WO2023159427A1 - 共表达CD45和EpCAM的细胞群的检测和分离方法及其用途 - Google Patents

共表达CD45和EpCAM的细胞群的检测和分离方法及其用途 Download PDF

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WO2023159427A1
WO2023159427A1 PCT/CN2022/077693 CN2022077693W WO2023159427A1 WO 2023159427 A1 WO2023159427 A1 WO 2023159427A1 CN 2022077693 W CN2022077693 W CN 2022077693W WO 2023159427 A1 WO2023159427 A1 WO 2023159427A1
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epcam
cells
peripheral blood
blood mononuclear
cell
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PCT/CN2022/077693
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English (en)
French (fr)
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孙振
李斌
李文静
赵明明
王泽瑶
刘文娜
高青
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青岛华赛伯曼医学细胞生物有限公司
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Priority to CN202280001099.XA priority Critical patent/CN114729055B/zh
Priority to PCT/CN2022/077693 priority patent/WO2023159427A1/zh
Priority to CN202210491339.0A priority patent/CN114891106B/zh
Publication of WO2023159427A1 publication Critical patent/WO2023159427A1/zh

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    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K16/00—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies
    • C07K16/18—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans
    • C07K16/28—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants
    • C07K16/289—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants against CD45
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K16/00—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies
    • C07K16/18—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans
    • C07K16/28—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants
    • C07K16/30—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants from tumour cells
    • C—CHEMISTRY; METALLURGY
    • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12N—MICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
    • C12N5/00—Undifferentiated human, animal or plant cells, e.g. cell lines; Tissues; Cultivation or maintenance thereof; Culture media therefor
    • C12N5/06—Animal cells or tissues; Human cells or tissues
    • C12N5/0602—Vertebrate cells
    • C12N5/0693—Tumour cells; Cancer cells
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N15/00—Investigating characteristics of particles; Investigating permeability, pore-volume or surface-area of porous materials
    • G01N15/10—Investigating individual particles
    • G01N15/14—Optical investigation techniques, e.g. flow cytometry
    • 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
    • G01N33/569—Immunoassay; Biospecific binding assay; Materials therefor for microorganisms, e.g. protozoa, bacteria, viruses
    • G01N33/56966—Animal cells
    • 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
    • G01N33/57484—Immunoassay; Biospecific binding assay; Materials therefor for cancer involving compounds serving as markers for tumor, cancer, neoplasia, e.g. cellular determinants, receptors, heat shock/stress proteins, A-protein, oligosaccharides, metabolites
    • G01N33/57492—Immunoassay; Biospecific binding assay; Materials therefor for cancer involving compounds serving as markers for tumor, cancer, neoplasia, e.g. cellular determinants, receptors, heat shock/stress proteins, A-protein, oligosaccharides, metabolites involving compounds localized on the membrane of tumor or cancer cells
    • 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
    • G01N33/6872—Intracellular protein regulatory factors and their receptors, e.g. including ion channels
    • 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
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K2317/00—Immunoglobulins specific features
    • C07K2317/90—Immunoglobulins specific features characterized by (pharmaco)kinetic aspects or by stability of the immunoglobulin
    • C07K2317/92—Affinity (KD), association rate (Ka), dissociation rate (Kd) or EC50 value
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N15/00—Investigating characteristics of particles; Investigating permeability, pore-volume or surface-area of porous materials
    • G01N15/10—Investigating individual particles
    • G01N15/14—Optical investigation techniques, e.g. flow cytometry
    • G01N2015/1486—Counting the particles
    • 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
    • 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
    • G01N2333/70589—CD45
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N2800/00—Detection or diagnosis of diseases
    • G01N2800/52—Predicting or monitoring the response to treatment, e.g. for selection of therapy based on assay results in personalised medicine; Prognosis

Definitions

  • the present invention relates to the field of cellular immunology, in particular to a composition based on an anti-CD45 antibody and an anti-EpCAM antibody, a corresponding kit and its ability to detect and isolate co-expressed CD45 and EpCAM from peripheral blood mononuclear cells (PBMC) Use in Cell Populations. It also relates to the use of cell populations co-expressing CD45 and EpCAM for in vitro screening of cancer, guidance of treatment, and evaluation of treatment effectiveness.
  • PBMC peripheral blood mononuclear cells
  • Cancer is a tumor that threatens human health, and its morbidity and mortality are increasing rapidly worldwide.
  • lung cancer has insidious onset, untimely diagnosis, easy metastasis and recurrence, and extremely poor prognosis.
  • 70-75% of the patients are not discovered until the late stage, which greatly reduces the survival rate.
  • the expansion of primary tumor cells in patients is often undetectable by conventional histopathological examination.
  • circulating tumor cells (Circulating Tumor Cell, CTC) can be used for early diagnosis, as an auxiliary method for early screening, and can be used to identify whether patients after tumor resection need further systemic treatment.
  • CTC refers to the formation of tumor cells in the primary tumor or metastatic lesions that enter the circulating blood through active migration, invasion, or external factor interference to cause them to fall off (King et al., 2015; Lin et al., 2014).
  • Dr. Ashworth of Australia found cells similar to the primary tumor in the peripheral blood of patients who died of cancer through a microscope, and first proposed the concept of CTC (Ashworth, 1869).
  • the presence of CTCs is an important risk factor for cancer metastasis and reduced survival.
  • CTCs can reflect the characteristics of primary and metastatic lesions. Therefore, in the diagnosis and treatment of lung cancer, CTC detection, counting and phenotypic analysis have gradually become the focus and focus of current research, which has important value in early diagnosis, curative effect evaluation, prognosis prediction and guidance of individualized treatment.
  • LDCT low-dose spiral CT
  • tumor autoantibodies tumor markers cannot accurately distinguish benign from malignant tumors alone.
  • Nodules present the characteristics of diversity, different diseases with the same shadow/different shadows of the same disease cause great difficulty in distinguishing benign from malignant tumors, resulting in high false positive rate, overdiagnosis, delayed diagnosis, follow-up reexamination exacerbates anxiety of patients, Affect the normal work and life of patients.
  • it also has disadvantages such as medical source radiation and high screening costs. Theoretically speaking, early lung cancer patients have CTCs in the peripheral blood even before the formation of tiny lesions in the lungs. The difficulty lies in finding an effective detection method with high sensitivity and specificity.
  • CTCs After CTCs enter the peripheral blood, most of them undergo apoptosis or are phagocytized, and only a few can escape and develop into metastases. Studies have shown that a tumor with a volume of 1cm 3 (approximately 1g wet weight) usually contains 1x10 9 cells, and about 10 6 cells enter the blood every day (Chang et al., 2000).
  • the number of CTCs in the circulating blood often presents the characteristics of a dynamic decrease, and they are very rare when they reach the peripheral blood. According to research, only one tumor cell can be detected in every 10 6 -10 7 white blood cells (Paterlini-Brechot and Benali, 2007; Sleijfer et al., 2007). Therefore, it is not easy to accurately detect CTCs from tens of millions of background cells, which is the main reason for limiting their clinical application.
  • the current mainstream idea is to first enrich tumor cells in peripheral blood and then detect them. Enrichment methods are mainly carried out by using molecular markers or physical properties on the surface of tumor cells.
  • Subsequent detection includes real-time quantitative reverse transcription PCR (Quantitative Reverse-transcription PCR, qRT-PCR) and other gene level detection; flow cytometry (Flow Cytometry, FCM), CellSearch, CTC chip (CTC-chip) and other cell level detection.
  • quantitative reverse transcription PCR Quantitative Reverse-transcription PCR, qRT-PCR
  • flow cytometry Flow Cytometry, FCM
  • CellSearch CellSearch
  • CTC chip CTC chip
  • the present invention provides a composition comprising an anti-CD45 antibody and an anti-EpCAM antibody and a corresponding kit, and the use of the composition and the kit in detecting and isolating cells co-expressing CD45 and EpCAM from peripheral blood mononuclear cells (PBMC)
  • PBMC peripheral blood mononuclear cells
  • the use in the group; a cell group co-expressing CD45 and EpCAM and the use thereof are also provided.
  • the present invention aims to provide a more efficient detection method, and the detected cell population can be more accurately used for cancer screening, auxiliary diagnosis, curative effect detection, etc. /enrichment/identification of difficult problems.
  • the invention provides a composition comprising an anti-CD45 antibody and an anti-EpCAM antibody.
  • the present invention also provides a kit, which contains the composition of the present invention.
  • the present invention also provides the use of the composition or the kit in detecting and/or isolating a cell population co-expressing CD45 and EpCAM from peripheral blood mononuclear cells.
  • the present invention also provides a method for isolating a cell population co-expressing CD45 and EpCAM, comprising:
  • peripheral blood mononuclear cells Provide peripheral blood mononuclear cells
  • composition of the present invention or the kit of the present invention with the peripheral blood mononuclear cells, and incubating the resulting mixture;
  • the magnetic beads were removed to obtain a cell population co-expressing CD45 and EpCAM.
  • the present invention also provides a cell population co-expressing CD45 and EpCAM, which is obtained by the separation method described in the present invention.
  • the present invention also provides the use of the cell population co-expressing CD45 and EpCAM in screening and/or guiding cancer treatment.
  • the present invention also provides an in vitro screening method for cancer, comprising:
  • the present invention also provides another in vitro screening method for cancer, comprising:
  • composition of the present invention or the kit of the present invention with the peripheral blood mononuclear cells, and incubating the resulting mixture;
  • the present invention also provides a method for guiding cancer treatment, comprising:
  • the subject is further examined and/or treated.
  • the present invention also provides another method for guiding cancer treatment, comprising:
  • composition of the present invention or the kit of the present invention with the peripheral blood mononuclear cells, and incubating the resulting mixture;
  • the subject is further examined and/or treated.
  • the present invention also provides a method for evaluating the effectiveness of cancer therapy, comprising:
  • the second peripheral blood mononuclear cells of the subject are collected;
  • the anticancer treatment method for the patient When y ⁇ x, the anticancer treatment method for the patient is effective; when y ⁇ x, the anticancer treatment method for the patient fails to meet expectations.
  • the present invention also provides another method for evaluating the effectiveness of cancer treatment, comprising:
  • composition of the present invention or the kit of the present invention with the first peripheral blood mononuclear cells to obtain a first mixture and incubating;
  • the second peripheral blood mononuclear cells of the subject are collected;
  • composition of the present invention or the kit of the present invention with the second peripheral blood mononuclear cells to obtain a second mixture and incubating;
  • the anticancer treatment method for the patient When y ⁇ x, the anticancer treatment method for the patient is effective; when y ⁇ x, the anticancer treatment method for the patient fails to meet expectations.
  • the composition or the kit provided by the present invention can detect and isolate the cell population co-expressing CD45 and EpCAM from peripheral blood mononuclear cells (PBMC). Since the content of the cell population co-expressing CD45 and EpCAM in the peripheral blood mononuclear cells in healthy people is significantly lower than that of cancer patients, the composition, kit and isolated cell population co-expressing CD45 and EpCAM provided by the invention It can be used for the rapid in vitro screening of cancer, the treatment of cancer and the evaluation of the effectiveness of cancer treatment.
  • PBMC peripheral blood mononuclear cells
  • the cancer in vitro screening method, cancer treatment and cancer treatment effectiveness evaluation method provided by the present invention have the advantages of low cost, easy operation, and short time, and only need to draw 5-10ml of peripheral blood to extract PBMC.
  • the higher acceptance of subjects is conducive to the rapid screening of cancer, and has practical value for early detection, early diagnosis and early treatment of cancer.
  • Figures 4-8 show the results of flow cytometry analysis of the CD45 + EpCAM + cell population in the PBMC of healthy volunteers in the co-culture system of Example 2; wherein, Figure 4 is an electron micrograph of exosomes secreted by HCC827 cells ( Voltage 100.0kV, magnification ⁇ 60.0k); Figure 5 shows the particle size analysis results of exosomes secreted by HCC827 cells; Figure 6 shows the protein expression of exosomes secreted by HCC827 cells; Figure 7 shows PBMC, PBMC and HCC827 After co-culture of cells, co-culture of PBMC and HCC827 cell culture supernatant, co-culture of PBMC and 10 ⁇ g/ml exosome, co-culture of PBMC and 50 ⁇ g/ml exosome, and co-culture of PBMC and 100 ⁇ g/ml exosome, the PBMC Flow cytometry analysis results of CD45 + EpCAM + cell population; Figure 8 shows PBMC, PB
  • Figure 9 shows that in Example 3, after PBMC from healthy volunteers were co-cultured with HCC827 cells, the CD45 + EpCAM + cell population was sorted by magnetic beads coated with anti-CD45 antibody and magnetic beads coated with anti-EpCAM antibody The results of flow cytometry analysis.
  • Figures 10-11 show the results of flow cytometry analysis of the apoptosis of CD45 + EpCAM + cell populations in the PBMC of healthy volunteers in the co-culture system in Example 4; wherein, Figure 10 shows the co-culture of PBMCs, PBMCs and HCC827 cells , PBMC and HCC827 cell culture supernatant co-culture, PBMC and 10 ⁇ g/ml exosomes co-culture, PBMC and 50 ⁇ g/ml exosomes co-culture and PBMC and 100 ⁇ g/ml exosomes co-culture, CD45 + EpCAM in PBMC - and flow cytometric analysis of CD45 + EpCAM + cell apoptosis; Figure 11 shows the co-culture of PBMC, PBMC and HCC827 cells, the co-culture of PBMC and HCC827 cell culture supernatant, the co-culture of PBMC and 10 ⁇ g/ml exosomes, the co-culture of PBMC
  • CEA carcinoembryonic antigen
  • the present invention aims to solve the existing problems of large sampling volume and difficulties in separation/enrichment/identification for detecting the presence of CTCs.
  • CTCs are often used to judge the prognosis of cancer treatment or the spread of tumors.
  • some cell molecular markers of non-cancer origin are often used as excluded parameters.
  • CD45 molecules are specifically expressed on all white blood cells.
  • common CTC tests such as CellSearch etc. exclude CD45 + cells from the cell population detected by CTC analysis.
  • Others have specifically studied how to efficiently remove leukocytes to improve the recovery rate of CTCs.
  • CD45 + EpCAM + cells existed in 100% of lung cancer tumor tissues.
  • leukocytes all express CD45, but do not express EpCAM; and cells that usually express EpCAM do not express CD45, so it is usually not recognized that there are cells that co-express CD45 and EpCAM.
  • CD45 + EpCAM + cells may be derived from the fusion of exosomes secreted by tumor cells and white blood cells.
  • CD45 + EpCAM + cells also existed in the peripheral blood of tumor patients, while the content of CD45 + EpCAM + cells in PBMC of healthy people was significantly lower than that of tumor patients (such as lung cancer patients). Therefore, the CD45 + EpCAM + cells in PBMCs can be detected or isolated for in vitro screening, treatment or treatment effectiveness assessment of cancer.
  • the present invention provides a composition comprising an anti-CD45 antibody and an anti-EpCAM antibody.
  • anti-CD45 antibodies and anti-EpCAM antibodies suitable for the present invention can be various anti-CD45 antibodies and anti-EpCAM antibodies known in the art.
  • commercially available anti-CD45 antibodies and anti-EpCAM antibodies can be used to implement the present invention, and techniques known in the art (such as hybridoma technology) can also be used to prepare anti-CD45 antibodies and anti-EpCAM antibodies.
  • the anti-CD45 antibody is a rat-derived anti-human CD45 monoclonal antibody, a mouse-derived anti-human CD45 monoclonal antibody, a goat-derived anti-human CD45 monoclonal antibody, and a rabbit-derived anti-human CD45 monoclonal antibody.
  • the affinity of the anti-CD45 monoclonal antibody is greater than 1.0 ⁇ 10 -11 mol/L.
  • the anti-EpCAM antibody is selected from rat-derived anti-human EpCAM monoclonal antibody, mouse-derived anti-human EpCAM monoclonal antibody, goat-derived anti-human EpCAM monoclonal antibody, and rabbit-derived anti-human EpCAM monoclonal antibody.
  • the affinity of the anti-EpCAM antibody is greater than or equal to 2.69 ⁇ 10 -10 mol/L.
  • the anti-EpCAM antibody is a polyclonal antibody and/or the anti-CD45 antibody is a polyclonal antibody.
  • the mass ratio of the anti-EpCAM antibody to the anti-CD45 antibody is 1:8.3.
  • the anti-EpCAM antibody and the anti-CD45 antibody are conjugated to biotin or fluorescein, respectively, including but not limited to fluorescein isothiocyanate (FITC), phycoerythrin (PE ), allophycocyanin (APC), peridinium chlorophyll protein (PerCP), etc.
  • FITC fluorescein isothiocyanate
  • PE phycoerythrin
  • APC allophycocyanin
  • PerCP peridinium chlorophyll protein
  • the antibody when the antibody is coupled with biotin, the antibody can be combined with magnetic beads coupled with streptavidin, so as to achieve separation, detection and subsequent further use.
  • fluorescein it can be used for the detection of CD45 + EpCAM + cell population directly by flow cytometry and subsequent further uses.
  • composition provided by the present invention may also contain suitable solvents, including but not limited to PBS, EDTA, BSA and the like.
  • the present invention also provides a kit, which contains the composition described in the present invention.
  • the kit also contains magnetic beads.
  • the magnetic beads used in the present invention can be various magnetic beads used for cell separation or enrichment known in the art.
  • streptavidin is coupled to the magnetic beads, so as to bind to the anti-CD45 antibody in the composition and the biotin coupled to the anti-EpCAM antibody, so as to combine with the anti-CD45 antibody.
  • Antibody and CD45 + EpCAM + cells bound by the anti-EpCAM antibody were isolated.
  • composition or the kit provided by the present invention can be used for isolating a cell population co-expressing CD45 and EpCAM (CD45 + EpCAM + ) from peripheral blood mononuclear cells.
  • the peripheral blood mononuclear cells are derived from a tumor patient.
  • the tumor includes but not limited to lung cancer, breast cancer, ovarian cancer, cervical cancer, etc.; preferably, the tumor is lung cancer.
  • the present invention provides the use of anti-CD45 antibody and anti-EpCAM antibody, the composition according to the present invention or the kit according to the present invention in detecting and/or isolating a cell population co-expressing CD45 and EpCAM.
  • polyclonal antibodies of different species can also be used to implement the co-expression of CD45 and EpCAM cell populations detection and/or isolation.
  • the anti-CD45 polyclonal antibody as an example, the goat-derived anti-human CD45 polyclonal antibody can be used as the primary antibody to bind to CD45; the rabbit-derived anti-goat antibody conjugated with biotin or fluorescein can be used as the secondary antibody, It is used to bind the primary antibody, so as to realize the detection and separation of the cell population expressing CD45.
  • the above-mentioned goat-derived anti-human CD45 polyclonal antibody can also be replaced by other species of anti-human CD45 polyclonal antibody, including but not limited to rat-derived anti-human CD45 polyclonal antibody, mouse-derived anti-human CD45 polyclonal antibody Antibody, rabbit-derived anti-human CD45 polyclonal antibody.
  • the secondary antibodies include, but are not limited to, rabbit-derived anti-goat antibodies, mouse-derived anti-goat antibodies, rat-derived anti-goat antibodies, goat-derived anti-rabbit antibodies, and the like.
  • the present invention also provides a method for isolating a cell population co-expressing CD45 and EpCAM, comprising:
  • peripheral blood mononuclear cells can be obtained by methods known in the art.
  • step (12) the method of mixing and incubating the composition or kit with the PBMC peripheral blood mononuclear cells is a known method in the art, and conditions such as time and temperature required for incubation can be determined according to actual conditions .
  • the incubation temperature is 4° C.
  • the incubation time is 20 minutes.
  • step (13) by adding the magnetic beads to the mixture, the magnetic beads are coupled with streptavidin, which can be coupled with the anti-CD45 antibody and anti-EpCAM antibody in the composition. Binding with the protein, and then obtaining the magnetic beads of the cell population co-expressing CD45 and EpCAM.
  • step (12) first mix and incubate the composition in the kit with the peripheral blood mononuclear cells to obtain a mixture; in step (13), mix the composition in the kit The magnetic beads can be incubated with the mixture.
  • the CD45 + EpCAM + cell population when isolating the cell population co-expressing CD45 and EpCAM, can be isolated at one time, or the EpCAM + cell population can be separated first, and then the CD45 + cell population can be separated from the EpCAM + cell population.
  • the number of CD45 + cells in peripheral blood mononuclear cells is usually more than that of EpCAM + cells, it is preferable to isolate the CD45 + cell population first in the stepwise isolation method.
  • the magnetic beads when using the magnetic beads to separate the cell population co-expressing CD45 and EpCAM from the mixture, first use the magnetic beads to separate the CD45 + cells in the mixture, and then use the magnetic beads to separate the CD45+ cells from the mixture. + cells were isolated from EpCAM + cells.
  • step (14) the method for removing the magnetic beads can use known methods in the art, including but not limited to performing magnetic separation on a magnetic stand to remove the magnetic beads.
  • the present invention also provides a cell population co-expressing CD45 and EpCAM, which is obtained by the separation method described in the present invention.
  • the method for isolating the cell population co-expressing CD45 and EpCAM provided by the present invention can rapidly and efficiently isolate the cell population co-expressing CD45 and EpCAM, and the cell population co-expressing CD45 and EpCAM can be used for screening and/or guiding cancer treatment .
  • the uses of the cell population co-expressing CD45 and EpCAM provided by the present invention include but are not limited to in vitro screening of cancer, guidance of cancer treatment and evaluation of the effectiveness of cancer treatment methods.
  • the above-mentioned use of the cell population co-expressing CD45 and EpCAM in the present invention has multiple advantages: firstly, the sampling volume is reduced. The invention only needs to extract 5-10 ml of peripheral blood from the subject to extract PBMC, which is easier for the subject to accept and solves the problem of large sampling volume in CTC detection; secondly, it is easy to operate and takes a short time.
  • the present invention separates the cell populations co-expressing CD45 and EpCAM and uses them for the above purposes, it can be done by flow cytometry without complicated steps or instruments.
  • the present invention significantly reduces detection costs , simplifies the technical operation; third, the sensitivity is higher.
  • the inventors of the present invention have found through research that the number of CD45 + EpCAM + cells is more than that of CD45 - EpCAM + cells, and this part of suggestive CD45 + EpCAM + cells will be removed when using the existing CTC enrichment or detection method loss, resulting in greatly reduced sensitivity in detection, screening or diagnosis.
  • the present invention uses the content of the cell population co-expressing CD45 and EpCAM as an index, and its sensitivity is not only higher than that of CTC, but also higher than that of CEA (about twice) the most sensitive index in current lung cancer screening.
  • the cell population co-expressing CD45 and EpCAM is used for screening, treatment, and evaluation of cancers including but not limited to lung cancer, breast cancer, ovarian cancer, cervical cancer, etc.; preferably lung cancer.
  • the present invention also provides an in vitro screening method for cancer, comprising:
  • the peripheral blood mononuclear cells of the subject can be obtained by methods known in the art.
  • the subject is an individual suspected of having cancer, particularly an individual suspected of having or at high risk of lung cancer.
  • step (22) the method of isolating the subject's cell population co-expressing EpCAM and CD45 by the separation method of the present invention is as described in steps (11)-(14) above.
  • step (23) through the experimental detection of the present invention, the ratio of CD45 + EpCAM + cell number to PBMC number in the healthy population PBMC is 0.01% on average, when the cell number of CD45 + EpCAM + cell population accounts for the ratio of PBMC number is higher than 0.01%, the subject is suspected to have cancer, and the probability is higher than 88%.
  • the method provided by the present invention as in steps (21)-(23) uses magnetic beads to first separate and obtain CD45 + EpCAM + cell populations, and then use the CD45 + EpCAM + cell populations for screening.
  • the present invention can also perform screening more quickly and easily by flow cytometry.
  • the present invention also provides another in vitro screening method for cancer, comprising:
  • the peripheral blood mononuclear cells of the subject can be obtained by methods known in the art.
  • the subject is an individual suspected of having cancer, particularly an individual suspected of having or at high risk of lung cancer.
  • step (32) the composition of the present invention or the kit of the present invention is mixed and incubated with the peripheral blood mononuclear cells, so that the anti-CD45 antibody and anti-EpCAM antibody co-label CD45 + in PBMC EpCAM + cell population.
  • step (33) routine detection methods such as flow cytometry, immunofluorescence staining, Western blotting, real-time quantitative reverse transcription PCR, etc. in the art can be used to detect the cell population co-expressing CD45 and EpCAM.
  • detection is preferably performed by flow cytometry. Specifically, the cells in the mixture were stained to detect the CD45 + EpCAM + cell population.
  • flow cytometry methods known in the art can be used.
  • Step (34) is the same as step (23) described above, and will not be repeated here.
  • flow cytometry is preferably used to directly obtain the data of the ratio of CD45 + EpCAM + cell populations to PBMCs, which can obtain results more directly and quickly, and requires more samples for PBMCs Less, lower requirements for experimental equipment, it is of great value in clinical rapid screening and auxiliary diagnosis.
  • the present invention also provides a method for guiding cancer treatment.
  • a method for guiding cancer treatment include:
  • peripheral blood mononuclear cells of the subject can be obtained by methods known in the art.
  • the subject is an individual suspected of having cancer, particularly an individual suspected of having or at high risk of lung cancer.
  • Step (42) is the same as the aforementioned step (22), and will not be repeated here.
  • step (43) when the ratio of the cell number of the cell population co-expressing CD45 and EpCAM to the cell number of the peripheral blood mononuclear cells is higher than 0.01%, it is suspected that the subject has cancer, And the probability is higher than 88%, further diagnosis is required to confirm that the subject has cancer.
  • the subject can be treated with corresponding cancer treatment.
  • the treatment of the present invention is known in the art, including but not limited to chemotherapy, immunotherapy and/or radiation therapy.
  • the cancer treatment method of the present invention can also be treated on the basis of the proportion data of CD45 + EpCAM + cell population in PBMC directly obtained by flow cytometry, after diagnosis and diagnosis.
  • the present invention also provides another method for guiding cancer treatment, comprising:
  • step (51) is the same as step (31) described above, step (52) is identical to step (32) described above, and step (53) is identical to step (33) described above, and will not be repeated here .
  • step (54) when the ratio of the cell number of the cell population co-expressing CD45 and EpCAM to the cell number of the peripheral blood mononuclear cells is higher than 0.01%, it is suspected that the subject has cancer, And the probability is higher than 88%, further diagnosis is required to confirm that the subject has cancer. After the diagnosis, the subject can be treated with corresponding cancer treatment.
  • the present invention also provides a method for evaluating the effectiveness of cancer treatment, comprising:
  • (61) Take the first peripheral blood mononuclear cells from the subject, wherein the subject has cancer and has not received anti-cancer treatment;
  • the evaluation method provided by the present invention is to detect the proportion of CD45 + EpCAM + cell population in PBMC of cancer patients before and after anti-cancer treatment, and then compare the data before and after treatment to determine the proportion of CD45 + EpCAM + cell population in PBMC whether the proportion of If it decreases, it indicates that the anti-cancer treatment is effective; if it does not decrease, it indicates that the anti-cancer treatment has not met expectations.
  • the evaluation method provided by the present invention can be used to evaluate the anti-cancer treatment for a specific individual, using different treatment methods, different drugs or combinations thereof, different administration methods, different doses, different dosage forms, etc. Whether cancer treatment is effective for a specific individual.
  • the peripheral blood mononuclear cells of the subject can be obtained using methods known in the art, and the subject is an individual diagnosed with cancer, preferably diagnosed with lung cancer individual.
  • the cell number of the first peripheral blood mononuclear cell obtained in step (61) is set equal to the cell number of the second peripheral blood mononuclear cell obtained in step (64), to improve the evaluation result accuracy.
  • the present invention can also be evaluated on the basis of the ratio data of CD45 + EpCAM + cell population to PBMC directly obtained by flow cytometry.
  • the present invention also provides another method for evaluating the effectiveness of cancer therapy, including:
  • the peripheral blood mononuclear cells of the subject can be obtained using methods known in the art, and the subject is an individual diagnosed with cancer, preferably diagnosed with lung cancer individual.
  • the cell number of the first peripheral blood mononuclear cells obtained in step (71) is set equal to the cell number of the second peripheral blood mononuclear cells obtained in step (75), to improve the evaluation result accuracy.
  • steps (73) and (77) conventional methods in the art for detecting cell markers can be used to detect the cell population co-expressing CD45 and EpCAM.
  • detection is preferably performed by flow cytometry. Specifically, the cells in the mixture were stained by detecting the CD45 + EpCAM + cell population. For specific detection steps of cell staining and flow cytometry, methods known in the art can be used.
  • the tumor tissue of the lung cancer patient was obtained by minimally invasive surgery, placed in a 10 cm diameter petri dish, and washed once with normal saline;
  • the cells are divided into two parts, the all-negative group and the test group, each group has a cell volume of 50 ⁇ l, that is, 2.5 ⁇ 10 5 live cells;
  • PBMC peripheral blood mononuclear cells
  • the anticoagulant tube containing the blood sample is sterilized by 75% alcohol and put into the ultra-clean bench, open the cover of the anticoagulant tube, transfer the peripheral blood to a 50ml centrifuge tube, and centrifuge at 650g for 10min;
  • Mononuclear cells in peripheral blood include lymphoid and mononuclear cells. Their volume, shape and density are different from other cells. Cells such as red blood cells and white blood cells have the highest density, followed by lymphoid and monocytes, and platelets have the lowest density.
  • the sample density separation fluid is used for the separation of different cells in peripheral blood through density separation. Prepare the sample density separation solution, the volume of which is consistent with the volume of the precipitate and normal saline mixture;
  • Figure 1 is a flow diagram, showing that compared with PBMC of healthy volunteers, the proportion of CD45 + EpCAM + cells in PBMC and tumor tissue of lung cancer patients is significantly increased.
  • Figure 2 is a statistical graph showing that compared with PBMC of healthy volunteers, the proportion of CD45 + EpCAM + cells in PBMC and tumor tissue of lung cancer patients was significantly increased, which was consistent with the results of flow cytometry.
  • Figure 3 is a statistical graph, and the results can be seen that the proportion of CD45 + EpCAM + cells in the tumor tissue of lung cancer patients is significantly higher than that of the corresponding PBMC ; There is a certain linear relationship, the patients with higher proportion of CD45 + EpCAM + cells in lung cancer tumor tissue have higher proportion in PBMC than healthy volunteers.
  • the HCC827 cell fusion rate reaches 80-90%, the cells are subcultured, and the cells are cultured with RPMI1640 complete medium containing exosome-free serum for 48-72 hours, and the cell culture supernatant is collected;
  • the exosome sample can be loaded after the instrument performance test is passed with the standard product. Note that gradient dilution is required to prevent the sample from clogging the injection needle;
  • 1PBMC group resuspend PBMC (1x10 6 ) cells in 2ml of RPMI1640 complete medium containing exosome-free serum and add them to a 6-well plate;
  • 3PBMC and HCC827 cell culture supernatant co-culture group use 2ml of HCC827 cell culture supernatant to resuspend PBMC (1x10 6 ) cells and add to 6-well plate;
  • PBMC and HCC827 cell exosome co-culture group resuspend PBMC (1x10 6 ) cells with 2ml of RPMI1640 complete medium containing exosome-free serum, then add 10 ⁇ g/ml exosomes, resuspend and mix well and add to 6 wells in the board;
  • PBMC and HCC827 cell exosome co-culture group resuspend PBMC (1x10 6 ) cells in 2ml RPMI1640 complete medium containing exosome-free serum, then add 50 ⁇ g/ml exosomes, resuspend and mix well, and add to 6 wells in the board;
  • PBMC and HCC827 cell exosome co-culture group resuspend PBMC (1x10 6 ) cells with 2ml of RPMI1640 complete medium containing exosome-free serum, then add 100 ⁇ g/ml exosomes, resuspend and mix well and add to 6 wells in the board;
  • Figure 4 is an electron microscope analysis diagram of exosomes. According to Figure 4, exosomes secreted by HCC827 cells appear as typical disc-shaped vesicles. The particle size of exosomes is 30-150nm. The results in Figure 5 show that the particle size of exosomes secreted by HCC827 cells is about 70nm. The results of flow cytometry in Figure 6 showed that, compared with the control group, the exosomes secreted by HCC827 cells highly expressed the protein CD63.
  • CD45 + EpCAM + cells were detected using magnetic beads coated with anti-CD45 antibody (purchased from Miltenyi Biotec) and magnetic beads coated with anti-EpCAM antibody (purchased from Miltenyi Biotec):
  • PBMC from healthy volunteers were co-cultured with HCC827 cells at a ratio of 1:3, and the cells were collected into a 15ml centrifuge tube after 24 hours;
  • Healthy volunteer PBMC and HCC827 cells were co-cultured at a ratio of 1:3, and flow staining was performed after two-step sorting of CD45 and EpCAM magnetic beads, and analyzed by Beckman flow cytometry. The results are shown in Figure 9.
  • the flow cytometric results shown in Figure 9 are consistent with the flow cytometric results of PBMCs from healthy volunteers and PBMCs from lung cancer patients in Figure 1.
  • CD45 and EpCAM magnetic beads were sorted by two-step flow staining, this method can obtain and detect CD45 + EpCAM + cells.
  • CD45 + EpCAM + cell apoptosis increased after PBMC from healthy volunteers were co-cultured with HCC827 cells:
  • 1PBMC group resuspend PBMC (1x10 6 ) cells in 2ml of RPMI1640 complete medium containing exosome-free serum and add them to a 6-well plate;
  • 3PBMC and HCC827 cell culture supernatant co-culture group use 2ml of HCC827 cell culture supernatant to resuspend PBMC (1x10 6 ) cells and add to 6-well plate;
  • PBMC and HCC827 cell exosome co-culture group resuspend PBMC (1x10 6 ) cells with 2ml of RPMI1640 complete medium containing exosome-free serum, then add 10 ⁇ g/ml exosomes, resuspend and mix well and add to 6 wells in the board;
  • PBMC and HCC827 cell exosome co-culture group resuspend PBMC (1x10 6 ) cells in 2ml RPMI1640 complete medium containing exosome-free serum, then add 50 ⁇ g/ml exosomes, resuspend and mix well, and add to 6 wells in the board;
  • PBMC and HCC827 cell exosome co-culture group resuspend PBMC (1x10 6 ) cells with 2ml of RPMI1640 complete medium containing exosome-free serum, then add 100 ⁇ g/ml exosomes, resuspend and mix well and add to 6 wells in the board;
  • Fc receptor blocking agents are added to each sample, Incubate at room temperature for 10 minutes;
  • the cells of each sample are divided into two parts, the all-negative group and the test group, and the cell volume of each group is 50 ⁇ l, that is, 5 ⁇ 10 5 live cells;
  • the cell apoptosis flow staining was analyzed by Beckman flow cytometer, and the results are shown in Figures 10-11.
  • Figure 10 and Figure 11 compared with CD45 + EpCAM - cells in the PBMC experimental group, the apoptosis (Annexin V + ) of CD45 + EpCAM + cells had no significant change.
  • PBMC and HCC827 cells were co-cultured at a ratio of 1:3, the apoptosis of CD45 + EpCAM + cells was significantly increased compared with that of CD45 + EpCAM - cells.
  • the apoptosis of CD45 + EpCAM + cells was significantly increased compared with CD45 + EpCAM - cells.
  • the content of serum gastrin-releasing peptide precursor (ProGRP) and neuron-specific enolase (NSE) in the serum of 1 patient exceeded the normal value (4%);
  • the content of cytokeratin 19 fragment (CYFRA21-1) in the serum of 3 patients exceeded the normal value (13%);
  • the content of carcinoembryonic antigen (CEA) in the serum of 9 patients among the 25 lung cancer patients exceeded the normal range ( 36%), while the proportion of CD45 + EpCAM + cells was higher than 0.01% (the mean value of the proportion of CD45 + EpCAM + cells in PBMC of healthy volunteers) was 22 people (88%).

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Abstract

本发明涉及一种共表达CD45和EpCAM的细胞群的检测和分离方法及其用途。本发明将包含抗CD45抗体和抗EpCAM抗体的组合物或试剂盒用于从PBMC中检测和分离共表达CD45和EpCAM的细胞群，并用于癌症的快速体外筛查、指导癌症的治疗以及癌症治疗有效性的评估。

Description

共表达CD45和EpCAM的细胞群的检测和分离方法及其用途 技术领域
本发明涉及细胞免疫学领域，尤其涉及一种基于抗CD45抗体和抗EpCAM抗体的组合物、相应的试剂盒及其在从外周血单个核细胞(PBMC)中检测和分离共表达CD45和EpCAM的细胞群中的用途。还涉及将共表达CD45和EpCAM的细胞群用于癌症的体外筛查、治疗的指导以及治疗有效性的评估。
背景技术
癌症是一种威胁人类健康的肿瘤，在全球范围内其发病率和死亡率迅速增长。2018年全世界新增1,810万新发病例和960万癌症死亡病例，其中肺癌的发病率及死亡率位居首位(Bray et al.,2018)。肺癌作为第一大癌症杀手，发病隐匿、诊断不及时、易转移复发、预后极差，而且70-75％的患者发展到晚期才被发现，大大降低了生存率。通常利用常规组织病理学检查无法检测到患者体内原发性肿瘤细胞的扩展。近年来发现循环肿瘤细胞(Circulating Tumor Cell,CTC)可以用于早期诊断，可作为早期筛查的辅助方法，并可用于识别肿瘤切除后的患者是否需要进一步全身治疗。
CTC是指原发肿瘤或转移病灶内的肿瘤细胞通过主动迁移、侵袭或者外在因素干扰导致其脱落，从而进入循环血液所形成(King et al.,2015；Lin et al.,2014)。1869年，澳大利亚Ashworth医生通过显微镜在因癌症死亡的患者外周血中发现了与原发肿瘤类似的细胞，并首次提出了CTC的概念(Ashworth,1869)。CTC的存在是癌症转移和降低生存率的一个重要危险因素。CTC作为液体活检的靶点，其结果能够反映原发性和转移性病变的特征。因此，在肺癌诊疗中CTC检测、计数及表型分析逐渐成为当前研究的热点和焦点，其在早期诊断、疗效评价、预后预测以及指导个体化治疗等方面有重要价值。
在肺癌筛查方面，常用的低剂量螺旋CT(LDCT)、肿瘤自身抗体、肿瘤标志物等方法尚不能单独精准地鉴别肿瘤的良恶性，例如最常应用的LDCT，由于在影像学中肺小结节呈现出多样性的特点，异病同影/同病异影给鉴别肿瘤良恶性造成很大困难，从而导致较高的假阳性率、过度诊断、延误诊断、随访复查加剧患者焦虑心理、影响患者正常工作生活。此外，它还存在医源辐射、筛查费用高等弊端。理论上讲，早期肺癌患者，甚至在肺 内尚未形成微小病灶之前，外周血中已存在CTC，其难点在于寻找灵敏性、特异性较高的有效的检测手段。
CTC进入外周血后，大部分发生凋亡或被吞噬，只有少数能够逃逸并发展成为转移灶。研究表明，体积为1cm 3(约1g湿重)大小的肿瘤通常包含1x10 9个细胞，每日约有10 6个细胞入血(Chang et al.,2000)。
在循环血液中CTC数量常呈现出动态递减的特点，到达外周血时已十分稀少。据研究，每10 6-10 7个白细胞中才可以检测到1个肿瘤细胞(Paterlini-Brechot and Benali,2007；Sleijfer et al.,2007)。因此，要从数以千万计以上背景的细胞中精准地检测到CTC并非易事，这是限制其在临床上发挥作用的主要原因。目前的主流理念是先对外周血中的肿瘤细胞进行富集，然后对其进行检测。富集方法主要是利用肿瘤细胞表面的分子标志物或物理特性来进行。后续的检测包括实时定量反转录PCR(Quantitative Reverse-transcription PCR,qRT-PCR)等基因水平的检测；流式细胞检测技术(Flow Cytometry,FCM)、CellSearch、CTC芯片(CTC-chip)等细胞水平的检测。
虽然用于临床研究的CTC分离和富集技术很多，但是目前来说仍普遍存在取样量大、灵敏度差、特异性低、操作繁琐、成本高昂等缺点，如密度梯度离心法要求血量较大；ISET灵敏度低；3D微型过滤器价格昂贵、血液需要稀释；qRT-PCR法由于不同的CTC之间肿瘤标志物的表达水平不同，因而其标志物的含量与实际个体并不总是具有正相关性；CellSearch检测过程操作繁琐等。
发明内容
本发明提供了包含抗CD45抗体和抗EpCAM抗体的组合物及相应的试剂盒，以及将该组合物和试剂盒在从外周血单个核细胞(PBMC)中检测和分离共表达CD45和EpCAM的细胞群中的用途；还提供了一种共表达CD45和EpCAM的细胞群及其用途。本发明旨在提供一种更加高效的检测方法，所检测到的细胞群可以更加准确地用于癌症的筛查、辅助诊断、疗效检测等，解决了目前检测CTC时存在的取样量大，分离/富集/鉴别困难的问题。
一方面，本发明提供了一种组合物，所述组合物包含抗CD45抗体和抗EpCAM抗体。
另一方面，本发明还提供了一种试剂盒，所述试剂盒含有本发明所述的组合物。
另一方面，本发明还提供了所述组合物或所述试剂盒在从外周血单个核细胞中检测和/或分离共表达CD45和EpCAM的细胞群中的用途。
另一方面，本发明还提供了一种共表达CD45和EpCAM的细胞群的分离方法，包括：
提供外周血单个核细胞；
将本发明所述的组合物或本发明所述的试剂盒与所述外周血单个核细胞混合，孵育所得混合物；
向所述混合物加入磁珠，经孵育，得到结合有共表达CD45和EpCAM的细胞群的磁珠；
去除磁珠，得到共表达CD45和EpCAM的细胞群。
另一方面，本发明还提供了一种共表达CD45和EpCAM的细胞群，所述细胞群通过本发明所述的分离方法获得。
另一方面，本发明还提供了所述共表达CD45和EpCAM的细胞群在筛查和/或指导癌症治疗中的用途。
另一方面，本发明还提供了一种癌症的体外筛查方法，包括：
取受试者的外周血单个核细胞；
通过本发明所述的分离方法分离所述受试者的共表达CD45和EpCAM的细胞群；
当所述共表达CD45和EpCAM的细胞群的细胞数占所述外周血单个核细胞的细胞数的比例高于0.01％时，应进行进一步的诊断和/或治疗。
另一方面，本发明还提供了另一种癌症的体外筛查方法，包括：
取受试者的外周血单个核细胞；
将本发明所述的组合物或本发明所述的试剂盒与所述外周血单个核细胞混合，孵育所得混合物；
检测所述混合物中共表达CD45和EpCAM的细胞群；
当所述共表达CD45和EpCAM的细胞群的细胞数占所述外周血单个核细胞的细胞数的比例高于0.01％时，应进行进一步的诊断和/或治疗。
另一方面，本发明还提供了一种指导癌症治疗的方法，包括：
取受试者的外周血单个核细胞；
通过本发明所述的分离方法分离所述受试者的共表达CD45和EpCAM的细胞群；
当所述共表达CD45和EpCAM的细胞群的细胞数占所述外周血单个核细胞的细胞数的比例高于0.01％时，对所述受试者进行进一步检查和/或治疗。
另一方面，本发明还提供了另一种指导癌症治疗的方法，包括：
取受试者的外周血单个核细胞；
将本发明所述的组合物或本发明所述的试剂盒与所述外周血单个核细胞混合，孵育所得混合物；
检测所述混合物中共表达CD45和EpCAM的细胞群；
当所述共表达CD45和EpCAM的细胞群的细胞数占所述外周血单个核细胞的细胞数的比例高于0.01％时，对所述受试者进行进一步检查和/或治疗。
另一方面，本发明还提供了一种癌症治疗有效性的评估方法，包括：
取受试者的第一外周血单个核细胞，其中，所述受试者患有癌症且未进行抗癌治疗；
通过本发明所述的分离方法分离所述受试者的共表达CD45和EpCAM的第一细胞群；
记录所述第一细胞群的细胞数占所述外周血单个核细胞的细胞数的比例x；
对所述患者进行抗癌治疗后，取所述受试者的第二外周血单个核细胞；
通过本发明所述的分离方法分离所述受试者的共表达CD45和EpCAM的第二细胞群；
记录所述第二细胞群的细胞数占所述外周血单个核细胞的细胞数的比例y；
当y＜x时，则对所述患者进行抗癌治疗的方法有效；当y≥x时，则对所述患者进行抗癌治疗的方法未达到预期。
另一方面，本发明还提供了另一种癌症治疗有效性的评估方法，包括：
取受试者的第一外周血单个核细胞，其中，所述受试者患有癌症且未进行抗癌治疗；
将本发明所述的组合物或本发明所述的试剂盒与所述第一外周血单个核细胞混合得到第一混合物并孵育；
检测所述第一混合物中共表达CD45和EpCAM的第一细胞群；
记录所述第一细胞群的细胞数占所述第一外周血单个核细胞的细胞数的比例x；
对所述患者进行抗癌治疗后，取所述受试者的第二外周血单个核细胞；
将本发明所述的组合物或本发明所述的试剂盒与所述第二外周血单个核细胞混合得到第二混合物并孵育；
检测所述第二混合物中共表达CD45和EpCAM的第二细胞群；
记录所述第二细胞群的细胞数占所述第二外周血单个核细胞的细胞数的比例y；
当y＜x时，则对所述患者进行抗癌治疗的方法有效；当y≥x时，则对所述患者进行抗癌治疗的方法未达到预期。
本发明具有如下有益效果：
本发明提供的组合物或试剂盒，可以从外周血单个核细胞(PBMC)中检测和分离共表达CD45和EpCAM的细胞群。由于健康人群中该共表达CD45和EpCAM的细胞群在外 周血单个核细胞中的含量明显低于癌症患者，因此本发明提供的组合物、试剂盒以及分离得到的共表达CD45和EpCAM的细胞群可以用于癌症的快速体外筛查、癌症的治疗以及癌症治疗有效性的评估。
相应地，本发明提供的癌症的体外筛查方法、癌症的治疗以及癌症治疗有效性的评估方法具有成本低、易操作、时间短的优点，仅需抽取5-10ml外周血提取PBMC即可，受试者接受程度更高，有利于实现癌症的快速筛查，对癌症的早期发现、早期诊断和早期治疗具有实用价值。
附图说明
图1-3显示了实施例1中，对PBMC中CD45 +EpCAM +细胞群的流式细胞术分析结果；其中，图1为健康志愿者PBMC、肺癌患者PBMC及肺癌患者肿瘤组织中CD45 +EpCAM +细胞群的流式细胞术分析结果；图2的左侧图为健康志愿者PBMC与肺癌患者PBMC中CD45 +EpCAM +细胞群比例的统计分析结果；图2的右侧图为肺癌患者PBMC及肿瘤组织中CD45 +EpCAM +细胞群比例的统计分析结果；图3为健康志愿者PBMC、肺癌患者PBMC及肺癌患者肿瘤组织中CD45 +EpCAM +细胞群比例之间的比较分析结果；健康志愿者PBMC：n＝25；肺癌患者PBMC：n＝25；肺癌患者肿瘤组织：n＝25，利用t检验分析显著性差异。
图4-8显示了实施例2的共培养体系中，健康志愿者PBMC中CD45 +EpCAM +细胞群的流式细胞术分析结果；其中，图4为HCC827细胞分泌的外泌体的电镜图(电压100.0kV，放大倍数×60.0k)；图5为HCC827细胞分泌的外泌体的粒径分析结果；图6为HCC827细胞分泌的外泌体的蛋白表达情况；图7为PBMC、PBMC与HCC827细胞共培养、PBMC与HCC827细胞培养上清共培养、PBMC与10μg/ml外泌体共培养、PBMC与50μg/ml外泌体共培养及PBMC与100μg/ml外泌体共培养后，PBMC中CD45 +EpCAM +细胞群的流式细胞术分析结果；图8为PBMC、PBMC与HCC827细胞共培养、PBMC与HCC827细胞培养上清共培养、PBMC与10μg/ml外泌体共培养、PBMC与50μg/ml外泌体共培养及PBMC与100μg/ml外泌体共培养后，PBMC中CD45 +EpCAM +细胞群比例的统计分析结果；PBMC组、PBMC与HCC827细胞共培养组、PBMC与HCC827细胞培养上清共培养组、PBMC与10μg/ml外泌体共培养组、PBMC与50μg/ml外泌体共培养组及PBMC与100μg/ml外泌体共培养组，每组样本n＝3，利用t检验分析显著性差异。
图9显示了实施例3中，健康志愿者PBMC与HCC827细胞共培养后，利用包被有抗CD45抗体的磁珠和包被有抗EpCAM抗体的磁珠分选后，CD45 +EpCAM +细胞群的流式细胞术分析结果。
图10-11显示了实施例4中，共培养体系中，健康志愿者PBMC中CD45 +EpCAM +细胞群凋亡的流式细胞术分析结果；其中，图10为PBMC、PBMC与HCC827细胞共培养、PBMC与HCC827细胞培养上清共培养、PBMC与10μg/ml外泌体共培养、PBMC与50μg/ml外泌体共培养及PBMC与100μg/ml外泌体共培养后，PBMC中CD45 +EpCAM -及CD45 +EpCAM +细胞凋亡的流式分析；图11为PBMC、PBMC与HCC827细胞共培养、PBMC与HCC827细胞培养上清共培养、PBMC与10μg/ml外泌体共培养、PBMC与50μg/ml外泌体共培养及PBMC与100μg/ml外泌体共培养后，PBMC中CD45 +EpCAM -及CD45 +EpCAM +细胞凋亡的统计分析；PBMC组、PBMC与HCC827细胞共培养组、PBMC与HCC827细胞培养上清共培养组、PBMC与10μg/ml外泌体共培养组、PBMC与50μg/ml外泌体共培养组及PBMC与100μg/ml外泌体共培养组，每组样本n＝3，利用t检验分析显著性差异。
图12显示了实施例5中肺癌患者术前血清学检测结果；其中，肺癌患者：n＝25。
图13显示了实施例5中，肺癌患者PBMC中CD45 +EpCAM +细胞群比例与患者血清中癌胚抗原(CEA)含量分析结果；其中，肺癌患者：n＝25。
具体实施方式
下面将结合实施例对本发明作进一步阐述，但这些实施例不对本发明构成任何限制。
本发明旨在解决现有检测CTC存在的取样量大、分离/富集/鉴别困难的问题。
在本领域中，CTC通常被用来判断癌症治疗的预后或者肿瘤的扩散情况。在CTC的检测过程中，常常用一些非癌症来源的细胞分子标记物作为排除的参数。CD45分子特异性表达在所有白细胞上，为避免白细胞的存在对进一步分析带来的背景及其他不利因素，常见的CTC检测如CellSearch等，均将CD45 +的细胞排除在CTC分析检测的细胞群外。还有人专门研究了如何高效去除白细胞以提高CTC回收率的方法。然而，本发明的发明人发现，100％的肺癌肿瘤组织内存在CD45 +EpCAM +的细胞。作为本领域的常规技术理解，白细胞都表达CD45，但不表达EpCAM；而通常表达EpCAM的细胞不表达CD45，因此通常不会意识到存在共表达CD45和EpCAM的细胞。经过发明人的进一步确认和分析，确定存在这类共表达CD45和EpCAM的细胞，并且推测这些CD45 +EpCAM +细胞的形成可能源于 肿瘤细胞分泌的外泌体与白细胞的融合。同时还发现，肿瘤患者的外周血中也存在CD45 +EpCAM +细胞，而健康人群PBMC的CD45 +EpCAM +细胞含量明显低于肿瘤患者(如肺癌患者)。因此可通过检测或分离PBMC中的CD45 +EpCAM +细胞用于癌症的体外筛查、治疗或治疗有效性评估。
基于此，为了获得所述CD45 +EpCAM +细胞，本发明提供了一种组合物，所述组合物包含抗CD45抗体和抗EpCAM抗体。
具体地，适用于本发明的抗CD45抗体和抗EpCAM抗体可以是本领域已知的各种抗CD45抗体和抗EpCAM抗体。例如，可使用市售的抗CD45抗体和抗EpCAM抗体来实施本发明，也可以采用本领域已知的技术(如杂交瘤技术)来制备获得抗CD45抗体和抗EpCAM抗体。
在一些实施方案中，所述抗CD45抗体为大鼠源抗人CD45单抗、小鼠源抗人CD45单抗、羊源抗人CD45单抗和兔源抗人CD45单抗。优选地，所述抗CD45单抗的亲和力大于1.0×10 -11mol/L。
在一些实施方案中，所述抗EpCAM抗体选自大鼠源抗人EpCAM单抗、小鼠源抗人EpCAM单抗、羊源抗人EpCAM单抗和兔源抗人EpCAM单抗。优选地，所述抗EpCAM抗体的亲和力大于等于2.69×10 -10mol/L。
在一些实施方案中，所述抗EpCAM抗体为多克隆抗体和/或所述抗CD45抗体为多克隆抗体。
在一些实施方案中，所述抗EpCAM抗体与所述抗CD45抗体的质量比为1:8.3。
在一些实施方案中，所述抗EpCAM抗体和所述抗CD45抗体分别与生物素或荧光素偶联，所述荧光素包括但不限于异硫氰酸荧光素(FITC)、藻红蛋白(PE)、别藻青蛋白(APC)、多甲藻叶绿素蛋白(PerCP)等。其中，当所述抗体偶联生物素时，可以使所述抗体与偶联有链霉亲和素的磁珠结合，从而实现分离、检测以及后续的进一步用途。当所述抗体偶联荧光素时，可用于直接通过流式细胞术实现CD45 +EpCAM +细胞群的检测以及后续的进一步用途。
可以理解的是，本发明提供的组合物还可以含有合适的溶剂，包括但不限于PBS、EDTA、BSA等。
相应地，本发明还提供了一种试剂盒，所述试剂盒含有本发明所述的组合物。
在一些实施方案中，所述试剂盒还含有磁珠。本发明所用的磁珠可以是本领域已知的各种用于细胞分离或富集的磁珠。优选地，所述磁珠上偶联有链霉亲和素，从而与所述组 合物中的所述抗CD45抗体和所述抗EpCAM抗体上偶联的生物素结合，使与所述抗CD45抗体和所述抗EpCAM抗体结合的CD45 +EpCAM +细胞被分离。
本发明提供的所述组合物或所述试剂盒可用于从外周血单个核细胞中分离共表达CD45和EpCAM(CD45 +EpCAM +)的细胞群。
在一些实施方案中，所述外周血单个核细胞来源于肿瘤患者。所述肿瘤包括但不限于肺癌、乳腺癌、卵巢癌、宫颈癌等；优选地，所述肿瘤为肺癌。
相应地，本发明提供了抗CD45抗体和抗EpCAM抗体、如本发明所述的组合物或如本发明所述的试剂盒在检测和/或分离共表达CD45和EpCAM的细胞群中的用途。
在一些实施方案中，当所述抗EpCAM抗体为多克隆抗体和/或所述抗CD45抗体为多克隆抗体时，还可以使用不同种属的多克隆抗体来实施共表达CD45和EpCAM的细胞群的检测和/或分离。具体地，以抗CD45多克隆抗体为例，可以以羊源抗人CD45多克隆抗体作为一抗，用于结合CD45；以偶联有生物素或荧光素的兔源抗羊抗体作为二抗，用于结合所述一抗，从而实现对表达CD45的细胞群的检测和分离。作为一抗，上述以羊源抗人CD45多克隆抗体也可以替换为其他种属抗人CD45多克隆抗体，包括但不限于大鼠源抗人CD45多克隆抗体、小鼠源抗人CD45多克隆抗体、兔源抗人CD45多克隆抗体。所述二抗包括但不限于兔源抗羊抗体、小鼠源抗羊抗体、大鼠源抗羊抗体、羊源抗兔抗体等。
相应地，本发明还提供了一种共表达CD45和EpCAM的细胞群的分离方法，包括：
(11)提供外周血单个核细胞；
(12)将本发明所述组合物或本发明所述试剂盒与所述外周血单个核细胞混合，孵育所得混合物；
(13)向所述混合物加入磁珠，经孵育，得到结合有共表达CD45和EpCAM的细胞群的磁珠；
(14)去除磁珠，得到共表达CD45和EpCAM的细胞群。
具体地，步骤(11)中，可采用本领域的已知方法获取外周血单个核细胞(PBMC)。
步骤(12)中，将所述组合物或试剂盒与所述PBMC外周血单个核细胞混合、孵育的方法为本领域的已知方法，可根据实际情况确定孵育所需的时间、温度等条件。在一些实施方案中，所述孵育的温度为4℃，所述孵育的时间为20min。
步骤(13)中，通过向所述混合物加入所述磁珠，所述磁珠偶联有链霉亲和素，可以与所述组合物中的抗CD45抗体和抗EpCAM抗体上偶联的生物素结合，进而得到共表达CD45和EpCAM的细胞群的磁珠。
可以理解的是，当使用所述试剂盒分离所述共表达CD45和EpCAM的细胞群，且所述试剂盒已经含有所述磁珠时，所述磁珠与所述组合物在所述试剂盒中分开放置，步骤(12)中，先将所述试剂盒中的所述组合物与所述外周血单个核细胞混合孵育得到混合物；步骤(13)中，再将所述试剂盒中的所述磁珠与所述混合物孵育即可。
本发明在分离共表达CD45和EpCAM的细胞群时，既可以一次性分离CD45 +EpCAM +的细胞群，也可以采用先分离EpCAM +的细胞群，再从EpCAM +的细胞群中分离CD45 +的细胞群的分步法，最终分离获得CD45 +EpCAM +的细胞群，反之亦然。即，本发明对于分离CD45 +和EpCAM +的细胞群的先后顺序没有特别要求，可以同时或依次进行。然而，由于外周血单个核细胞中CD45 +的细胞数量通常多于EpCAM +细胞，因此，在分步分离的方法中，优选先分离CD45 +的细胞群。在一个实施方案中，使用所述磁珠从所述混合物中分离所述共表达CD45和EpCAM的细胞群时，先使用磁珠将混合物中CD45 +的细胞分离出来，然后再使用磁珠从CD45 +的细胞中分离出EpCAM +的细胞。
步骤(14)中，去除所述磁珠的方法可采用本领域的已知方法，包括但不限于在磁力架上进行磁力分离以去除磁珠。
相应地，本发明还提供了一种共表达CD45和EpCAM的细胞群，其是通过本发明所述的分离方法获得。本发明提供的共表达CD45和EpCAM的细胞群的分离方法可以快速、高效地分离共表达CD45和EpCAM的细胞群，所述共表达CD45和EpCAM的细胞群可用于筛查和/或指导癌症治疗。
本发明提供的所述共表达CD45和EpCAM的细胞群的用途包括但不限于用于癌症的体外筛查、指导癌症治疗以及癌症治疗方法有效性的评估中。本发明所述共表达CD45和EpCAM的细胞群的上述用途具有多个优势：首先，降低取样量。本发明仅需抽取受试者5-10ml外周血提取PBMC即可，受试者更容易接受，解决了CTC检测存在的取样量大的问题；其次，易于操作、时间短。本发明分离所述共表达CD45和EpCAM的细胞群并用于上述用途时，可以通过流式细胞术来完成，无需复杂的步骤或仪器，与CellSearch等检测方法相比较，本发明显著降低了检测成本，简化了技术操作；第三，灵敏度更高。本发明的发明人经研究发现，CD45 +EpCAM +细胞数量比CD45 -EpCAM +细胞多，在采用现有的CTC富集或检测方法时，会将这部分具有提示性的CD45 +EpCAM +细胞去除掉，进而导致在检测、筛查或诊断时的敏感度大大降低。本发明通过以共表达CD45和EpCAM的细胞群含量作为指标，其灵敏度不仅高于CTC，还高于目前肺癌筛查中最敏感的指标CEA(两倍左右)。
在一些实施方案中，所述共表达CD45和EpCAM的细胞群用于筛查、治疗、评估的癌症包括但不限于肺癌、乳腺癌、卵巢癌、宫颈癌等；优选肺癌。
相应地，本发明还提供了一种癌症的体外筛查方法，包括：
(21)取受试者的外周血单个核细胞；
(22)通过本发明所述的分离方法分离所述受试者的共表达CD45和EpCAM的细胞群；
(23)当所述共表达CD45和EpCAM的细胞群的细胞数占所述外周血单个核细胞的细胞数的比例高于0.01％时，应进行进一步的诊断和/或治疗。
具体地，步骤(21)中，可采用本领域的已知方法获取所述受试者的外周血单个核细胞。在一些实施方案中，所述受试者为怀疑患有癌症的个体，特别是怀疑患有肺癌或者是肺癌高危个体。
步骤(22)中，通过本发明所述的分离方法分离所述受试者的共表达EpCAM和CD45的细胞群的方法如前文步骤(11)-(14)所述。
步骤(23)中，经本发明实验检测，健康人群PBMC中CD45 +EpCAM +细胞数量占PBMC数量的比例平均为0.01％，当CD45 +EpCAM +的细胞群的细胞数占PBMC数量的比例高于0.01％时，则怀疑所述受试者患有癌症，且几率高于88％。
本发明提供的如步骤(21)-(23)的方法是采用磁珠先分离获得CD45 +EpCAM +细胞群，再将所述CD45 +EpCAM +细胞群用于筛查。除此之外，本发明还可以在通过流式细胞术来更加快速简便地进行筛查。相应地，本发明还提供了另一种癌症的体外筛查方法，包括：
(31)取受试者的外周血单个核细胞；
(32)将本发明所述的组合物或本发明所述的试剂盒与所述外周血单个核细胞混合，孵育所得混合物；
(33)检测所述混合物中共表达CD45和EpCAM的细胞群；
(34)当所述共表达CD45和EpCAM的细胞群的细胞数占所述外周血单个核细胞的细胞数的比例高于0.01％时，应进行进一步的诊断和/或治疗。
具体地，步骤(31)中，可采用本领域的已知方法获取所述受试者的外周血单个核细胞。在一些实施方案中，所述受试者为怀疑患有癌症的个体，特别是怀疑患有肺癌或者是肺癌高危个体。
步骤(32)中，将本发明所述的组合物或本发明所述的试剂盒与所述外周血单个核细胞混合孵育，使所述抗CD45抗体和抗EpCAM抗体共同标记PBMC中的CD45 +EpCAM +细胞群。
步骤(33)中，可采用本领域的流式细胞术、免疫荧光染色法、蛋白质印迹法、实时定量反转录PCR等常规检测方法来检测共表达CD45和EpCAM的细胞群。在一些实施方案中，优选通过流式细胞术进行检测。具体地，对所述混合物中的细胞进行染色，检测CD45 +EpCAM +细胞群。对细胞染色以及流式细胞术的具体检测步骤可采用本领域已知方法。
步骤(34)与前文所述步骤(23)相同，此处不再赘述。
本发明提供的步骤(31)-(34)的方法，优选采用流式细胞术直接获得CD45 +EpCAM +细胞群占PBMC的比例数据，可以更加直接快速地获得结果，且对于PBMC样本量要求更少，对实验设备的要求更低，在临床快速筛查、辅助诊断中具有重要价值。
相应地，本发明还提供了一种指导癌症治疗的方法。包括：
(41)取受试者的外周血单个核细胞；
(42)通过本发明所述的分离方法分离所述受试者的共表达CD45和EpCAM的细胞群；
(43)当所述共表达CD45和EpCAM的细胞群的细胞数占所述外周血单个核细胞的细胞数的比例高于0.01％时，对所述受试者进行进一步检查和/或治疗。
具体地，步骤(41)中，可采用本领域的已知方法获取所述受试者的外周血单个核细胞。在一些实施方案中，所述受试者为怀疑患有癌症的个体，特别是怀疑患有肺癌或者是肺癌高危个体。
步骤(42)与前述所述步骤(22)相同，此处不再赘述。
步骤(43)中，当所述共表达CD45和EpCAM的细胞群的细胞数占所述外周血单个核细胞的细胞数的比例高于0.01％时，则怀疑所述受试者患有癌症，且几率高于88％，需进行进一步的诊断以确认所述受试者患有癌症。确诊后，可对所述受试者进行相应的癌症治疗。本发明所述治疗为本领域已知方法，包括但不限于化学疗法、免疫疗法和/或放射疗法。
类似地，本发明的癌症治疗方法也可在流式细胞术直接获得CD45 +EpCAM +细胞群占PBMC的比例数据的基础上，经诊断、确诊后治疗。相应地，本发明还提供了另一种指导癌症治疗的方法，包括：
(51)取受试者的外周血单个核细胞；
(52)将本发明所述的组合物或本发明所述的试剂盒与所述外周血单个核细胞混合，孵育所得混合物；
(53)检测所述混合物中共表达CD45和EpCAM的细胞群；
(54)当所述共表达CD45和EpCAM的细胞群的细胞数占所述外周血单个核细胞的细胞数的比例高于0.01％时，需对所述受试者进行进一步的诊断。
具体地，步骤(51)与前文所述步骤(31)相同，步骤(52)与前文所述步骤(32)相同，步骤(53)与前文所述步骤(33)相同，此处不再赘述。
步骤(54)中，当所述共表达CD45和EpCAM的细胞群的细胞数占所述外周血单个核细胞的细胞数的比例高于0.01％时，则怀疑所述受试者患有癌症，且几率高于88％，需进行进一步的诊断以确认所述受试者患有癌症。确诊后，可对所述受试者进行相应的癌症治疗。
本发明还提供了一种癌症治疗有效性的评估方法，包括：
(61)取受试者的第一外周血单个核细胞，其中，所述受试者患有癌症且未进行抗癌治疗；
(62)通过本发明所述的分离方法分离所述受试者的共表达CD45和EpCAM的第一细胞群；
(63)记录所述第一细胞群的细胞数占所述外周血单个核细胞的细胞数的比例x；
(64)对所述患者进行抗癌治疗后，取所述受试者的第二外周血单个核细胞；
(65)通过本发明所述的分离方法分离所述受试者的共表达CD45和EpCAM的第二细胞群；
(66)记录所述第二细胞群的细胞数占所述外周血单个核细胞的细胞数的比例y；
(67)当y＜x时，则对所述患者进行抗癌治疗的方法有效；当y≥x时，则对所述患者进行抗癌治疗的方法未达到预期。
本发明提供的评估方法是在癌症患者进行抗癌治疗前后，分别检测其PBMC中的CD45 +EpCAM +细胞群占比，然后将治疗前后的数据进行比较，判断CD45 +EpCAM +细胞群在PBMC中的比例是否减少。如减少，则表明该抗癌治疗是有效的；如未减少，则表明该抗癌治疗未达到预期。本发明提供的所述评估方法可以用于评估针对具体个体进行抗癌治疗时，采用不同的治疗方法、不同的药物或其组合、不同的给药方式、不同的剂量、不同的剂型等对该具体个体的癌症治疗是否有效。
具体地，步骤(61)中，可采用本领域的已知方法获取所述受试者的外周血单个核细胞，所述受试者为已经确诊患有癌症的个体，优选为确诊患有肺癌的个体。
在一些实施方案中，将步骤(61)中获取的第一外周血单个核细胞的细胞数与步骤(64)中获取的第二外周血单个核细胞的细胞数设置为相等，以提高评估结果的准确性。
类似地，本发明也可在流式细胞术直接获得CD45 +EpCAM +细胞群占PBMC的比例数据的基础上进行评估。相应地，本发明还提供了另一种癌症治疗有效性的评估方法，包括：
(71)取受试者的第一外周血单个核细胞，其中，所述受试者患有癌症且未进行抗癌治疗；
(72)将本发明所述的组合物或本发明所述的试剂盒与所述第一外周血单个核细胞混合得到第一混合物并孵育；
(73)检测所述第一混合物中共表达CD45和EpCAM的第一细胞群；
(74)记录所述第一细胞群的细胞数占所述第一外周血单个核细胞的细胞数的比例x；
(75)对所述患者进行抗癌治疗后，取所述受试者的第二外周血单个核细胞；
(76)将本发明所述的组合物或本发明所述的试剂盒与所述第二外周血单个核细胞混合得到第二混合物并孵育；
(77)检测所述第二混合物中共表达CD45和EpCAM的第二细胞群；
(78)记录所述第二细胞群的细胞数占所述第二外周血单个核细胞的细胞数的比例y；
(79)当y＜x时，则对所述患者进行抗癌治疗的方法有效；当y≥x时，则对所述患者进行抗癌治疗的方法未达到预期。
具体地，步骤(71)中，可采用本领域的已知方法获取所述受试者的外周血单个核细胞，所述受试者为已经确诊患有癌症的个体，优选为确诊患有肺癌的个体。
在一些实施方案中，将步骤(71)中获取的第一外周血单个核细胞的细胞数与步骤(75)中获取的第二外周血单个核细胞的细胞数设置为相等，以提高评估结果的准确性。
步骤(73)和(77)中，可采用本领域的常规用于检测细胞标志物的方法来检测共表达CD45和EpCAM的细胞群。在一些实施方案中，优选通过流式细胞术进行检测。具体地，对所述混合物中的细胞进行染色，通过检测CD45 +EpCAM +细胞群。对细胞染色以及流式细胞术的具体检测步骤可采用本领域已知方法。
为使本发明上述实施细节和操作能清楚地被本领域技术人员理解，以及本发明实施例共表达CD45和EpCAM的细胞群的检测和分离方法及其用途的进步性能显著的体现，以下通过多个实施例来举例说明上述技术方案。
下述实施例中所使用的实验方法如无特殊说明，均为常规方法。
下述实施例中所用的材料、试剂等，如无特殊说明，均可从商业途径得到。
实施例1
1.肺癌肿瘤组织细胞上CD45和EpCAM表达的流式检测：
(101)采用微创手术获得肺癌患者的肿瘤组织，将其置于直径10cm培养皿中，生理盐水清洗一遍；
(102)用眼科剪或者手术刀将肿瘤组织剪成1mm 3大小的组织块；
(103)加入适量的生理盐水，然后将剪碎的肿瘤组织转移至50ml离心管中，400g离心5min；
(104)离心结束后，弃去上清，加入1ml生理盐水重悬细胞后，加生理盐水至50ml，上下颠倒混匀；
(105)利用70μm滤网将细胞过滤至新的50ml离心管中，获得细胞悬液；
(106)取适量的细胞进行细胞计数后，400g离心5min；
(107)离心结束后，弃去上清，加入1ml生理盐水重悬细胞后，取0.5x10 6细胞进行流式染色；
(108)400g离心10min；
(109)离心结束后，弃去上清，用100μl含2％胎牛血清的PBS重悬细胞沉淀。抗体的Fc部分会与位于白细胞或者肿瘤细胞表面的Fc受体连接，因此为避免这种非特异性结合导致的背景信号的产生或者非特异性染色的出现，每个样品加入Fc受体阻断剂，室温孵育10min；
(110)细胞分成两份，全阴性组和待检测组，每组细胞体积50μl，即2.5x10 5个活细胞；
(111)待检测组细胞中加入1.25μl APC-EpCAM及Alexa Fluor 700-CD45抗体，4℃冰箱内孵育20min；
(112)孵育结束后，向检测组细胞中加入1.25μl PerCP-7AAD染料，室温孵育10min；
(113)孵育结束后，向每管细胞中加入1ml含2％胎牛血清的PBS，400g离心5min；
(114)离心结束后，弃去上清，加入200μl含2％胎牛血清的PBS重悬细胞，充分混匀；
(115)细胞经70μm滤网过滤后进行流式检测。
2.外周血单个核细胞(PBMC)上CD45和EpCAM表达的流式检测：
(201)抽取健康志愿者及肺癌患者外周血5-10ml至抗凝管中；
(202)盛有血液样本的抗凝管经75％酒精消毒后放进超净台，打开抗凝管的盖子，将外周血转移至50ml离心管内，650g离心10min；
(203)离心结束后，血液分为两层，用巴氏吸管将上层血浆弃掉；
(204)向沉淀中加入等体积的生理盐水，用巴氏吸管吹打混匀；
(205)外周血中单个核细胞包括淋巴和单核等细胞，其体积、形态和密度与其他细胞不同，红细胞和白细胞等细胞密度最大，其次是淋巴和单核细胞，血小板的密度最小。样本密度分离液通过密度分离作用，用于外周血中不同细胞的分离。准备样本密度分离液，其体积与沉淀和生理盐水混匀液的体积一致；
(206)用巴氏吸管将沉淀和生理盐水混匀液缓慢加入样本密度分离液中，二者不能混匀；
(207)650g离心10min；
(208)离心结束后，共分为4层，用巴氏吸管将第二层取出至新的50ml离心管中，加入生理盐水至50ml；
(209)600g，离心10min，弃去上清；
(210)加入适量生理盐水吹打混匀，细胞计数，每个样本取0.5x10 6细胞进行流式染色；
(211)400g离心10min；
(212)离心结束后，弃去上清，用100μl含2％胎牛血清的PBS重悬细胞沉淀。抗体的Fc部分会与位于白细胞或者肿瘤细胞表面的Fc受体连接，因此为避免这种非特异性结合导致的背景信号的产生或者非特异性染色的出现，每个样品加入Fc受体阻断剂，室温孵育10min；
(213)每个样本的细胞分成两份，全阴性组和待检测组，每组细胞体积50μl，即2.5x10 5个活细胞；
(214)待检测组细胞中加入1.25μl APC-EpCAM及Alexa Fluor 700-CD45抗体，4℃冰箱内孵育20min；
(215)孵育结束后，向检测组细胞中加入1.25μl PerCP-7AAD染料，室温孵育10min；
(216)孵育结束后，向每管细胞中加入1ml含2％胎牛血清的PBS，400g离心5min；
(217)离心结束后，弃去上清，加入200μl含2％胎牛血清的PBS重悬细胞，充分混匀；
(218)细胞经70μm滤网过滤后进行流式检测。
健康志愿者PBMC、肺癌患者PBMC及肺癌肿瘤组织单细胞悬液流式染色结束后，利用贝克曼流式细胞仪进行分析，结果如图1-3所示。图1为流式图，显示了与健康志愿者PBMC相比较，肺癌患者PBMC及肿瘤组织中CD45 +EpCAM +细胞比例明显增多。图2为统计图，显示了与健康志愿者PBMC相比较，肺癌患者PBMC与及肿瘤组织中CD45 +EpCAM +细胞比例明显增多，与流式细胞术结果一致。图3为统计图，其结果可以看出，肺癌患者的肿瘤组织与其对应PBMC相比较，肿瘤组织中CD45 +EpCAM +细胞比例明显升高；肺癌患者肿瘤组织中CD45 +EpCAM +细胞比例与PBMC中的有一定的线性关系，肺癌肿瘤组织中CD45 +EpCAM +细胞比例较高的患者，PBMC中其比例均高于健康志愿者。
实施例2
外周血单个核细胞(PBMC)中CD45 +EpCAM +细胞形成的原因研究。
1.HCC827细胞外泌体的提取：
(301)HCC827细胞融合率达到80-90％，细胞传代，用含无外泌体血清的RPMI1640完全培养基培养细胞48-72h，收集细胞培养上清液；
(302)300-500g,4℃离心5min去除细胞；
(303)离心结束后，将细胞培养上清转移至新的离心管中，2,000g,4℃离心10min,去除细胞碎片；
(304)离心结束后，将细胞培养上清转移至新的离心管中，10,000g,4℃离心30min,去除凋亡小体；
(305)离心结束后，将细胞培养上清转移至新的离心管中，120,000g,4℃离心70min,弃上清收集沉淀；
(306)加入1ml PBS重悬沉淀后，加PBS至50ml，再次以120,000g,4℃离心70min,沉淀即为所提取的外泌体；
(307)加入1ml PBS重悬沉淀后，转移至1.5ml离心管中，-80℃保存。
2.外泌体样品透射电镜观察：
(308)将外泌体取出10μl；
(309)吸取样品10μl滴加于铜网上沉淀1min，滤纸吸去浮液；
(310)醋酸双氧铀10μl滴加于铜网上沉淀1min，滤纸吸去浮液；
(311)常温干燥数分钟；
(312)100kv进行电镜检测成像，并获得透射电镜成像结果。
3.外泌体样品粒径分析：
(313)将外泌体取出10μl稀释到30μl；
(314)先用标准品进行仪器性能测试合格后方可进行外泌体样品上样，注意需进行梯度稀释避免样本堵塞进样针；
(315)待样本完成检测即可获得仪器检测外泌体的粒径信息。
4.外泌体样品蛋白指标检测：
第1天：
(316)使用BCA法测外泌体蛋白的浓度，并根据标准曲线算出待测样品蛋白浓度；
(317)取含有25μg蛋白的外泌体，并用含0.1％BSA的PBS补足体积至100μl；
(318)取20μl振荡混匀的磁珠转移至合适的离心管中；
(319)向盛有磁珠的离心管中加200μl含0.1％BSA的PBS，充分混匀；
(320)将离心管置于磁力架上1min，弃去上清液；
(321)将准备好的外泌体转移至含有磁珠的外泌体中，充分混匀；
(322)将外泌体和磁珠的混合液置于样本混合器上，放于4℃冰箱，孵育过夜。
第2天：
(323)孵育结束后，13,000g，4℃离心3-5s，弃去上清，加入300μl含0.1％BSA的PBS，用移液枪轻柔的混匀；
(324)将离心管置于磁力架上1min，弃去上清液；加入400μl含0.1％BSA的PBS，用移液枪轻柔的混匀；
(325)将离心管置于磁力架上1min，弃去上清液；
(326)加入300μl含0.1％BSA的PBS重悬磁珠结合的外泌体，此时磁珠结合的外泌体浓度相当于1x10 6个细胞；
(327)取1.5μl PE-CD63抗体转移至合适的离心管中；
(328)取100μl磁珠结合的外泌体转移至盛有抗体的离心管中，用移液枪轻柔的混匀；
(329)置于转速为1,000rpm的摇床上，室温孵育45-60min；
(330)孵育结束后，加入300μl含0.1％BSA的PBS，用移液枪轻柔的混匀；
(331)将离心管置于磁力架上1min，弃去上清液；
(332)加入100μl含0.1％BSA的PBS重悬磁珠结合的外泌体，用移液枪轻柔的混匀，进行流式检测。
5.健康志愿者PBMC与HCC827细胞共培养实验：
(333)制备PBMC及HCC827细胞的单细胞悬液，细胞计数；
(334)实验分组：
①PBMC组：用2ml含无外泌体血清的RPMI1640完全培养基重悬PBMC(1x10 6)细胞后加入6孔板中；
②PBMC与HCC827细胞共培养组：用2ml含无外泌体血清的RPMI1640完全培养基重悬PBMC与HCC827细胞(PBMC:HCC827＝1:3)后加入6孔板中；
③PBMC与HCC827细胞培养上清共培养组：用2ml HCC827细胞培养上清重悬PBMC(1x10 6)细胞后加入6孔板中；
④PBMC与HCC827细胞外泌体共培养组：用2ml含无外泌体血清的RPMI1640完全培养基重悬PBMC(1x10 6)细胞，然后加入10μg/ml外泌体，重悬混匀后加入6孔板中；
⑤PBMC与HCC827细胞外泌体共培养组：用2ml含无外泌体血清的RPMI1640完全培养基重悬PBMC(1x10 6)细胞，然后加入50μg/ml外泌体，重悬混匀后加入6孔板中；
⑥PBMC与HCC827细胞外泌体共培养组：用2ml含无外泌体血清的RPMI1640完全培养基重悬PBMC(1x10 6)细胞，然后加入100μg/ml外泌体，重悬混匀后加入6孔板中；
(335)将细胞放入37℃培养箱内培养24h后，观察细胞，然后收集细胞；
(336)400g离心10min；
(337)离心结束后，弃去上清，用100μl含2％胎牛血清的PBS重悬细胞沉淀。抗体的Fc部分会与位于白细胞或者肿瘤细胞表面的Fc受体连接，因此为避免这种非特异性结合导致的背景信号的产生或者非特异性染色的出现，每个样品加入Fc受体阻断剂，室温孵育10min；
(338)每个样本的细胞分成两份，全阴性组和待检测组，每组细胞体积50μl，即5x10 5个活细胞；
(339)待检测组细胞中加入2.5μl APC-EpCAM及Alexa Fluor 700-CD45抗体，4℃冰箱内孵育20min；
(340)孵育结束后，向检测组细胞中加入2.5μl PerCP-7AAD染料，室温孵育10min；
(341)孵育结束后，向每管细胞中加入1ml含2％胎牛血清的PBS，400g离心5min；
(342)离心结束后，弃去上清，加入200μl含2％胎牛血清的PBS重悬细胞，充分混匀；
(343)细胞经70μm滤网过滤后进行流式检测。
健康志愿者PBMC与HCC827细胞共培养实验结束后，然后进行流式染色，利用贝克曼流式细胞仪进行分析，结果如图4-8所示。图4为外泌体电镜分析图，根据图4显示，HCC827细胞分泌的外泌体呈现为典型的盘状囊泡。外泌体的粒径在30-150nm，图5结果显示，HCC827细胞分泌的外泌体粒径在70nm左右。图6流式结果显示，与对照组相比较，HCC827细胞分泌的外泌体高表达蛋白CD63。根据图7和图8显示，与PBMC相比较，PBMC与HCC827细胞按1:3的比例共培养后，CD45 +EpCAM +细胞比例显著升高；与PBMC相比较，PBMC与HCC827细胞培养上清共培养后，CD45 +EpCAM +细胞比例升高。与PBMC相比较，在含10μg/ml外泌体的培养基中，PBMC中CD45 +EpCAM +细胞比例无明显变化；而在含50μg/ml和100μg/ml外泌体的.培养基中，PBMC中CD45 +EpCAM +细胞比例明显增多。从图8可以看出，随着外泌体浓度的升高，PBMC中CD45 +EpCAM +细胞比例随之升高。
实施例3
利用包被有抗CD45抗体的磁珠(购自Miltenyi Biotec)和包被有抗EpCAM抗体(购自Miltenyi Biotec)的磁珠检测CD45 +EpCAM +细胞：
(401)健康志愿者PBMC与HCC827细胞以1:3的比例进行共培养，24h后收集细胞至15ml离心管中；
(402)利用CD45磁珠分选CD45 +细胞：
①收集的细胞离心，300g离心10min；
②弃去上清，并用80μl含0.5％的牛血清白蛋白的MACS溶液重悬细胞；
③加20μl CD45磁珠，混匀后置于4℃冰箱内孵育15min；
④孵育结束后，向离心管中加入2ml含0.5％的牛血清白蛋白的MACS溶液充分混匀，300g离心10min；
⑤将MACS柱置于磁力架上，并用3ml含0.5％的牛血清白蛋白的MACS溶液润洗；
⑥离心结束后的细胞，弃去上清，用含0.5％的牛血清白蛋白的MACS溶液重悬后加到润洗后的MACS柱内；
⑦向加有样本的MACS柱内加入3ml含0.5％的牛血清白蛋白的MACS溶液进行CD45 -细胞的分离；
⑧重复2次⑦步骤；
⑨向含有细胞样品的MACS柱中加5ml含0.5％的牛血清白蛋白的MACS溶液，然后用注射器将CD45 +细胞冲到新的15ml离心管中；
(403)利用EpCAM磁珠分选EpCAM +细胞：
①将得到的CD45 +细胞离心，300g离心10min；
②弃去上清，并用60μl含0.5％的牛血清白蛋白的MACS溶液重悬细胞；
③加20μl Fc抗体和EpCAM磁珠，混匀后置于4℃冰箱内孵育30min；
④孵育结束后，向离心管中加入2ml含0.5％的牛血清白蛋白的MACS溶液充分混匀，300g离心10min；
⑤将MACS柱置于磁力架上，并用3ml含0.5％的牛血清白蛋白的MACS溶液润洗；
⑥离心结束后的细胞，弃去上清，用含0.5％的牛血清白蛋白的MACS溶液重悬后加到润洗后的MACS柱内；
⑦向加有样本的MACS柱内加入3ml含0.5％的牛血清白蛋白的MACS溶液进行EpCAM -细胞的分离；
⑧重复2次⑦步骤；
⑨向含有细胞样品的MACS柱中加5ml含0.5％的牛血清白蛋白的MACS溶液，然后用注射器将EpCAM +细胞冲到新的15ml离心管中；
(404)将得到的细胞进行离心，300g离心10min；
(405)离心结束后，弃去上清，加入适量的PBS重悬细胞，细胞计数，取0.5x10 6细胞转移至新的1.5ml离心管中；
(406)400g离心10min；
(407)离心结束后，弃去上清，用100μl含2％胎牛血清的PBS重悬细胞沉淀。抗体的Fc部分会与位于白细胞或者肿瘤细胞表面的Fc受体连接，因此为避免这种非特异性结合导致的背景信号的产生或者非特异性染色的出现，每个样品加入Fc受体阻断剂，室温孵育10min；
(408)孵育结束后，向细胞中加入2.5μl APC-EpCAM及Alexa Fluor 700-CD45抗体，4℃冰箱内孵育20min；
(409)孵育结束后，向细胞中加入2.5μl PerCP-7AAD染料，室温孵育10min；
(410)孵育结束后，向细胞中加入1ml含2％胎牛血清的PBS，400g离心5min；
(411)离心结束后，弃去上清，加入200μl含2％胎牛血清的PBS重悬细胞，充分混匀；
(412)细胞经70μm滤网过滤后进行流式检测。
健康志愿者PBMC与HCC827细胞以1:3的比例共培养后，经过CD45和EpCAM磁珠两步分选后进行流式染色，利用贝克曼流式细胞仪进行分析，结果如图9所示。如图9中的流式结果与图1中的健康志愿者PBMC、肺癌患者PBMC的流式结果相比较具有一致性，说明健康志愿者PBMC与HCC827细胞以1:3的比例共培养后，经过CD45和EpCAM磁珠两步分选后进行流式染色，此方法能够获得并检测到CD45 +EpCAM +细胞。
实施例4
健康志愿者PBMC与HCC827细胞共培养后，CD45 +EpCAM +细胞凋亡增加：
(501)制备PBMC及HCC827细胞的单细胞悬液，细胞计数；
(502)实验分组：
①PBMC组：用2ml含无外泌体血清的RPMI1640完全培养基重悬PBMC(1x10 6)细胞后加入6孔板中；
②PBMC与HCC827细胞共培养组：用2ml含无外泌体血清的RPMI1640完全培养基重悬PBMC与HCC827细胞(PBMC:HCC827＝1:3)后加入6孔板中；
③PBMC与HCC827细胞培养上清共培养组：用2ml HCC827细胞培养上清重悬PBMC(1x10 6)细胞后加入6孔板中；
④PBMC与HCC827细胞外泌体共培养组：用2ml含无外泌体血清的RPMI1640完全培养基重悬PBMC(1x10 6)细胞，然后加入10μg/ml外泌体，重悬混匀后加入6孔板中；
⑤PBMC与HCC827细胞外泌体共培养组：用2ml含无外泌体血清的RPMI1640完全培养基重悬PBMC(1x10 6)细胞，然后加入50μg/ml外泌体，重悬混匀后加入6孔板中；
⑥PBMC与HCC827细胞外泌体共培养组：用2ml含无外泌体血清的RPMI1640完全培养基重悬PBMC(1x10 6)细胞，然后加入100μg/ml外泌体，重悬混匀后加入6孔板中；
(503)将细胞放入37℃培养箱内培养24h后，观察细胞，然后收集细胞；
(504)400g离心10min；
(505)离心结束后，弃去上清，用100μl含2％胎牛血清的PBS重悬细胞沉淀。抗体的Fc部分会与位于白细胞或者肿瘤细胞表面的Fc受体连接，因此为避免这种非特异性结合导致的背景信号的产生或者非特异性染色的出现，每个样品加入Fc受体阻断剂，室温孵育10min；
(506)每个样本的细胞分成两份，全阴性组和待检测组，每组细胞体积50μl，即5x10 5个活细胞；
(507)待检测组细胞中加入2.5μl APC-EpCAM及Alexa Fluor 700-CD45抗体，4℃冰箱内孵育20min；
(508)孵育结束后，向每管细胞中加入1ml含2％胎牛血清的PBS，400g离心5min；
(509)离心结束后，弃去上清后，待检测组细胞中加入100μl 1x Annexin V结合缓冲液(Binding Buffer)重悬细胞，混匀；
(510)室温孵育15min；
(511)向待检测组细胞中加入2.5μl Annexin V和7-AAD抗体，混匀；
(512)室温避光孵育15min；
(513)染色结束后，向待检测组细胞中加入100μl 1x Annexin V结合缓冲液，混匀后即可上机检测。
通过细胞凋亡流式染色，利用贝克曼流式细胞仪进行分析，结果如图10-11所示。根据图10和图11显示，PBMC实验组，与CD45 +EpCAM -细胞相比较，CD45 +EpCAM +细胞的凋亡(Annexin V +)无明显变化。PBMC与HCC827细胞按1:3的比例共培养后，与CD45 +EpCAM -细胞相比较，CD45 +EpCAM +细胞的凋亡显著增加。PBMC与HCC827细胞培养上清共培养后，与CD45 +EpCAM -细胞相比较，CD45 +EpCAM +细胞的凋亡显著增加。PBMC与HCC827细胞外泌体(10μg/ml、50μg/ml、100μg/ml)共培养后，与CD45 +EpCAM -细胞相比较，CD45 +EpCAM +细胞的凋亡显著增加。从图11中可以看出，随着外泌体浓度的升高，PBMC中CD45 +EpCAM +细胞凋亡并没有随之升高，并且在外泌体浓度为50μg/ml的培养条件下，CD45 +EpCAM +细胞中Annexin V +细胞比例最高。
实施例5
对人群PBMC中CD45 +EpCAM +细胞的检测作为可能发生肺癌的判断：
如图12所示，肺癌患者术前血清学检测结果所示，参考目前常用的肺癌血清学检测各指标正常值的范围，25位肺癌患者的血清中鳞状细胞癌相关抗原(SSC)以及糖类抗原125(CA25)的含量都在正常范围内。25位肺癌患者中有1位患者的血清中血清胃泌素释放肽前体(ProGRP)及神经元特异性烯醇化酶(NSE)的含量超过正常值(4％)；23位肺癌患者中有3位患者的血清中细胞角蛋白19片段(CYFRA21-1)的含量超过正常值(13％)；25位肺癌患者中有9位患者的血清中癌胚抗原(CEA)的含量超出正常范围(36％)，而CD45 +EpCAM +细胞比例高于0.01％(健康志愿者PBMC中CD45 +EpCAM +细胞比例的平均值)的为22人(88％)。并且CD45 +EpCAM +细胞比例高于健康正常人数值的肺癌患者的血清中CEA含量超出正常范围的有8位。除此之外，CD45 +EpCAM +细胞比例高于健康正常 人数值的22位肺癌患者的病理结果中TTF-1为阳性的有21人、NapsinA为阳性的有18人。因此，除部分患者血清中CEA含量超出正常范围外(36％)，其他几种癌症指标均不能反映出癌症的发生，对于肺癌筛查的意义有限。如图13中，本发明中检测的25位肺癌患者PBMC中，CD45 +EpCAM +细胞比例高于健康人数值的患者有22位(88％)，比目前最敏感的CEA高出2倍左右。因此在肺癌的筛查上可以作为一种辅助方法。
以上所述实施例仅表达了本发明的几种实施方式，其描述较为具体和详细，但并不能因此而理解为对本发明专利范围的限制。应当指出的是，对于本领域的普通技术人员来说，在不脱离本发明构思的前提下，还可以做出若干变形和改进，这些都属于本发明的保护范围。因此，本发明专利的保护范围应以所附权利要求为准。

Claims (20)

  1. 一种组合物，其特征在于，所述组合物包含抗CD45抗体和抗EpCAM抗体。
  2. 根据权利要求1所述的组合物，其特征在于，所述抗CD45抗体为大鼠源抗人CD45单抗、小鼠源抗人CD45单抗、羊源抗人CD45单抗和兔源抗人CD45单抗；和/或
    所述抗EpCAM抗体选自大鼠源抗人EpCAM单抗、小鼠源抗人EpCAM单抗、羊源抗人EpCAM单抗和兔源抗人EpCAM单抗。
  3. 根据权利要求1或2所述的组合物，其特征在于，所述抗CD45抗体的亲和力大于1.0×10 -11mol；和/或
    所述抗EpCAM抗体的亲和力大于等于2.69×10 -10mol/L。
  4. 根据权利要求1-3任一项所述的组合物，其特征在于，所述抗CD45抗体和所述抗EpCAM抗体分别与生物素或荧光素偶联。
  5. 根据权利要求1-4任一项所述的组合物，其特征在于，所述抗CD45抗体与所述抗EpCAM抗体的质量比为1:8.3。
  6. 一种试剂盒，其特征在于，所述试剂盒含有权利要求1-5任一项所述的组合物；任选地，所述试剂盒还含有磁珠；优选地，所述磁珠与链霉亲和素偶联。
  7. 权利要求1-5任一项所述的组合物或权利要求6所述的试剂盒在从外周血单个核细胞中检测和/或分离共表达CD45和EpCAM的细胞群中的用途。
  8. 根据权利要求7所述的用途，其特征在于，所述外周血单个核细胞来源于肿瘤患者，所述肿瘤选自肺癌、乳腺癌、卵巢癌和宫颈癌；优选地，所述肿瘤为肺癌。
  9. 一种共表达CD45和EpCAM的细胞群的分离方法，其特征在于，包括：
    提供外周血单个核细胞；
    将权利要求1-5任一项所述的组合物或权利要求6所述的试剂盒与所述外周血单个核细胞混合，孵育所得混合物；
    向所述混合物加入磁珠，经孵育，得到结合有共表达CD45和EpCAM的细胞群的磁珠；
    去除磁珠，得到共表达CD45和EpCAM的细胞群。
  10. 一种共表达CD45和EpCAM的细胞群，其特征在于，所述细胞群通过权利要求9所述的分离方法获得。
  11. 权利要求10所述的共表达CD45和EpCAM的细胞群在筛查和/或指导癌症治疗中的用途；优选地，所述癌症为肺癌。
  12. 一种癌症的体外筛查方法，其特征在于，包括：
    取受试者的外周血单个核细胞；
    通过权利要求9所述的分离方法分离所述受试者的共表达CD45和EpCAM的细胞群；
    当所述共表达CD45和EpCAM的细胞群的细胞数占所述外周血单个核细胞的细胞数的比例高于0.01％时，应进行进一步的诊断和/或治疗。
  13. 一种癌症的体外筛查方法，其特征在于，包括：
    取受试者的外周血单个核细胞；
    将权利要求1-5任一项所述的组合物或权利要求6所述的试剂盒与所述外周血单个核细胞混合，孵育所得混合物；
    检测所述混合物中共表达CD45和EpCAM的细胞群；
    当所述共表达CD45和EpCAM的细胞群的细胞数占所述外周血单个核细胞的细胞数的比例高于0.01％时，应进行进一步的诊断和/或治疗。
  14. 根据权利要求12或13所述的体外筛查方法，其特征在于，所述所述癌症选自肺癌、乳腺癌、卵巢癌和宫颈癌；优选地，所述癌症为肺癌。
  15. 一种指导癌症治疗的方法，其特征在于，包括：
    取受试者的外周血单个核细胞；
    通过权利要求9所述的分离方法分离所述受试者的共表达CD45和EpCAM的细胞群；
    当所述共表达CD45和EpCAM的细胞群的细胞数占所述外周血单个核细胞的细胞数的比例高于0.01％时，对所述受试者进行进一步检查和/或治疗。
  16. 一种指导癌症治疗的方法，其特征在于，包括：
    取受试者的外周血单个核细胞；
    将权利要求1-5任一项所述的组合物或权利要求6所述的试剂盒与所述外周血单个核细胞混合，孵育所得混合物；
    检测所述混合物中共表达CD45和EpCAM的细胞群；
    当所述共表达CD45和EpCAM的细胞群的细胞数占所述外周血单个核细胞的细胞数的比例高于0.01％时，对所述受试者进行进一步检查和/或治疗。
  17. 根据权利要求15或16所述的治疗方法，其特征在于，检测所述混合物的细胞中共表达CD45和EpCAM的细胞群的步骤中，所述检测方法包括流式细胞术；和/或
    所述治疗包括化学疗法、免疫疗法和/或放射疗法。
  18. 一种癌症治疗有效性的评估方法，其特征在于，包括：
    取受试者的第一外周血单个核细胞，其中，所述受试者患有癌症且未进行抗癌治疗；
    通过权利要求9所述的分离方法分离所述受试者的共表达CD45和EpCAM的第一细胞群；
    记录所述第一细胞群的细胞数占所述外周血单个核细胞的细胞数的比例x；
    对所述患者进行抗癌治疗后，取所述受试者的第二外周血单个核细胞；
    通过权利要求9所述的分离方法分离所述受试者的共表达CD45和EpCAM的第二细胞群；
    记录所述第二细胞群的细胞数占所述外周血单个核细胞的细胞数的比例y；
    当y＜x时，则对所述患者进行抗癌治疗的方法有效；当y≥x时，则对所述患者进行抗癌治疗的方法未达到预期。
  19. 一种癌症治疗有效性的评估方法，其特征在于，包括：
    取受试者的第一外周血单个核细胞，其中，所述受试者患有癌症且未进行抗癌治疗；
    将权利要求1-5任一项所述的组合物或权利要求6所述的试剂盒与所述第一外周血单个核细胞混合得到第一混合物并孵育；
    检测所述第一混合物中共表达CD45和EpCAM的第一细胞群；
    记录所述第一细胞群的细胞数占所述第一外周血单个核细胞的细胞数的比例x；
    对所述患者进行抗癌治疗后，取所述受试者的第二外周血单个核细胞；
    将权利要求1-5任一项所述的组合物或权利要求6所述的试剂盒与所述第二外周血单个核细胞混合得到第二混合物并孵育；
    检测所述第二混合物中共表达CD45和EpCAM的第二细胞群；
    记录所述第二细胞群的细胞数占所述第二外周血单个核细胞的细胞数的比例y；
    当y＜x时，则对所述患者进行抗癌治疗的方法有效；当y≥x时，则对所述患者进行抗癌治疗的方法未达到预期。
  20. 根据权利要求18或19所述的评估方法，其特征在于，检测所述第一混合物中共表达CD45和EpCAM的第一细胞群的步骤中，以及检测所述第二混合物中共表达CD45和EpCAM的第二细胞群的步骤中，所述检测方法包括流式细胞术；和/或
    所述治疗包括化学疗法、免疫疗法和/或放射疗法。
PCT/CN2022/077693 2022-02-24 2022-02-24 共表达CD45和EpCAM的细胞群的检测和分离方法及其用途 WO2023159427A1 (zh)

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