
- anti-MUC1 antibody when measuring the concentration of “total MUC1” in the form of a sandwich type assay such as SPFS, ELISA, etc., “anti-MUC1 antibody” is referred to as “anti-KL-6”.
- anti-KL-6 when “monoclonal antibody” is used, the “total MUC1” whose concentration is measured is all MUC1 (referred to as total MUC1 (KL6)) having reactivity with the anti-KL-6 monoclonal antibody. .
- Blood sample In the analysis method of the present invention, a blood sample derived from a diagnostic object is used as a sample for measuring the concentration of a specific glycoprotein.
- the diagnostic object is typically a human but a non-human mammal such as a human disease model animal (mouse, rat, guinea pig, rabbit, goat, cat, dog, pig, monkey, etc.) Also good.
- a human disease model animal mouse, rat, guinea pig, rabbit, goat, cat, dog, pig, monkey, etc.
- prostate cancer As an example of a preferred human diagnostic subject, it is strongly suggested that other diagnostic methods suffer from prostate cancer, but the possibility that the affected disease is a benign prostatic disease cannot be excluded. Examples include patients who need to clarify whether they have prostate cancer.
- Prostate benign disease is typically benign prostatic hyperplasia (benign prostatic hyperplasia: BPH), but other benign diseases related to the prostate such as prostatitis are also included.
- BPH benign prostatic hyperplasia
- the blood sample may be whole blood, or serum or plasma prepared from whole blood. Further, the blood sample may contain an anticoagulant added at the time of blood collection, a diluent, a reagent, etc. added as needed after the collection.
- a blood sample may be collected and prepared according to a known method.
- a lectin that recognizes and binds to a LacdiNAc residue is used to quantify LacdiNAc-PSA.
- a representative example of such a lectin is WFA, but the lectin that can be used in the present invention is not limited to this. That is, any lectin that has the ability to recognize and bind to LacdiNAc residues contained in the sugar chain of LacdiNAc-PSA and can be used to measure the concentration of LacdiNAc-PSA in a blood sample. Similar to WFA, it can be used in the present invention.
- the lectin lectin-II (TJA) that recognizes and binds to both ⁇ -GalNAc residue and fucose ⁇ (1,2) galactose residue. -II).
- WFA recognizes and binds galactose in addition to Tn and LacdiNAc residues, but its binding power is extremely weak and its binding constant is several orders of magnitude lower than WFA. Must not.
- Lectins other than WFA preferably have the ability to recognize and bind to only Tn and LacdiNAc residues among the sugar residues, but recognize saccharides other than Tn and LacdiNAc residues. Thus, if the ability to bond is in a sufficiently weak range that does not become a substantial obstacle to carrying out the present invention, it can be used in the present invention.
- Quantitative method When carrying out the analysis method of the present invention, from the three measurement objects of total MUC1, LacdiNAc-PSA, and total PSA, selected items necessary for the embodiment or all three items are selected. It is necessary to measure and quantify the object.
- the method for quantifying these measurement objects is not particularly limited as long as a measurement value having sufficient accuracy for performing the analysis in each embodiment can be obtained, and is appropriately selected from known quantification methods. You can choose.
- SPFS SurfacemonPlasmon-field enhanced Fluorescence Spectroscopy
- ATR total reflection attenuation
- the concentration of the measurement object in the blood sample can be determined. Since such SPFS is extremely sensitive compared to a general fluorescent labeling method or the like, the concentration can be measured even when the concentration of the measurement target in the sample is extremely low.
- the plurality of measurement items can be quantified in parallel.
- a sensor chip SPFS measurement member
- Such an embodiment can reduce the number of necessary members, reagents and steps, and save the cost and time required for quantification, as compared with the embodiment in which each measurement object is quantified using a plurality of sensor chips.
- diagnostic information is analyzed based on the concentrations of total MUC1, LacdiNAc-PSA and total PSA in the blood sample.
- the “measurement” obtained according to a predetermined measurement protocol by a quantitative method such as SPFS is used. It is also possible to use “value” in the analysis without converting it to “concentration” expressed in a predetermined unit such as ng / mL.
- the measurement value of fluorescence intensity is usually expressed in arbitrary units (arbitrary unit: au), but the threshold value is set using the measurement value reflecting the concentration of the measurement object in the blood sample, Analysis of diagnostic information may be performed.
- a measurement target can be quantified in the form of a sandwich-type assay that forms a complex consisting of a solid phase probe (antibody) -measurement object-fluorescent labeling probe (lectin or antibody). It is common.
- LacdiNAc-PSA which is a glycoprotein having a specific sugar residue, among total MUC1, LacdiNAc-PSA and total PSA, there are typically two quantification methods.
- the first quantification method does not perform glycoprotein fractionation using a lectin that recognizes and binds to a specific sugar residue, subjecting the entire blood sample (glycoprotein) to SPFS, and a solid phase probe (antibody ) Of the glycoprotein captured in (1) is quantified by fluorescent labeling using a fluorescent labeling probe (lectin) that binds to the specific sugar residue. Glycoproteins that do not have a specific sugar residue bind to the immobilized probe, but a fluorescent labeling probe (lectin) that recognizes a specific sugar residue does not bind to it. Must not.
- JP 2013-76666 A quantifies a specific glycoprotein (PSA) using SPFS and a specific lectin (such as WFA) as in the first quantification method.
- PSA specific glycoprotein
- WFA specific lectin
- a glycoprotein having a specific sugar chain is fractionated in advance using a lectin that recognizes and binds to a specific sugar residue, and only the fraction is subjected to SPFS for solid phase immobilization.
- a glycoprotein having a specific sugar residue captured by a probe (antibody) is quantified by fluorescent labeling using a fluorescent labeling probe (antibody) that binds to the glycoprotein.
- LacdiNAc-PSA having reactivity between a lectin that recognizes a specific sugar residue and an anti-PSA antibody can be quantified.
- Patent Document 1 includes a specific glycoprotein (PSA) using a column (lectin affinity column) packed with a carrier bound with a specific lectin (such as WFA).
- PSA specific glycoprotein
- WFA specific lectin
- a lectin affinity column is prepared by reacting a carrier for a column with a lectin that recognizes and binds to a specific sugar residue corresponding to a measurement object.
- a blood sample is applied to the lectin affinity column, and a measurement target having a specific sugar residue in the blood sample is bound to the lectin.
- a fraction containing a substance that does not bind to lectin (unbound fraction) is collected as an effluent when a washing buffer is added to the column.
- the elution buffer is a solution in which a hapten sugar capable of dissociating the measurement object bound to the lectin is dissolved.
- the hapten sugar may be selected according to the lectin. For example, when WFA is used as the lectin, GalNAc can be used as the hapten sugar.
- the anti-MUC1 antibody can be prepared by a known technique, and a commercially available one can also be purchased. From the viewpoint of measurement stability, it is preferable to use a monoclonal antibody rather than a polyclonal antibody.
- Examples of commercially available anti-MUC1 monoclonal antibodies include VU-3D1, VU-12E1, VU-11E2, VU-12E1, VU-3C6, VU-13F11, VU-5F12, VU-4C2, VU-2G7, VU -4H5, VU-11D1, M4021209, M3A106, M9E7, Ma552, VU-3C6, SM3, DF3, No. 1, no.
- the fluorescence-labeled anti-MUC1 antibody can be prepared by binding a target fluorescent substance to the anti-MUC1 antibody using a known technique.
- a commercially available fluorescent substance labeling kit or the like can also be used.
- the fluorescent substance is not particularly limited, and a known fluorescent dye that can emit appropriate fluorescence by SPFS can be used.
- the type of the anti-MUC1 antibody of the solid-phased anti-MUC1 antibody and the type of the anti-MUC1 antibody of the fluorescently labeled anti-MUC1 antibody may be the same or different. Since MUC1 has a very large molecule and a common repeating structure, the same kind of anti-MUC1 antibody can be immobilized and fluorescently labeled.
- LacdiNAc-PSA As a first method for quantifying LacdiNAc-PSA, the whole blood sample (PSA) that is not fractionated LacdiNAc-PSA is subjected to SPFS and is immobilized on the surface of the sensor chip.
- Anti-PSA antibody solid-phased anti-PSA antibody
- LacdiNAc-PSA LacdiNAc-PSA
- a lectin for LacdiNAc-PSA fluorescence-labeled LacdiNAc-PSA lectin
- the anti-PSA antibody can be prepared by a known general technique, and a commercially available one can also be purchased. From the viewpoint of measurement stability, it is preferable to use a monoclonal antibody rather than a polyclonal antibody.
- Examples of commercially available anti-PSA monoclonal antibodies include PS2, PS3, PS4, PS5, PS6, PS15, 2H9, 3B4, 5A6, 5G6, 8G4, 9A8, 9G2, PS1, 8A6, 2H9, 1H12, No. 1, and the like. 79.
- an antibody having a protein portion as an epitope rather than a PSA sugar chain so as not to prevent the fluorescently labeled LacdiNAc-PSA lectin from recognizing and binding a specific sugar residue in the sugar chain.
- the fluorescently labeled LacdiNAc-PSA lectin can be prepared by binding a target fluorescent substance to a lectin that recognizes a LacdiNAc residue typified by WFA using a known general technique.
- a commercially available fluorescent substance labeling kit or the like can also be used.
- the fluorescent substance is not particularly limited, and a known fluorescent dye that can emit appropriate fluorescence by SPFS can be used.
- PSA having LacdiNAc residues not only PSA having LacdiNAc residues but also PSA having LacdiNAc residues and fucose ⁇ (1,2) galactose residues are used to obtain diagnostic information regarding prostate cancer. It is also possible to use both of the PSAs to be quantified (see Patent Document 1 and Patent Document 5). In that case, a fluorescent-labeled LacdiNAc-PSA lectin is prepared using a lectin that recognizes both LacdiNAc residues and fucose ⁇ (1,2) galactose residues, for example, Kikarasuuri lectin-II (TJA-II). It is also possible to do.
- a LacdiNAc-PSA fraction is prepared from a blood sample in advance using a lectin for LacdiNAc-PSA1, the LacdiNAc-PSA fraction is subjected to SPFS, and an immobilized anti-PSA antibody , LacdiNAc-PSA, and a method of forming a sandwich-type immune complex consisting of three components: a fluorescent substance-bound anti-PSA antibody (fluorescence-labeled anti-PSA antibody).
- the solid-phased anti-PSA antibody used in the second quantification method of LacdiNAc-PSA can be the same type as the solid-phased anti-PSA antibody used in the first quantification method of LacdiNAc-PSA described above.
- the fluorescently labeled anti-PSA antibody can be prepared by binding a target fluorescent substance to the anti-PSA antibody using a known technique, and in that case, a commercially available fluorescent substance labeling kit or the like can also be used.
- the fluorescent substance is not particularly limited, and a known fluorescent dye that can emit appropriate fluorescence by SPFS can be used.
- an anti-PSA antibody solid-phased anti-PSA antibody immobilized on the surface of a sensor chip, PSA, and an anti-PSA antibody (fluorescent substance) bound to a phosphor are used. And a method of forming a sandwich-type immune complex consisting of three (labeled anti-PSA antibody).
- the solid-phased anti-PSA antibody used for quantification of total PSA can be the same type as the solid-phased anti-PSA antibody used for quantification of LacdiNAc-PSA.
- the type of fluorescently labeled anti-PSA antibody (fluorescent substance and / or anti-PSA antibody) used for quantification of total PSA is the same as that of fluorescently labeled anti-PSA antibody (fluorescent substance and / or fluorescent substance and / or anti-PSA antibody) used in the second method of LacdiNAc-PSA quantification.
- the same type of anti-MUC1 antibody can be used.
- ELISA As a quantification method of measurement objects other than SPFS, ELISA currently used widely as a quantification method of a living body related substance is mentioned, for example.
- an analyte can be quantified in the form of a sandwich-type assay that forms a complex consisting of a solid phase probe (antibody), an analyte, and an enzyme labeling probe (antibody or lectin).
- the measurement object is quantified based on the amount of dye (signal intensity) generated by the reaction between the enzyme of the enzyme labeling probe and a predetermined substrate.
- LacdiNAc-PSA is quantified using ELISA, as in the second quantification method of LacdiNAc-PSA described above, for example, WFA is supported by using a lectin that recognizes and binds to a specific sugar residue.
- the fraction containing LacdiNAc-PSA must be separated from all PSA in the blood sample in advance using the lectin affinity column.
- Patent Document 1 describes a method for quantifying PSA, which is a specific glycoprotein, using ELISA and a lectin affinity column carrying a specific lectin. can do.
- Threshold value for determining whether or not the concentration value of total MUC1 in the measured blood sample used in the first embodiment and the second, third and fourth embodiments using the same is a certain disease
- the threshold value (first threshold value regarding the total MUC1) can be set by a general method.
- the concentration of total MUC1 is measured for blood samples derived from a plurality of patients diagnosed with prostate cancer and blood samples derived from a plurality of patients confirmed to be benign prostate diseases such as benign prostatic hyperplasia, By obtaining the concentration contained in the latter measurement data at a ratio equal to or higher than the reference, this concentration can be used as a threshold for estimating prostate benign disease.
- the ratio used as the standard of the measurement data corresponds to the reliability regarding the estimation of benign prostatic disease, that is, the probability that the estimation is correct.
- a highly reliable threshold value can be set.
- the measured value of the total MUC1 concentration of a blood sample is compared with the threshold value thus set, and if the measured value of the total MUC1 concentration is greater than the threshold value, the blood sample is suffering from a benign prostate disease It can be estimated with a certain probability that it is derived from a diagnosis object.
- Threshold value for comparison with the measurement value of the total PSA concentration in the blood sample used in the second embodiment, for comparison with the measurement value of the LacdiNAc-PSA concentration in the blood sample used in the third embodiment This threshold value (first threshold value for LacdiNAc-PSA) can also be set by the same method as described above.
- the concentration of LacdiNAc-PSA in the blood sample for detecting prostate cancer with high metastasis, prostate cancer with prostate benign disease or hormone resistant prostate cancer used in the fourth embodiment, total MUC1 Threshold values for comparison with the respective concentrations can also be set by the same method as described above.
- the threshold values used in the fourth embodiment are different from the threshold values used in the third embodiment, and generally both LacdiNAc-PSA and total MUC1 are higher than those in the third embodiment.
- Both the analysis in the third embodiment and the analysis in the fourth embodiment are common in that the concentration of LacdiNAc-PSA and the concentration of total MUC1 in the blood sample are compared with a predetermined threshold value, and therefore can be performed simultaneously. Is possible.
- a kit can be constructed by collecting necessary reagents.
- the diagnostic information analysis method is typically carried out using a quantitative method based on a sandwich type assay such as SPFS or ELISA, and if necessary, in combination with a fractionation method using a lectin affinity column. Therefore, the kit typically also has reagents for forming a sandwich-type immune complex suitable for those methods, that is, an antibody that is a biological substance for immobilization and a lectin or antibody that is a biological substance for detection. And a lectin for producing a lectin affinity column can be used as a constituent as necessary.
- the kit for carrying out the first embodiment of the diagnostic information analysis method may be configured to include at least an anti-MUC1 antibody as a reagent for quantifying total MUC1. it can.
- This anti-MUC1 antibody is used for solid phase binding to the surface of a sensor chip for SPFS or a substrate for ELISA, and if the quantitative method is SPFS, it is bound to a fluorescent substance to produce a fluorescently labeled anti-MUC1 antibody. If the quantification method is ELISA, it is used for detection to produce an enzyme-labeled anti-MUC1 antibody by binding with an enzyme that reacts with a predetermined substrate. Therefore, the anti-MUC1 antibody in this case includes an anti-MUC1 antibody for immobilization and an anti-MUC1 antibody for detection, but they may be of the same type.
- a kit for carrying out the second embodiment of the diagnostic information analyzing method can be configured to include at least the following reagents: As a reagent for quantifying total MUC1 Anti-MUC1 antibody; Anti-PSA antibody as a reagent for quantifying PSA.
- the reagent for quantifying the total MUC1 is the same as that of the first embodiment of the kit described above.
- the anti-PSA antibody as a reagent for quantifying PSA should be used for solid phase binding to the surface of a sensor chip for SPFS or a substrate for ELISA, and SPFS be the quantification method.
- SPFS be the quantification method.
- the anti-PSA antibody in this case includes an anti-PSA antibody for immobilization and an anti-PSA antibody for detection.
- the kit for carrying out the third embodiment of the diagnostic information analysis method can be configured to include at least the following reagents: As a reagent for quantifying total MUC1 An anti-MUC1 antibody; a lectin that recognizes and binds to an anti-PSA antibody and a LacdiNAc residue as a reagent for quantifying LacdiNAc-PSA.
- the reagent for quantifying the total MUC1 is the same as that of the first embodiment of the kit described above.
- the anti-PSA antibody contained in the kit is used for solid phase binding to the surface of a sensor chip for SPFS or a substrate for ELISA.
- a lectin that recognizes and binds to a LacdiNAc residue is used to produce a lectin for fluorescently labeled LacdiNAc-PSA by binding to a fluorescent substance if the quantification method is SPFS, and is predetermined if the quantification method is ELISA It is used for detection to produce an enzyme-labeled LacdiNAc-PSA lectin by binding with an enzyme that reacts with the substrate.
- the anti-PSA antibody included in the kit is used for solid phase binding to the surface of a sensor chip for SPFS or a substrate for ELISA, and the quantification method is SPFS. If present, it is combined with a fluorescent substance to produce a fluorescent labeled anti-PSA antibody. If the quantification method is ELISA, it is used for detection to produce an enzyme labeled anti-PSA antibody by binding to an enzyme that reacts with a predetermined substrate. Therefore, the anti-PSA antibody in this case includes an anti-PSA antibody for immobilization and an anti-PSA antibody for detection. On the other hand, a lectin that recognizes and binds to LacdiNAc residues is used to prepare a lectin affinity column for preparing a LacdiNAc-PSA fraction.
- an anti-KL-6 monoclonal antibody is preferable.
- the embodiment including both the anti-MUC1 antibody for immobilization and the anti-MUC1 antibody for detection. are preferably both anti-KL-6 monoclonal antibodies.
- the kit for carrying out the diagnostic information analysis method of each embodiment may include reagents, instruments, instructions for use, etc. other than the above-described reagents as necessary.
- reagents and instruments include a reagent for immobilizing a predetermined antibody on the surface of a sensor chip for SPFS or a substrate for ELISA, a reagent for binding a fluorescent substance to a predetermined lectin or antibody.
- the instruction manual also includes information necessary for carrying out the diagnostic information analysis method according to each embodiment of the present invention, such as a method (protocol) for using the reagents and instruments described above, and analysis of diagnostic information. And the like can be described.
- the substrate on which the gold thin film was thus formed was immersed in an ethanol solution of 10-carboxy-1-decanethiol (concentration 25 mg / mL) for 24 hours or more to form a SAM film on the surface of the gold thin film.
- the substrate was taken out of the ethanol solution, washed with ethanol and isopropanol, and then dried using an air gun.
- phosphate buffered saline containing 50 mM N-hydroxysuccinimide and 100 mM ethyl (dimethylaminopropyl) carbodiimide was fed and circulated for 20 minutes.
- 2.5 mL of a commercially available anti-MUC1 monoclonal antibody (anti-KL-6 monoclonal antibody) solution is circulated for 30 minutes to immobilize the antibody on the SAM membrane and form an anti-MUC1 antibody-immobilized region.
- non-specific adsorption prevention treatment in the flow path was performed by circulating and feeding phosphate buffered saline containing 1% by weight bovine serum albumin for 30 minutes.
- Tris-buffered physiological saline containing 0.05% by weight of Tween (registered trademark) 20 was circulated for 10 minutes.
- Blank measurement step In a state where the flow path was filled with the Tris-buffered physiological saline, a laser beam with a wavelength of 635 nm was adjusted to the amount of photons with an optical filter, and was irradiated to the metal thin film through the prism from the back surface of the plasmon excitation sensor.
- a CCD image sensor (Texas Instruments Co., Ltd.) installed at the top of the measurement area with an objective lens with a magnification of 20 times was used to measure the intensity of light that passed through a filter that cuts off wavelengths other than fluorescent components. . Since this measured value is a noise value that does not include the fluorescence emitted by the phosphor labeled with MUC1, it is a blank value.
- Labeling step 5 mL of phosphate buffered saline (1 ng / mL) containing Alexa Fluor 647-labeled anti-MUC1 antibody prepared in the preparation / preparation step (4) was circulated for 20 minutes.
- Second washing step Tris-buffered saline containing 0.05% by weight of Tween (registered trademark) 20 was circulated for 20 minutes.
- Signal measurement step The light intensity was measured in the same manner as in the blank measurement step with the flow path filled with the Tris buffered saline. This measured value corresponds to a signal including fluorescence emitted from a phosphor labeled with MUC1.
- FIG. 1 shows the result of quantification of the quantification step (1): total MUC1 (KL6). It has been shown that the concentration of total MUC1 (KL6) in the blood sample is higher in patients with benign prostatic hyperplasia than in patients with prostate cancer. Therefore, based on this result, it can be seen that, for example, a concentration corresponding to a certain value of 4.5 to 5 units can be set as the threshold value in the first embodiment of the analysis method of the present invention.
- FIG. 2 shows the quantification step (1): the result of quantification of total MUC1 (KL6) (horizontal axis) and the quantification step (2): the result of quantification of total PSA (vertical axis).
- KL6 the result of quantification of total MUC1
- PSA vertical axis
- a false positive result that the threshold for total PSA that has been used for conventional diagnosis includes a gray zone and a certain number of patients with benign prostatic hyperplasia is prostate cancer is obtained. Even in the case of giving, it can be seen that it is possible to correctly determine that a false-positive patient has prostatic hypertrophy by using a threshold regarding total MUC1 (KL6) together.
- FIG. 3 shows the quantification step (1): the result of quantification of total MUC1 (KL6) (horizontal axis) and the quantification step (3): the result of quantification of LacdiNAc-PSA (vertical axis).
- KL6 the result of quantification of total MUC1
- LacdiNAc-PSA vertical axis
- the threshold for LacdiNAc-PSA disclosed in Patent Document 1 includes a gray zone, and a false positive result that a certain number of patients with benign prostatic hyperplasia is prostate cancer Even in the case of giving a positive value, it can be seen that a false-positive patient can be correctly determined to have prostatic hypertrophy by using a threshold value related to total MUC1 (KL6).
- FIG. 3 shows one sample having a high total MUC1 (KL6) concentration and a relatively high concentration of LacdiNAc-PSA (a sample surrounded by a dotted circle), which is a prostate cancer.
- KL6 total MUC1
- LacdiNAc-PSA a sample surrounded by a dotted circle
- FIG. 3 shows one sample having a high total MUC1 (KL6) concentration and a relatively high concentration of LacdiNAc-PSA (a sample surrounded by a dotted circle), which is a prostate cancer.
- KL6 total MUC1
- LacdiNAc-PSA a sample surrounded by a dotted circle
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Abstract
Description
[1] 診断対象に由来する血液検体中の全てのムチン-1(トータルMUC1)の濃度を測定し、得られた測定値を閾値と比較し、トータルMUC1の濃度の測定値が閾値よりも大きいことをもって、診断対象が罹患している疾患は前立腺癌ではなく前立腺良性疾患であると推定する診断用情報の分析方法。
[2] 診断対象に由来する血液検体中の全てのムチン-1(トータルMUC1)の濃度を測定し、得られた測定値を閾値と比較し、トータルMUC1の濃度が閾値よりも大きいことをもって、診断対象が罹患している疾患は前立腺癌ではなく前立腺良性疾患であると推定する診断用情報の分析方法と、診断対象が前立腺疾患に罹患していることを示す前立腺特異抗原に関する診断用情報とを組み合わせて、診断対象が前立腺良性疾患と前立腺癌のどちらに罹患しているかを推定する診断用情報の分析方法。
[3] 診断対象に由来する血液検体中の全てのムチン-1(トータルMUC1)の濃度を測定し、得られた測定値を閾値と比較し、トータルMUC1の濃度の測定値が閾値よりも大きいことをもって、診断対象が罹患している疾患は前立腺癌ではなく前立腺良性疾患であると推定する診断用情報の分析方法と、診断対象に由来する血液検体中の、N-アセチル-D-ガラクトサミンβ1-4Nアセチルグルコサミン残基を認識して結合するレクチンとの反応性を有する前立腺特異抗原(LacdiNAc-PSA)の濃度を測定し、得られた測定値を閾値と比較し、LacdiNAc-PSAの濃度の測定値が閾値よりも大きいことをもって、診断対象が罹患している疾患は前立腺良性疾患ではなく前立腺癌であると推定する診断用情報の分析方法とを組み合わせて、診断対象が前立腺良性疾患と前立腺癌のどちらに罹患しているかを推定する診断用情報の取得方法。
[4] [3]の診断用情報の分析方法において、診断対象が前立腺癌に罹患していると推定される場合に、さらに、トータルMUC1の濃度の測定値が[3]に記載の閾値より大きなもう一つの閾値よりも大きく、かつLacdiNAc-PSAの濃度の測定値が[3]に記載の閾値より大きなもう一つの閾値よりも大きいことをもって、診断対象が罹患している前立腺癌が、転移性の高い前立腺癌、前立腺良性疾患を伴う前立腺癌またはホルモン抵抗性の前立腺癌であると推定する診断用情報の分析方法。
[5] 前記前立腺良性疾患が前立腺肥大症である、[1]~[4]のいずれか一項に記載の診断用情報の分析方法。
[6] 前記トータルMUC1が、抗KL-6モノクローナル抗体との反応性を有するものである、[1]~[5]のいずれか一項に記載の診断用情報の分析方法。
[7] [1]に記載の診断用情報の分析方法を実施するためのキットであって、トータルMUC1を定量するための抗ムチン-1抗体を含む診断用キット。
[8] [2]に記載の診断用情報の分析方法を実施するためのキットであって、トータルMUC1を定量するための抗ムチン-1抗体と、抗前立腺特異抗原を定量するための抗前立腺特異抗原抗体とを含む診断用キット。
[9] [3]または[4]に記載の診断用情報の分析方法を実施するためのキットであって、トータルMUC1を定量するための抗ムチン-1抗体と、抗前立腺特異抗原を定量するための抗前立腺特異抗原抗体およびN-アセチル-D-ガラクトサミンβ1-4Nアセチルグルコサミン残基を認識して結合するレクチンを含む診断用キット。
[10] 前記抗ムチン-1抗体が抗KL-6モノクローナル抗体である、[7]~[9]のいずれか一項に記載の診断用キット。
[11] さらに、診断用情報の分析方法を実施するために必要な情報を記載した使用説明書を含む、[7]~[10]のいずれか一項に記載の診断用キット。
本発明の診断用情報の分析方法の第1実施形態は、診断対象に由来する血液検体中の全てのMUC1、すなわちトータルMUC1の濃度を測定し、得られた測定値を閾値と比較し、トータルMUC1の濃度の測定値が閾値よりも大きいことをもって、診断対象が罹患している疾患は前立腺癌ではなく前立腺良性疾患であると推定する診断用情報の分析方法である。
本発明の分析方法では、特定の糖タンパク質の濃度を測定するための試料として、診断対象に由来する血液検体を用いる。
本発明の分析方法の第3実施形態および第4実施形態では、LacdiNAc-PSAを定量するためにLacdiNAc残基を認識して結合するレクチンを用いる。そのようなレクチンの代表例としてはWFAが挙げられるが、本発明で用いることのできるレクチンはこれに限定されるものではない。すなわち、LacdiNAc-PSAの糖鎖中に含まれるLacdiNAc残基を認識して結合する能力を有し、血液検体中のLacdiNAc-PSAの濃度を測定するために利用することのできるレクチンであれば、WFAと同様に本発明で用いることができる。
本発明の分析方法を実施する際には、トータルMUC1、LacdiNAc-PSAおよびトータルPSAの3項目の測定対象物から、実施形態に応じて必要な、選ばれた項目または全3項目の対象物を測定、定量する必要がある。これらの測定対象物の定量方法は、各実施形態における分析を実施するために十分な精度を有する測定値が得られるものであれば特に限定されるものではなく、公知の定量方法の中から適宜選択することができる。
SPFSを実施するための基本的な構成、すなわち、センサーチップ、測定装置およびシステム、測定手順等の実施形態は公知であり、これらを応用して本発明を適切に実施することができる。SPFSでは、固相化用プローブ(抗体)-測定対象物-蛍光標識用プローブ(レクチンまたは抗体)の三者からなる複合体を形成させる、サンドイッチ型アッセイの形態で測定対象物を定量することが一般的である。
トータルMUC1の定量方法としては、センサーチップの表面に固相化された抗MUC1抗体(固相化抗MUC1抗体)、MUC1、および蛍光物質が結合した抗MUC1抗体(蛍光標識抗MUC1抗体)の三者からなるサンドイッチ型免疫複合体を形成させる方法が挙げられる。
LacdiNAc-PSAの定量における第1の方法としては、LacdiNAc-PSAを分画していない血液検体(PSA)全体をSPFSに供し、センサーチップの表面に固相化された抗PSA抗体(固相化抗PSA抗体)、LacdiNAc-PSA、および蛍光体が結合したLacdiNAc-PSA用レクチン(蛍光標識LacdiNAc-PSA用レクチン)の三者からなるサンドイッチ型免疫複合体を形成させる方法が挙げられる。
トータルPSAの定量方法としては、センサーチップの表面に固相化された抗PSA抗体(固相化抗PSA抗体)、PSA、および蛍光体が結合した抗PSA抗体(蛍光標識抗PSA抗体)の三者からなるサンドイッチ型免疫複合体を形成させる方法が挙げられる。
SPFS以外の測定対象物の定量方法としては、たとえば、生体関連物質の定量方法として汎用されているELISAが挙げられる。ELISAでは、固相化用プローブ(抗体)-測定対象物-酵素標識用プローブ(抗体またはレクチン)の三者からなる複合体を形成させる、サンドイッチ型アッセイの形態で測定対象物を定量することが一般的であり、酵素標識用プローブの酵素と所定の基質との反応により生成する色素量(シグナル強度)に基づいて測定対象物を定量する。
第1実施形態およびこれを利用する第2,第3および第4実施形態で用いられる、測定した血液検体中のトータルMUC1の濃度値を、ある疾患であるか否かを判別するための閾値(トータルMUC1に関する第1の閾値)のは、一般的な手法によって設定することができる。たとえば、前立腺癌と確定診断された複数の患者に由来する血液検体、および前立腺肥大症等の前立腺良性疾患と確定診断された複数の患者に由来する血液検体について、トータルMUC1の濃度を測定し、後者の測定データが基準とする比率以上で含まれる濃度を求めることにより、この濃度を前立腺良性疾患と推定するための閾値とすることができる。前記測定データの基準とする比率が、前立腺良性疾患の推定に関する信頼性、即ち、推定が正しい確率に相当する。測定データの母集団であるサンプル数を多くするほど、信頼性の高い閾値を設定することが可能となる。ある血液検体のトータルMUC1の濃度の測定値をそのようにして設定された閾値と比較し、トータルMUC1の濃度の測定値が閾値よりも大きければ、この血液検体は前立腺良性疾患に罹患している診断対象に由来するものであると、ある確率でもって推定することができる。前記測定データから、前立腺良性疾患に罹患している診断対象由来の血液検体について分析した場合に100%陽性と判定し、前立腺癌に罹患している診断対象由来の血液検体について分析した場合に100%陰性と判定できる閾値を設定できれば理想的であるが、現実的にそのようなことは困難である。目的とする分析の精度を考慮して、前立腺良性疾患に罹患している診断対象由来の血液検体について分析した場合に望ましい高い確率で陽性と判定できる閾値、逆に言えば前立腺癌に罹患している診断対象由来の血液検体について分析した場合に擬陽性と判定されてしまう確率をなるべく低くできる閾値を設定すればよい。
本発明の診断用情報の分析方法を効率的に実施するために、必要な試薬類をまとめてキットを構成することができる。診断用情報の分析方法は、典型的にはSPFSやELISAのようなサンドイッチ型アッセイに基づく定量方法を用いて、また必要に応じてレクチンアフィニティーカラムによる分画法を併用して実施する。したがってキットも、典型的にはそれらの方法に適したサンドイッチ型免疫複合体を形成するための試薬類、すなわち、固相化用生体関連物質である抗体および検出用生体関連物質であるレクチンまたは抗体を主要な構成物とし、また必要に応じてレクチンアフィニティーカラムを作製するためのレクチンも構成物とすることができる。
(1)プラズモン励起センサーの作製
厚さ1mmのガラス製の透明平面基板((株)オハラ「S-LAL 10」、屈折率1.72)をプラズマ洗浄した後、この基板の片面にクロム薄膜をスパッタリング法によって形成し、このクロム薄膜の表面にさらに金薄膜をスパッタリング法によって形成した。クロム薄膜の厚さは1~3nm、金薄膜の厚さは44~52nmであった。このようにして金薄膜が形成された基板を、10-カルボキシ-1-デカンチオールのエタノール溶液(濃度25mg/mL)に24時間以上浸漬し、金薄膜の表面にSAM膜を形成した。この基板をエタノール溶液から取り出し、エタノールおよびイソプロパノールで洗浄した後、エアガンを用いて乾燥させた。
前記工程で作製したプラズモン励起センサー(金薄膜)の表面に、幅2mm、長さ14mmの流路となる穴を有する、厚さ0.5mmのシート状のシリコーンゴムスペーサーを積載した。さらにその上に、両端に貫通孔を有する厚さ2mmのポリメチルメタクリレート板を積載して圧着し、ビスでプラズモン励起センサーに固定して、貫通穴を通じて試料、試薬等を送液することのできる流路を備えた、SPFS用流路型測定部材を作製した。
WFA(L-1350、Vector社)を、Alexa Fluor(商標名)647タンパク質ラベリングキット(インビトロゲン社)を用いて蛍光標識化した。手順はそのキットに添付されたプロトコールに従った。未反応のレクチンおよび蛍光色素を除去するため、限外濾過膜(日本ミリポア(株)製)を用いて反応物を精製し、Alexa Fluor 647標識WFA溶液を得た。吸光度を測定してその溶液のAlexa Fluor 647標識WFAの濃度を求めた後、4℃で保存した。
前記工程(3)において、WFAの代わりに市販の抗MUC1モノクローナル抗体(抗KL-6モノクローナル抗体)を用い、それ以外は同様にして、Alexa Fluor 647標識抗MUC1抗体を作製した。なお、この抗MUC1モノクローナル抗体は、後述する抗MUC1抗体固相化領域の形成にも用いた。
前記工程(3)において、WFAの代わりに市販の抗PSAモノクローナル抗体(ミクリ免疫研究所(株)、クローンNo.79、2.5mg/mL)を用い、それ以外は同様にして、Alexa Fluor 647標識抗PSA抗体を作製した。
前立腺癌の確定診断を受けた患者に由来する血清サンプルおよび前立腺肥大症の確定診断を受けた患者に由来する血清サンプルそれぞれについて、リン酸緩衝溶液にて2~10倍に稀釈し、血液検体を調製した。
前記作製・調製工程(6)で調製した血液検体のそれぞれについて、下記の手順により、トータルMUC1、LacdiNAc-PSAおよびトータルPSAそれぞれの濃度を測定した。
(1-1)抗MUC1抗体固相化領域の形成
前記作製・調製工程(2)で作製したSPFS用流路型測定部材の流路に、超純水を10分間、その後、リン酸緩衝生理食塩水を20分間、ペリスタポンプによって、室温(25℃)、流速500μL/分の条件で循環送液し、プラズモン励起センサーの表面を平衡化した。続いて、N-ヒドロキシコハク酸イミドを50mMと、エチル(ジメチルアミノプロピル)カルボジイミドを100mMとを含むリン酸緩衝生理食塩水を5mL送液し、20分間循環させた。その後、市販の抗MUC1モノクローナル抗体(抗KL-6モノクローナル抗体)溶液2.5mLを30分間循環送液することで、SAM膜上に当該抗体を固相化し、抗MUC1抗体固相化領域を形成した。さらに、1重量%牛血清アルブミンを含むリン酸緩衝生理食塩水を30分間循環送液することによって、流路内の非特異吸着防止処理を行った。
試料送液工程:前記抗MUC1抗体固相化領域が形成された流路に、前記作製・調製工程(6)で調製した血液検体を25分間、循環送液した。
(2-1)抗PSA抗体固相化領域の形成
トータルMUC1の定量における前記工程(1-1)において、前記抗MUC1モノクローナル抗体の代わりに市販の抗PSAモノクローナル抗体を用い、それ以外は同様にして、抗PSA抗体固相化領域を形成した。
トータルMUC1の定量における前記工程(1-2)において、前記作製・調製工程(4)で作製したAlexa Fluor 647標識抗MUC1抗体の代わりに、前記作製・調製工程(5)で作製したAlexa Fluor 647標識抗PSA抗体を用い、それ以外は同様にして、トータルPSAを定量した。
(3-1)抗PSA抗体固相化領域の形成
トータルMUC1の定量における前記工程(1-1)において、前記抗MUC1モノクローナル抗体の代わりに市販の抗PSAモノクローナル抗体を用い、それ以外は同様にして、抗PSA抗体固相化領域を形成した。
トータルMUC1の定量における前記工程(1-2)において、前記作製・調製工程(4)で作製したAlexa Fluor 647標識抗MUC1抗体の代わりに、前記作製・調製工程(3)で作製したAlexa Fluor 647標識WFAを用い、それ以外は同様にして、LacdiNAc-PSAを定量した。
図1に、前記定量工程(1):トータルMUC1(KL6)の定量の結果を示す。血液検体中のトータルMUC1(KL6)の濃度は、前立腺癌患者よりも前立腺肥大症患者の方が高いことが示されている。したがって、この結果に基づいた場合は、たとえば4.5~5unitのある値に相当する濃度を、本発明の分析方法の第1実施形態における閾値として設定することが可能であることが分かる。
Claims (11)
- 診断対象に由来する血液検体中の全てのムチン-1(トータルMUC1)の濃度を測定し、得られた測定値を閾値と比較し、トータルMUC1の濃度の測定値が閾値よりも大きいことをもって、診断対象が罹患している疾患は前立腺癌ではなく前立腺良性疾患であると推定する診断用情報の分析方法。
- 診断対象に由来する血液検体中の全てのムチン-1(トータルMUC1)の濃度を測定し、得られた測定値を閾値と比較し、トータルMUC1の濃度の測定値が閾値よりも大きいことをもって、診断対象が罹患している疾患は前立腺癌ではなく前立腺良性疾患であると推定する診断用情報の分析方法と、
診断対象が前立腺疾患に罹患していることを示す前立腺特異抗原に関する診断用情報と
を組み合わせて、診断対象が前立腺良性疾患と前立腺癌のどちらに罹患しているかを推定する診断用情報の分析方法。 - 診断対象に由来する血液検体中の全てのムチン-1(トータルMUC1)の濃度を測定し、得られた測定値を閾値と比較し、トータルMUC1の濃度の測定値が閾値よりも大きいことをもって、診断対象が罹患している疾患は前立腺癌ではなく前立腺良性疾患であると推定する診断用情報の分析方法と、
診断対象に由来する血液検体中の、N-アセチル-D-ガラクトサミンβ1-4Nアセチルグルコサミン残基を認識して結合するレクチンとの反応性を有する前立腺特異抗原(LacdiNAc-PSA)の濃度を測定し、得られた測定値を閾値と比較し、LacdiNAc-PSAの濃度の測定値が閾値よりも大きいことをもって、診断対象が罹患している疾患は前立腺良性疾患ではなく前立腺癌であると推定する診断用情報の分析方法と
を組み合わせて、診断対象が前立腺良性疾患と前立腺癌のどちらに罹患しているかを推定する診断用情報の分析方法。 - 請求項3の診断用情報の分析方法において、診断対象が前立腺癌に罹患していると推定される場合に、さらに、
トータルMUC1の濃度の測定値が請求項3に記載の閾値より大きなもう一つの閾値よりも大きく、かつLacdiNAc-PSAの濃度の測定値が請求項3に記載の閾値より大きなもう一つの閾値よりも大きいことをもって、診断対象が罹患している前立腺癌が、転移性の高い前立腺癌、前立腺良性疾患を伴う前立腺癌またはホルモン抵抗性の前立腺癌であると推定する診断用情報の分析方法。 - 前記前立腺良性疾患が前立腺肥大症である、請求項1~4のいずれか一項に記載の診断用情報の分析方法。
- 前記トータルMUC1が、抗KL-6モノクローナル抗体との反応性を有するものである、請求項1~5のいずれか一項に記載の診断用情報の分析方法。
- 請求項1に記載の診断用情報の分析方法を実施するためのキットであって、
トータルMUC1を定量するための抗ムチン-1抗体を含む診断用キット。 - 請求項2に記載の診断用情報の分析方法を実施するためのキットであって、
トータルMUC1を定量するための抗ムチン-1抗体と、抗前立腺特異抗原を定量するための抗前立腺特異抗原抗体とを含む診断用キット。 - 請求項3または4に記載の診断用情報の分析方法を実施するためのキットであって、
トータルMUC1を定量するための抗ムチン-1抗体と、LacdiNAc-PSAを定量するための抗前立腺特異抗原抗体およびN-アセチル-D-ガラクトサミンβ1-4Nアセチルグルコサミン残基を認識して結合するレクチンを含む診断用キット。 - 前記抗ムチン-1抗体が抗KL-6モノクローナル抗体である、請求項7~9のいずれか一項に記載の診断用キット。
- さらに、診断用情報の分析方法を実施するために必要な情報を記載した使用説明書を含む、請求項7~10のいずれか一項に記載の診断用キット。
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- 2013-12-27 EP EP13900337.0A patent/EP3088895A4/en not_active Withdrawn
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JPWO2015097863A1 (ja) | 2017-03-23 |
JP6323463B2 (ja) | 2018-05-16 |
US20160305960A1 (en) | 2016-10-20 |
US10222385B2 (en) | 2019-03-05 |
EP3088895A1 (en) | 2016-11-02 |
EP3088895A4 (en) | 2017-08-09 |
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