DIAGNOSIS KIT AND CHIP FOR BLADDER CANCER USING BLADDER CANCER SPECIFIC METHYLATION MARKER GENE

Information

  • Patent Application
  • 20170240976
  • Publication Number
    20170240976
  • Date Filed
    May 03, 2017
    7 years ago
  • Date Published
    August 24, 2017
    7 years ago
Abstract
The present invention relates to a kit and nucleic acid chip for diagnosing bladder cancer using a bladder cancer-specific marker gene. More particularly, the invention relates to a kit and nucleic acid chip for diagnosing bladder cancer, which can detect the promoter methylation of a bladder cancer-specific gene, the promoter or exon region of which is methylated specifically in transformed cells of bladder cancer. The use of the diagnostic kit or nucleic acid chip of the invention enables diagnosis of bladder cancer at an early stage of transformation, thus enabling early diagnosis of bladder cancer, and can diagnose bladder cancer in a more accurate and rapid manner compared to a conventional method.
Description
SEQUENCE LISTING

The instant application contains a Sequence Listing which has been submitted in ASCII format via EFS-Web and is hereby incorporated by reference in its entirety. Said ASCII copy, created on May 2, 2017, is named 322DIVCIP2_SeqID_ST25.txt and is 112026 bytes in size.


TECHNICAL FIELD

The present invention relates to a kit and nucleic acid chip for diagnosing bladder cancer using a bladder cancer-specific marker gene, and more particularly to a kit and nucleic acid chip for diagnosing bladder cancer, which can detect the promoter methylation of a bladder cancer-specific gene, the promoter region of which is methylated specifically in transformed cells of bladder cancer.


BACKGROUND ART

Bladder cancer is the most frequent cancer of the urinary system and was found to be caused by many factors. It is known that bladder cancer is mainly caused by smoking or various chemical substances (paints for leather, air pollutants, artificial sweetening agents, nitrates and the like) which irritate the bladder wall while they are excreted as urine after being absorbed in vivo.


As conventional methods for diagnosing bladder cancer, a method of finding abnormal cells in urine is used, but has low accuracy. Also, cystoscopy comprising inserting a catheter into the bladder and collecting suspected tissue from the bladder is an invasive method having relatively high accuracy.


Generally, when bladder cancer is diagnosed at an early stage, the survival rate of bladder cancer patients is increased, but it is not easy to diagnose bladder cancer at an early stage. As a method for diagnosing bladder cancer, a method of incising part of the body is currently being used, but it has difficulty in diagnosing bladder cancer at an early stage.


Bladder cancers are classified, according to invasion into the muscular layer of the bladder, into superficial cancer and invasive cancer. Generally, about 30% of patients upon diagnosis of bladder cancer are invasive bladder cancer patients. Thus, in order to increase the survival period of patients, it is the best method to diagnose bladder cancer at early stage when the bladder cancer lesions are small. Accordingly, there is an urgent need to development a diagnostic method more efficient than various prior diagnostic methods for bladder cancer, that is, a bladder cancer-specific biomarker which allows early diagnosis of bladder cancer, can treat a large amount of samples and has high sensitivity and specificity.


Recently, methods of diagnosing cancer through the measurement of DNA methylation have been suggested. DNA methylation occurs mainly on the cytosine of CpG islands in the promoter region of a specific gene to interfere with the binding of transcription factors, thus silencing the expression of the gene. Thus, detecting the methylation of CpG islands in the promoter of tumor inhibitory genes greatly assists in cancer research. Recently, an attempt has been actively made to determine promoter methylation, by methods such as methylation-specific PCR (hereinafter referred to as MSP) or automatic DNA sequencing, for the diagnosis and screening of cancer.


Although there are disputes on whether the methylation of promoter CpG islands directly induces cancer development or causes a secondary change after cancer development, it has been found that tumor suppressor genes, DNA repair genes, cell cycle regulatory genes and the line in several cancers are hyper-methylated, and thus the expression of these genes are silenced. Particularly, it is known that the hyper-methylation of the promoter region of a specific gene occurs at an early stage of cancer development.


Thus, the methylation of the promoter methylation of tumor-associated genes is an important indication of cancer and can be used in many applications, including the diagnosis and early diagnosis of cancer, the prediction of cancer development, the prediction of prognosis of cancer, follow-up examination after treatment, and the prediction of responses to anticancer therapy. Recently, an actual attempt to examine the promoter methylation of tumor-associated genes in blood, sputum, saliva, feces and to use the examined results for diagnosis and treatment of various cancers has been actively made (Esteller, M. et al., Cancer Res., 59:67, 1999; Sanchez-Cespedez, M. et al., Cancer Res., 60:892, 2000; Ahlquist, D. A. et al., Gastroenterol., 119:1219, 2000).


Accordingly, the present inventors have made many efforts to develop a diagnostic kit capable of effectively diagnosing bladder cancer and, as a result, have found that bladder cancer can be diagnosed by measuring the methylation degree using as a biomarker the promoter of methylation-associated genes which are expressed specifically in bladder cancer cells, thereby completing the present invention.


SUMMARY OF INVENTION

It is, therefore, an object of the present invention to provide a kit for diagnosing bladder cancer, which comprises the methylated promoter or exon region of a bladder cancer marker gene.


Another object of the present invention is to provide a nucleic acid chip for diagnosing bladder cancer, which comprises a probe capable of hybridizing with a fragment containing the CpG island of the bladder cancer-specific marker gene.


Still another object of the present invention is to provide a method for measuring the methylation of the promoter or exon region of a gene originated from a clinical sample.


To achieve the above objects, the present invention provides a kit for diagnosing bladder cancer, which comprises the methylated promoter or exon region of a bladder cancer marker gene selected from the group consisting of: (1) CDX2 (NM_001265)—caudal type homeobox transcription factor 2; (2) CYP1B1 (NM_000104)—cytochrome P450, family 1, subfamily B, polypeptide 1; (3) VSX1 (NM_199425)—visual system homeobox 1 homolog, CHX10-like (zebrafish); (4) HOXA11 (NM_005523)—homeobox A11; (5) T (NM_003181)—T, brachyury homolog (mouse); (6) TBX5 (NM_080717)—T-box 5; (7) PENK (NM_006211)—proenkephalin; (8) PAQR9 (NM_198504)—progestin and adipoQ receptor family member IV; (9) LHX2 (NM_004789)—LIM Homeobox 2; and (10) SIM2 (U80456)—single-minded homog 2 (Drosophila).


The present invention also provides a nucleic acid chip for diagnosing bladder cancer, which comprises a probe capable of hybridizing with a fragment containing the CpG island of the promoter or exon region of the bladder cancer marker gene selected from the group consisting of: (1) CDX2 (NM_001265)—caudal type homeobox transcription factor 2; (2) CYP1B1 (NM_000104)—cytochrome P450, family 1, subfamily B, polypeptide 1; (3) VSX1 (NM_199425)—visual system homeobox 1 homolog, CHX10-like (zebrafish); (4) HOXA11 (NM_005523)—homeobox A11; (5) T (NM_003181)—T, brachyury homolog (mouse); (6) TBX5 (NM_080717)—T-box 5; (7) PENK (NM_006211)—proenkephalin; (8) PAQR9 (NM_198504)—progestin and adipoQ receptor family member IV; (9) LHX2 (NM_004789)—LIM Homeobox 2; and (10) SIM2 (U80456)—single-minded homog 2 (Drosophila).


The present invention also provides a method for detecting the methylation of the promoter or exon region of a clinical sample-originated gene selected from the group consisting of CDX2, CYP1B1, VSX1, HOXA11, T, TBX5, PENK, PAQR9, LHX2 and SIM2.


Other features and embodiments of the present invention will be more apparent from the following detailed description and the appended claims.





BRIEF DESCRIPTION OF DRAWINGS


FIG. 1 is a schematic diagram showing a process of discovering a methylated biomarker for diagnosis of bladder cancer from the urinary cells of normal persons and bladder cancer patients through CpG micrroarray analysis.



FIG. 2 quantitatively shows the methylation degree obtained through pyrosequencing of 10 methylation biomarkers in bladder cancer cell lines.



FIG. 3A shows measurement results for the methylation indexes of the CDX2, the CYP1B1 and the T biomarker genes in clinical samples. FIG. 3A shows measurement results for the methylation degrees of the CDX2, the CYP1B1 and the T biomarker genes in the urinary cells of normal persons, Cystitis patients, hematuria patients and bladder cancer patients.



FIG. 3B shows measurement results for the methylation indexes of the TBX5, the LHX2 and the SIM2 biomarker genes in clinical samples. FIG. 3B shows measurement results for the methylation degrees of the TBX5, the LHX2 and the SIM2 biomarker genes in the urinary cells of normal persons, Cystitis patients, hematuria patients and bladder cancer patients.



FIG. 3C shows measurement results for the methylation indexes of the VSX1, the HOXA11 and the PENK biomarker genes in clinical samples. FIG. 3C shows measurement results for the methylation degrees of the VSX1, the HOXA11 and the PENK biomarker genes in the urinary cells of normal persons, Cystitis patients, hematuria patients and bladder cancer patients.



FIG. 3D shows measurement results for the methylation indexes of the PAQR9 biomarker genes in clinical samples. FIG. 3D shows measurement results for the methylation degrees of the PAQR9 biomarker genes in the urinary cells of normal persons, Cystitis patients, hematuria patients and bladder cancer patients.



FIG. 4A shows the results of receiver operating characteristic (ROC) curve analysis conducted to measure the sensitivity and specificity of the CDX2 and the CYP1B1 methylation biomarkers for diagnosis of bladder cancer.



FIG. 4B shows the results of receiver operation characteristic (ROC) curve analysis conducted to measure the sensitivity and specificity of the VSX1 and the HOXA11 methylation biomarkers for diagnosis of bladder cancer.



FIG. 4C shows the results of receiver operating characteristic (ROC) curve analysis conducted to measure the sensitivity and specificity of the T and the TBX5 methylation biomarkers for diagnosis of bladder cancer.



FIG. 4D shows the results of receiver operating characteristic (ROC) curve analysis conducted to measure the sensitivity and specificity of the PENK and the PAQR9 methylation biomarkers for diagnosis of bladder cancer.



FIG. 4E shows the results of receiver operating characteristic (ROC) curve analysis conducted to measure the sensitivity and specificity of the LHX2 and the SIM2 methylation biomarkers for diagnosis of bladder cancer.



FIG. 5 shows the frequency of methylation in the urinary cells of normal persons and bladder cancer patients.



FIGS. 6A-6D shows the methylation profile of an optimal panel of 6 biomarker genes for bladder cancer diagnosis (FIG. 6A), selected from among 10 biomarkers using logistic regression analysis, and shows the sensitivity and specificity of the gene panel for diagnosis of bladder cancer (FIG. 6B-D).



FIG. 7 shows the results of PCR performed using the methylated DNA-specific binding protein MBD in order to measure the methylation of the biomarker SIM2 gene for bladder cancer cell in bladder cancer cell lines.





DETAILED DESCRIPTION OF THE INVENTION, AND PREFERRED EMBODIMENTS

In one aspect, the present invention relates to a kit for diagnosing bladder cancer, which comprises the methylated promoter or exon region of a bladder cancer marker gene.


In another aspect, the present invention relates to a nucleic acid chip for diagnosing bladder cancer, which comprises a probe capable of hybridizing with a fragment containing the CpG island of the promoter or exon region of a bladder cancer marker gene.


In the present invention, the promoter or exon region may contain at least one methylated CpG dinucleotide. Also, the promoter or exon region is any one of DNA sequences represented in SEQ ID NO: 31 to SEQ ID NO: 40.


In the present invention, the probe preferably has a size ranging from 10 bp to 1 kb, and has a homology with a base sequence containing the CpG island of the promoter or exon region of a bladder cancer marker gene, such that it can hybridize with the base sequence. More preferably, the probe has a size of 10-100 bp, and has a homology with a base sequence containing the CpG island of the promoter or exon region of a bladder cancer marker gene, such that it can hybridize with the base sequence in strict conditions. If the size of the probe is less than 10 bp, non-specific hybridization will occur, and if it is more than 1 kb, the binding between the probes will occur, thus making it difficult to read hybridization results.


A method for screening a methylation marker gene according to the present invention comprises the steps of: (a) isolating genomic DNAs from transformed cells and non-transformed cells; (b) reacting the isolated genomic DNAs to with a protein binding to methylated DNA and isolating methylated DNAs from the genomic DNAs; and (c) amplifying the isolated methylated DNAs, hybridizing the amplified DNAs to CpG microarrays, and selecting a methylation marker gene showing the greatest difference in methylation degree between normal cells and cancer cells among from the hybridized genes.


By the method for screening the methylation biomarker gene, it is possible to screen various genes, which are methylated not only in bladder cancer, but also in various dysplasic stages which progress to bladder cancer. The screened genes are also useful for blood cancer screening, risk assessment, prognosis, disease identification, disease staging, and selection of therapeutic targets.


The identification of the methylated gene in bladder cancer and abnormalities at various stages enables early diagnosis of bladder cancer in an accurate and effective manner, and allows establishment of methylation data using multiple genes and identification of new therapeutic targets. Additionally, methylation data according to the present invention enables establishment of a more accurate system for diagnosing bladder cancer, when it is used together with a method for detecting other non-methylation-associated biomarkers.


The inventive method enables diagnosis of bladder cancer progression at various stages by determining the methylation stage of at least one nucleic acid biomarker obtained from a sample. When the methylation stage of nucleic acid isolated from a sample at each stage of bladder cancer is compared with the methylation stage of at least one nucleic acid obtained from a sample having no abnormality in the cell proliferation of bladder tissue, a certain stage of bladder cancer in the sample can be determined. The methylation stage may be hypermethylation.


In one embodiment of the present invention, nucleic acid can be methylated in the regulatory region of a gene. In another embodiment, since methylation begins from the outer boundary of the regulatory region of a gene and then spreads inward, detection of methylation at the outer boundary of the regulatory region enables early diagnosis of genes which are involved in cell transformation.


In still another embodiment of the present invention, the cell growth abnormality (dysplasia) of bladder tissue can be diagnosed by detecting the methylation of at least one nucleic acid of the following nucleic acids using a kit or a nucleic acid chip: CDX2 (NM_001265, caudal type homeobox transcription factor 2); CYP1B1 (NM_000104, cytochrome P450, family 1, subfamily B, polypeptide 1); VSX1 (NM_199425, visual system homeobox 1 homolog, CHX10-like (zebrafish)); HOXA11 (NM_005523, homeobox A11); T (NM_003181, T, brachyury homolog (mouse)); TBX5 (NM_080717, T-box 5); PENK (NM_006211, proenkephalin); and PAQR9 (NM_198504, progestin and adipoQ receptor family member IV); LHX2 (NM_004789) LIM Homeobox 2; SIM2 (U80456), single-minded homog 2 (Drosophila) gene and combination thereof.


The use of the diagnostic kit or nucleic acid chip of the present invention can determine the cell growth abnormality of bladder tissue in a sample. The method for determining the cell growth abnormality of bladder tissue comprises determining the methylation of at least one nucleic acid isolated from a sample. In the method, the methylation stage of at least one nucleic acid is compared with the methylation stage of a nucleic acid isolated from a sample having no cell growth abnormality (dysplasia).


The examples of said nucleic acid are follows: CDX2 (NM_001265, caudal type homeobox transcription factor 2); CYP1B1 (NM_000104, cytochrome P450, family 1, subfamily B, polypeptide 1); VSX1 (NM_199425, visual system homeobox 1 homolog, CHX10-like (zebrafish)); HOXA11 (NM_005523, homeobox A11); T (NM_003181, T, brachyury homolog (mouse)); TBX5 (NM_080717, T-box 5); PENK (NM_006211, proenkephalin); and PAQR9 (NM_198504, progestin and adipoQ receptor family member IV); LHX2 (NM_004789) LIM Homeobox 2; SIM2 (U80456), single-minded homog 2 (Drosophila) gene and combination thereof.


In still another embodiment of the present invention, cells capable of forming bladder cancer can be diagnosed at an early stage using the methylation gene marker. When genes confirmed to be methylated in cancer cells are methylated in cells which seem to be normal clinically or morphologically, the cells that seem to be normal are cells, the carcinogenesis of which is in progress. Thus, bladder cancer can be diagnosed at an early stage by detecting the methylation of bladder cancer-specific genes in the cells that seem to be normal.


The use of the methylation marker gene of the present invention enables detection of the cell growth abnormality (dysplasia progression) of bladder tissue in a sample. The method for detecting the cell growth abnormality (dysplasia progression) of bladder tissue comprises bringing at least one nucleic acid isolated from a sample into contact with an agent capable of determining the methylation status of the nucleic acid. The method comprises determining the methylation status of at least one region in at least one nucleic acid, and the methylation status of the nucleic acid differs from the methylation status of the same region in a nucleic acid isolated from a sample having no cell growth abnormality (dysplasia progression) of bladder tissue.


In still another embodiment of the present invention, transformed bladder cancer cells can be detected by examining the methylation of a marker gene using the above-described kit or nucleic acid chip.


In still another embodiment of the present invention, bladder cancer can be diagnosed by examining the methylation of a marker gene using the above-described kit or nucleic acid chip.


In still another embodiment of the present invention, the likelihood of progression to bladder cancer can be diagnosed by examining the methylation of a marker gene with the above-described kit or nucleic acid chip in a sample showing a normal phenotype. The sample may be solid or liquid tissue, cell, urine, serum or plasma.


In still another aspect, the present invention relates to a method for detecting the promoter methylation of a clinical sample-originated gene.


In the present invention, the method for measuring the promoter methylation of a clinical sample-originated gene may be selected from the group consisting of PCR, methylation specific PCR, real-time methylation specific PCR, PCR using a methylated DNA-specific binding protein, quantitative PCR, pyrosequencing and bisulfite sequencing, and the clinical sample is preferably a tissue, cell, blood or urine originated from patients suspected of cancer or subjects to be diagnosed.


In the present invention, the method for detecting the promoter methylation of the gene comprises the steps of: (a) isolating a sample DNA from a clinical sample; (b) amplifying the isolated DNA with primers capable of amplifying a fragment containing the promoter CpG island of a gene selected from the group consisting of CDX2, CYP1B1, VSX1, HOXA11, T, TBX5, PENK, PAQR9, LHX2 and SIM2; and (c) determining the promoter methylation of the DNA on the basis of whether the DNA has been amplified or not in step (b).


In an embodiment of the present disclosure, primer(s) that could amplify a methylated CpG of PENK might be used, and such primer(s) comprises at least one or more CpG dinucleotide in a region which hybridizes to the methylated CpG of PENK Specifically, the primer(s) for amplifying a methylated CpG of PENK comprise sequence(s) having a homology of 50% or more with sequence(s) selected from the group consisting of SEQ ID NOs: 43-44, 46-84, 86-148, 150-215, 217-285, 287-351, 353-422, 424-456. Preferably, the primer(s) for amplifying a methylated CpG of PENK comprise sequence(s) having a homology of at least 60%, 70%, 80%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99% and 100% with sequence(s) selected from the group consisting of SEQ ID NOs: 43-44, 46-84, 86-148, 150-215, 217-285, 287-351, 353-422, 424-456.


If required, probe(s) capable of hybridizing with a methylated CpG of PENK might be used. The probe(s) capable of hybridizing with a methylated CpG of PENK comprise at least one or more CpG dinucleotide in a region which hybridizes to the methylated CpG of PENK. Specifically, probe(s) might comprise sequence(s) having a homology of 50% or more with sequence(s) selected from the group consisting of SEQ ID NOs: 45, 85, 149, 216, 286, 352, 423 and 457. Preferably, the probe(s) capable of hybridizing with a methylated CpG of PENK comprise sequence(s) having a homology of at least 60%, 70%, 80%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99% and 100% with sequence(s) selected from the group consisting of SEQ ID NOs: 45, 85, 149, 216, 286, 352, 423 and 457.


In another embodiment of the present invention, the likelihood of development of tissue to bladder cancer can be evaluated by examining the methylation frequency of a gene which is methylated specifically in bladder cancer and determining the methylation frequency of tissue having the likelihood of progression to bladder cancer.


As used herein, “cell conversion” refers to the change in characteristics of a cell from one form to another such as from normal to abnormal, non-tumorous to tumorous, undifferentiated to differentiated, stem cell to non-stem cell. Further, the conversion may be recognized by morphology of the cell, phenotype of the cell, biochemical characteristics and so on.


As used herein, the term “early diagnosis” of cancer refers to discovering the likelihood of cancer before metastasis. Preferably, it refers to discovering the likelihood of cancer before a morphological change in a sample tissue or cell is observed. Additionally, the term “early diagnosis” of transformation the high probability of a cell to undergo transformation in its early stages before the cell is morphologically designated as being transformed.


As used herein, the term “hypermethylation” refers to the methylation of CpG islands.


As used herein, the term “sample” or “biological sample” is referred to in its broadest sense, and includes any biological sample obtained from an individual, body fluid, cell line, tissue culture or other sources, according to the type of analysis that is to be performed. Methods of obtaining body fluid and tissue biopsy from mammals are generally widely known. A preferred source is bladder biopsy.


Screening for Methylation Regulated Biomarkers

The present invention is directed to a method of determining biomarker genes that are methylated when the cell or tissue is converted or changed from one type of cell to another. As used herein, “converted” cell refers to the change in characteristics of a cell or tissue from one form to another such as from normal to abnormal, non-tumorous to tumorous, undifferentiated to differentiated and so on.


In one Example of the present invention, urinary cells were isolated from the urine of normal persons and bladder cancer patients, and then genomic DNAs were isolated from the urinary cells. In order to obtain only methylated DNAs from the genomic DNAs, the genomic DNAs were allowed to react with McrBt binding to methylated DNA, and then methylated DNAs binding to the McrBt protein were isolated. The isolated methylated DNAs binding to the McrBt protein were amplified, and then the DNAs originated from the normal persons were labeled with Cy3, and the DNAs originated from the bladder cancer patients were labeled with Cy5. Then, the DNAs were hybridized to human CpG-island microarrays, and 10 genes showing the greatest difference in methylation degree between the normal persons and the bladder cancer patients were selected as biomarkers.


In the present invention, in order to further confirm whether the 10 biomarkers have been methylated, pyrosequencing was performed.


Specifically, total genomic DNA was isolated from the bladder cell lines RT-4, J82, HT1197 and HT1376 and treated with bisulfite. The genomic DNA converted with bisulfite was amplified. Then, the amplified PCR product was subjected to pyrosequencing in order to measure the methylation degree of the genes. As a result, it could be seen that the 10 biomarkers were all methylated.


Biomarker for Bladder Cancer

The present invention provides a biomarker for diagnosing bladder cancer.


Biomarkers for Bladder Cancer—Using Cancer Cells for Comparison with Normal Cells


In one embodiment of the present invention, it is understood that “normal” cells are those that do not show any abnormal morphological or cytological changes. “Tumor” cells mean cancer cells. “Non-tumor” cells are those cells that were part of the diseased tissue but were not considered to be the tumor portion.


In one aspect, the present invention is based on the relationship between bladder cancer and the hypermethylation of the promoter or exon region of the following 10 genes: CDX2 (NM_001265, caudal type homeobox transcription factor 2); CYP1B1 (NM_000104, cytochrome P450, family 1, subfamily B, polypeptide 1); VSX1 (NM_199425, visual system homeobox 1 homolog, CHX10-like (zebrafish)); HOXA11 (NM_005523, homeobox A11); T (NM_003181, T, brachyury homolog (mouse)); TBX5 (NM_080717, T-box 5); PENK (NM_006211, proenkephalin); and PAQR9 (NM_198504, progestin and adipoQ receptor family member IV); LHX2 (NM_004789)—LIM Homeobox 2; and SIM2 (U80456)—single-minded homolog 2 (Drosophila); gene.


With other applications of the diagnostic kit or nucleic acid chip of the present invention, the invention can diagnose a cellular proliferative disorder of bladder tissue in a subject by determining the state of methylation of one or more nucleic acids isolated from the subject, wherein the state of methylation of one or more nucleic acids as compared with the state of methylation of one or more nucleic acids from a subject not having the cellular proliferative disorder of bladder tissue is indicative of a cellular proliferative disorder of bladder tissue in the subject. A preferred nucleic acid is a CpG-containing nucleic acid, such as a CpG island.


With other applications of the diagnostic kit or nucleic acid chip of the present invention, the cell growth abnormality of bladder tissue in a subject can be diagnosed comprising determining the methylation of one or more nucleic acids isolated from the subject. Said nucleic acid is preferably encoding the followings: CDX2 (NM_001265, caudal type homeobox transcription factor 2); CYP1B1 (NM_000104, cytochrome P450, family 1, subfamily B, polypeptide 1); VSX1 (NM_199425, visual system homeobox 1 homolog, CHX10-like (zebrafish)); HOXA11 (NM_005523, homeobox A11); T (NM_003181, T, brachyury homolog (mouse)); TBX5 (NM_080717, T-box 5); PENK (NM_006211, proenkephalin); and PAQR9 (NM_198504, progestin and adipoQ receptor family member IV); LHX2 (NM_004789)—LIM Homeobox 2; and SIM2 (U80456)—single-minded homolog 2 (Drosophila); gene and combinations thereof. The state of methylation of one or more nucleic acids as compared with the state of methylation of said nucleic acid from a subject not having a predisposition to the cellular proliferative disorder of bladder tissue is indicative of a cell proliferative disorder of bladder tissue in the subject.


As used herein, “predisposition” refers to an increased likelihood that an individual will have a disorder. Although a subject with a predisposition does not yet have the disorder, there exists an increased propensity to the disease.


Another embodiment of the invention provides a method for diagnosing a cellular proliferative disorder of bladder tissue in a subject comprising contacting a nucleic acid-containing specimen from the subject with an agent that provides a determination of the methylation state of nucleic acids in the specimen, and identifying the methylation state of at least one region of at least one nucleic acid, wherein the methylation state of at least one region of at least one nucleic acid that is different from the methylation state of the same region of the same nucleic acid in a subject not having the cellular proliferative disorder is indicative of a cellular proliferative disorder of bladder tissue in the subject.


The inventive method includes determining the state of methylation of one or more regions of one or more nucleic acids isolated from the subject. The phrases “nucleic acid” or “nucleic acid sequence” as used herein refer to an oligonucleotide, nucleotide, polynucleotide, or to a fragment of any of these, to DNA or RNA of genomic or synthetic origin which may be single-stranded or double-stranded, to DNA or RNA of genomic or synthetic origin which may represent a sense or antisense strand, peptide nucleic acid (PNA), or to any DNA-like or RNA-like material of natural or synthetic origin. As will be understood by those of skill in the art, when the nucleic acid is RNA, the deoxynucleotides A, G, C, and T are replaced by ribonucleotides A, G, C, and U, respectively.


The nucleic acid of interest can be any nucleic acid where it is desirable to detect the presence of a differentially methylated CpG island. The CpG island is a CpG rich region of a nucleic acid sequence.


Methylation

Any nucleic acid sample, in purified or nonpurified form, can be utilized in accordance with the present invention, provided it contains or is suspected of containing, a nucleic acid sequence containing a target locus (e.g., CpG-containing nucleic acid). One nucleic acid region capable of being differentially methylated is a CpG island, a sequence of nucleic acid with an increased density relative to other nucleic acid regions of the dinucleotide CpG. The CpG doublet occurs in vertebrate DNA at only about 20% of the frequency that would be expected from the proportion of G*C base pairs. In certain regions, the density of CpG doublets reaches the predicted value; it is increased by ten fold relative to the rest of the genome. CpG islands have an average G*C content of about 60%, and general DNA have an average G*C contents of about 40%. The islands take the form of stretches of DNA typically about one to two kilobases long. There are about 45,000 such islands in the human genome.


In many genes, the CpG islands begin just upstream of a promoter and extend downstream into the transcribed region. Methylation of a CpG island at a promoter usually prevents expression of the gene. The islands can also surround the 5′ region of the coding region of the gene as well as the 3′ region of the coding region. Thus, CpG islands can be found in multiple regions of a nucleic acid sequence including upstream of coding sequences in a regulatory region including a promoter region, in the coding regions (e.g., exons), in downstream of coding regions, for example, enhancer regions, and in introns.


In general, the CpG-containing nucleic acid is DNA. However, invention methods may employ, for example, samples that contain DNA, or DNA and RNA, including messenger RNA, wherein DNA or RNA may be single stranded or double stranded, or a DNA-RNA hybrid may be included in the sample.


A mixture of nucleic acids may also be employed. The specific nucleic acid sequence to be detected may be a fraction of a larger molecule or can be present initially as a discrete molecule, so that the specific sequence constitutes the entire nucleic acid. It is not necessary that the nucleic acid sequence is present initially in a pure form, the nucleic acid may be a minor fraction of a complex mixture, such as contained in whole human DNA. The nucleic acid-containing sample used for determination of the state of methylation of nucleic acids contained in the sample or detection of methylated CpG islands may be extracted by a variety of techniques such as that described by Sambrook, et al. (Molecular Cloning: A Laboratory Manual, Cold Spring Harbor, N.Y., 1989; incorporated in its entirety herein by reference).


A nucleic acid can contain a regulatory region which is a region of DNA that encodes information or controls transcription of the nucleic acid. Regulatory regions include at least one promoter. A “promoter” is a minimal sequence sufficient to direct transcription, to render promoter-dependent gene expression controllable for cell-type specific, tissue-specific, or inducible by external signals or agents. Promoters may be located in the 5′ or 3′ regions of the gene. Promoter regions, in whole or in part, of a number of nucleic acids can be examined for sites of CpG-island methylation. Moreover, it is generally recognized that methylation of the target gene promoter proceeds naturally from the outer boundary inward. Therefore, early stage of cell conversion can be detected by assaying for methylation in these outer areas of the promoter region.


Nucleic acids isolated from a subject are obtained in a biological specimen from the subject. If it is desired to detect bladder cancer or stages of bladder cancer progression, the nucleic acid may be isolated from bladder tissue by scraping or taking a biopsy. These specimens may be obtained by various medical procedures known to those of skill in the art.


In one aspect of the invention, the state of methylation in nucleic acids of the sample obtained from a subject is hypermethylation compared with the same regions of the nucleic acid in a subject not having the cellular proliferative disorder of bladder tissue. Hypermethylation, as used herein, is the presence of methylated alleles in one or more nucleic acids. Nucleic acids from a subject not having a cellular proliferative disorder of bladder tissues contain no detectable methylated alleles when the same nucleic acids are examined.


Sample

The present invention describes early diagnosis of bladder cancer and utilizes the methylation of bladder cancer-specific genes. The methylation of bladder cancer-specific genes also occurred in tissue near tumor sites. Therefore, in the method for early diagnosis of bladder cancer, the methylation of bladder cancer-specific genes can be detected by examining all samples including liquid or solid tissue. The samples include, but are not limited to, tissue, cell, urine, serum or plasma.


Individual Genes and Panel

It is understood that the present invention may be practiced using each gene separately as a diagnostic or prognostic marker, or a few marker genes combined into a panel display format so that several marker genes may be detected to increase reliability and efficiency. Further, any of the genes identified in the present application may be used individually or as a set of genes in any combination with any of the other genes that are recited in the application. Also, genes may be ranked and weighted according to their importance together with the number of genes that are methylated, and a level of likelihood of development to cancer can be assigned. Such algorithms are within the scope of the present invention.


Methylation Detection Methods
Methylation Specific PCR

When genomic DNA is treated with bisulfite, the methylated cytosine in the 5′-CpG′-3 region remains without changes, and unmethylated cytosine is changed to uracil. Thus, for a base sequence modified by bisulfite treatment, PCR primers corresponding to regions in which a 5′-CpG-3′ base sequence is present were constructed. Herein, two kinds of primers corresponding to the methylated case and the unmethylated case were constructed. When genomic DNA is modified with bisulfite and then subjected to PCR using the two kinds of primers, in the case in which the DNA is methylated, a PCR product is made from the DNA in which the primers corresponding to the methylated base sequence are used. In contrast, in the case in which the gene is unmethylated, a PCR product is made from the DNA in which the primers corresponding to the unmethylated base sequence are used. The methylation of DNA can be qualitatively analyzed using agarose gel electrophoresis.


Real-Time Methylation-Specific PCR

Real-time methylation-specific PCR is a real-time measurement method modified from methylation-specific PCR, and comprises treating genomic DNA with bisulfite, designing PCR primers corresponding to the methylated case and performing real-time PCR using the primers. Herein, methods of detecting methylation include two methods: a method of performing detection using a TanMan probe complementary to the amplified base sequence, and a method of performing detection using Sybergreen. Thus, real-time methylation-specific PCR selectively quantitatively analyze only DNA. Herein, a standard curve was prepared using an in vitro methylated DNA sample, and for standardization, a gene having no 5′-CpG-3′ sequence in the base sequence was also amplified as a negative control group and was quantitatively analyzed for the methylation degree.


Pyrosequencing

Pyrosequencing is a real-time sequencing method modified from a bisulfite sequencing method. In the same manner as bisulfite sequencing, genomic DNA was modified by bisulfite treatment, and then primers corresponding to a region having no 5′-CpG-3′ base sequence were constructed. After the genomic DNA had been treated with bisulfite, it was amplified with the PCR primers, and then subjected to real-time sequence analysis using sequencing primers. The amounts of cytosine and thymine in the 5′-CpG-3′ region were quantitatively analyzed, and the methylation degree was expressed as a methylation index.


PCR or Quantitative PCR Using Methylated DNA-Specific Binding Protein and DNA Chip

In a PCR or DNA chip method using a methylated DNA-specific binding protein, when a protein binding specifically only to methylated DNA is mixed with DNA, the protein binds specifically only to methylated DNA, and thus only methylated DNA can be isolated. In the present invention, genomic DNA was mixed with a methylated DNA-specific binding protein, and then only methylated DNA was selectively isolated. The isolated DNA was amplified using PCR primers corresponding to the promoter region thereof, and then the methylation of the DNA was measured by agarose gel electrophoresis.


In addition, the methylation of DNA can also be measured by a quantitative PCR method. Specifically, methylated DNA isolated using a methylated DNA-specific binding protein can be labeled with a fluorescent dye and hybridized to a DNA chip in which complementary probes are integrated, thus measuring the methylation of the DNA. Herein, the methylated DNA-specific binding protein is not limited to McrBt.


Detection of Differential Methylation-Methylation Sensitive Restriction Endonuclease

Detection of differential methylation can be accomplished by contacting a nucleic acid sample with a methylation sensitive restriction endonuclease that cleaves only unmethylated CpG sites under conditions and for a time to allow cleavage of unmethylated nucleic acid.


In a separate reaction, the sample is further contacted with an isoschizomer of the methylation sensitive restriction endonuclease that cleaves both methylated and unmethylated CpG-sites under conditions and for a time to allow cleavage of methylated nucleic acid.


Specific primers are added to the nucleic acid sample under conditions and for a time to allow nucleic acid amplification to occur by conventional methods. The presence of amplified product in the sample digested with methylation sensitive restriction endonuclease but absence of an amplified product in sample digested with an isoschizomer of the methylation sensitive restriction enzyme endonuclease that cleaves both methylated and unmethylated CpG-sites indicates that methylation has occurred at the nucleic acid region being assayed. However, lack of amplified product in the sample digested with methylation sensitive restriction endonuclease together with lack of an amplified product in the sample digested with an isoschizomer of the methylation sensitive restriction enzyme endonuclease that cleaves both methylated and unmethylated CpG-sites indicates that methylation has not occurred at the nucleic acid region being assayed.


As used herein, a “methylation sensitive restriction endonuclease” is a restriction endonuclease that includes CG as part of its recognition site and has altered activity when the C is methylated as compared to when the C is not methylated (e.g., Sma I). Non-limiting examples of methylation sensitive restriction endonucleases include MspI, HpaII, BssHII, BstUI and NotI. Such enzymes can be used alone or in combination. Other methylation sensitive restriction endonucleases such as SacII and EagI may be applied to the present invention, but are not limited to these enzymes.


An “isoschizomer” of a methylation sensitive restriction endonuclease is a restriction endonuclease that recognizes the same recognition site as a methylation sensitive restriction endonuclease but cleaves both methylated CGs and unmethylated CGs, such as for example, MspI.


Primers of the invention are designed to be “substantially” complementary to each strand of the locus to be amplified and include the appropriate G or C nucleotides as discussed above. This means that the primers must be sufficiently complementary to hybridize with their respective strands under conditions that allow the agent for polymerization to perform. Primers of the invention are employed in the amplification process, which is an enzymatic chain reaction that produces exponentially increasing quantities of target locus relative to the number of reaction steps involved (e.g., polymerase chain reaction (PCR)). Typically, one primer is complementary to the negative (−) strand of the locus (antisense primer) and the other is complementary to the positive (+) strand (sense primer). Annealing the primers to denatured nucleic acid followed by extension with an enzyme, such as the large fragment of DNA Polymerase I (Klenow) and nucleotides, results in newly synthesized + and − strands containing the target locus sequence. Because these newly synthesized sequences are also templates, repeated cycles of denaturing, primer annealing, and extension results in exponential production of the region (i.e., the target locus sequence) defined by the primer. The product of the chain reaction is a discrete nucleic acid duplex with termini corresponding to the ends of the specific primers employed.


Preferably, the method of amplifying is by PCR, as described herein and as is commonly used by those of ordinary skill in the art. However, alternative methods of amplification have been described and can also be employed such as real time PCR or linear amplification using isothermal enzyme. Multiplex amplification reactions may also be used.


Detection of Differential Methylation-Bifulfite Sequencing Method

Another method for detecting a methylated CpG-containing nucleic acid includes contacting a nucleic acid-containing specimen with an agent that modifies unmethylated cytosine, amplifying the CpG-containing nucleic acid in the specimen by means of CpG-specific oligonucleotide primers, wherein the oligonucleotide primers distinguish between modified methylated and non-methylated nucleic acid and detecting the methylated nucleic acid. The amplification step is optional and although desirable, is not essential. The method relies on the PCR reaction itself to distinguish between modified (e.g., chemically modified) methylated and unmethylated DNA. Such methods are described in U.S. Pat. No. 5,786,146, the contents of which are incorporated herein in their entirety especially as they relate to the bisulfite sequencing method for detection of methylated nucleic acid.


Substrates

Once the target nucleic acid region is amplified, the nucleic acid can be hybridized to a known gene probe immobilized on a solid support to detect the presence of the nucleic acid sequence.


As used herein, “substrate,” when used in reference to a substance, structure, surface or material, means a composition comprising a nonbiological, synthetic, nonliving, planar, spherical or flat surface that is not heretofore known to comprise a specific binding, hybridization or catalytic recognition site or a plurality of different recognition sites or a number of different recognition sites which exceeds the number of different molecular species comprising the surface, structure or material. The substrate may include, for example and without limitation, semiconductors, synthetic (organic) metals, synthetic semiconductors, insulators and dopants; metals, alloys, elements, compounds and minerals; synthetic, cleaved, etched, lithographed, printed, machined and microfabricated slides, devices, structures and surfaces; industrial polymers, plastics, membranes; silicon, silicates, glass, metals and ceramics; wood, paper, cardboard, cotton, wool, cloth, woven and nonwoven fibers, materials and fabrics.


Several types of membranes are known to one of skill in the art for adhesion of nucleic acid sequences. Specific non-limiting examples of these membranes include nitrocellulose or other membranes used for detection of gene expression such as polyvinylchloride, diazotized paper and other commercially available membranes such as GENESCREEN™, ZETAPROBE™ (Biorad), and NYTRAN™. Beads, glass, wafer and metal substrates are included. Methods for attaching nucleic acids to these objects are well known to one of skill in the art. Alternatively, screening can be done in liquid phase.


Hybridization Conditions

In nucleic acid hybridization reactions, the conditions used to achieve a particular level of stringency will vary, depending on the nature of the nucleic acids being hybridized. For example, the length, degree of homology, nucleotide sequence composition (e.g., GC/AT content), and nucleic acid type (e.g., RNA, DNA) of the hybridizing regions of the nucleic acids can be considered in selecting hybridization conditions. An additional consideration is whether one of the nucleic acids is immobilized, for example, on a filter.


An example of progressively higher stringency conditions is as follows: 2×SSC/0.1% SDS at about room temperature (hybridization conditions); 0.2×SSC/0.1% SDS at about room temperature (low stringency conditions); 0.2×SSC/0.1% SDS at about 42° C. (moderate stringency conditions); and 0.1×SSC at about 68° C. (high stringency conditions). Washing can be carried out using only one of these conditions, e.g., high stringency conditions, or each of the conditions can be used, e.g., for 10-15 minutes each, in the order listed above, repeating any or all of the steps listed. However, as mentioned above, optimal conditions will vary, depending on the particular hybridization reaction involved, and can be determined empirically. In general, conditions of high stringency are used for the hybridization of the probe of interest.


Label

The probe of interest can be detectably labeled, for example, with a radioisotope, a fluorescent compound, a bioluminescent compound, a chemiluminescent compound, a metal chelator, or an enzyme. Those of ordinary skill in the art will know of other suitable labels for binding to the probe, or will be able to ascertain such, using routine experimentation.


Kit

In accordance with the present invention, there is provided a kit useful for the detection of a cellular proliferative disorder in a subject. Kits according to the present invention include a carrier means compartmentalized to receive a sample therein, one or more containers comprising a first container containing a reagent which sensitively cleaves unmethylated cytosine, a second container containing primers for amplification of a CpG-containing nucleic acid, and a third container containing a means to detect the presence of cleaved or uncleaved nucleic acid. Primers contemplated for use in accordance with the invention include those set forth in SEQ ID NOS: 1-20, and any functional combination and fragments thereof.


In an embodiment of the present disclosure, primer(s) that could amplify a methylated CpG of PENK might be used, and such primer(s) comprises at least one or more CpG dinucleotide in a region which hybridizes to the methylated CpG of PENK Specifically, the primer(s) for amplifying a methylated CpG of PENK comprise sequence(s) having a homology of 50% or more with sequence(s) selected from the group consisting of SEQ ID NOs: 43-44, 46-84, 86-148, 150-215, 217-285, 287-351, 353-422, 424-456. Preferably, the primer(s) for amplifying a methylated CpG of PENK comprise sequence(s) having a homology of at least 60%, 70%, 80%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99% and 100% with sequence(s) selected from the group consisting of SEQ ID NOs: 43-44, 46-84, 86-148, 150-215, 217-285, 287-351, 353-422, 424-456.


If required, probe(s) capable of hybridizing with a methylated CpG of PENK might be used. The probe(s) capable of hybridizing with a methylated CpG of PENK comprise at least one or more CpG dinucleotide in a region which hybridizes to the methylated CpG of PENK. Specifically, probe(s) might comprise sequence(s) having a homology of 50% or more with sequence(s) selected from the group consisting of SEQ ID NOs: 45, 85, 149, 216, 286, 352, 423 and 457. Preferably, the probe(s) capable of hybridizing with a methylated CpG of PENK comprise sequence(s) having a homology of at least 60%, 70%, 80%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99% and 100% with sequence(s) selected from the group consisting of SEQ ID NOs: 45, 85, 149, 216, 286, 352, 423 and 457.


Functional combination or fragment refers to its ability to be used as a primer to detect whether methylation has occurred on the region of the genome sought to be detected.


Carrier means are suited for containing one or more container means such as vials, tubes, and the like, each of the container means comprising one of the separate elements to be used in the method. In view of the description provided herein of invention methods, those of skill in the art can readily determine the apportionment of the necessary reagents among the container means. For example, one of the container means can comprise a container containing methylation sensitive restriction endonuclease. One or more container means can also be included comprising a primer complementary to the nucleic acid locus of interest. In addition, one or more container means can also be included containing an isoschizomer of the methylation sensitive restriction enzyme.


EXAMPLES

Hereinafter, the present invention will be described in further detail with reference to examples. It is to be understood, however, that these examples are for illustrative purposes only and are not to be construed to limit the scope of the present invention.


Example 1: Discovery of Bladder Cancer-Specific Methylated Genes

In order to screen biomarkers which are methylated specifically in bladder cancer, about 20 ml of the urine of each of 10 bladder cancer patients and 10 normal persons was centrifuged in a centrifuge (Hanil Science Industrial Co., Ltd., Korea) at 4,200×g for 10 minutes to isolate urinary cells. The supernatant was discarded, and the cell precipitate was washed twice with 5 ml of PBS. Genomic DNA was isolated from the cell precipitate using the QIAamp DNA Mini kit (QIAGEN, USA). 500 ng of the isolated genomic DNA was sonicated (Vibra Cell, SONICS), thus constructing about 200-300-bp-genomic DNA fragments.


To obtain only methylated DNA from the genomic DNA, a methyl binding domain (MBD) known to bind to methylated DNA (Fraga et al., Nucleic Acid Res., 31:1765-1774, 2003) was used. Specifically, 2 μg of 6×His-tagged MBD was pre-incubated with 500 ng of the genomic DNA of E. coli JM110 (No. 2638, Biological Resource Center, Korea Research Institute of Bioscience & Biotechnology), and then bound to Ni-NTA magnetic beads (Qiagen, USA). 500 ng of the sonicated genomic DNA isolated from the urinary cells of the normal persons and the bladder cancer patients was allowed to react with the beads in the presence of binding buffer solution (10 mM Tris-HCl (pH 7.5), 50 mM NaCl, 1 mM EDTA, 1 mM DTT, 3 mM MgCl2, 0.1% Triton-X100, 5% glycerol, 25 mg/ml BSA) at 4° C. for 20 minutes. Then, the beads were washed three times with 500 μl of a binding buffer solution containing 700 mM NaCl, and then methylated DNA bound to the MBD was isolated using the QiaQuick PCR purification kit (QIAGEN, USA).


Then, the methylated DNAs bound to the MBD were amplified using a genomic DNA amplification kit (Sigma, USA, Cat. No. WGA2), and 4 μg of the amplified DNAs were labeled with Cy3 for the normal person-originated DNA and with Cy5 for the bladder cancer patient-originated DNA using the BioPrime Total Genomic Labeling system I (Invitrogen Corp., USA). The DNA of the normal persons and the DNA of the bladder patients were mixed with each other, and then hybridized to 244K human CpG microarrays (Agilent, USA) (FIG. 1). After the hybridization, the DNA mixture was subjected to a series of washing processes, and then scanned using an Agilent scanner. The calculation of signal values from the microarray images was performed by calculating the relative difference in signal strength between the normal person sample and the bladder cancer patient sample using Feature Extraction program v. 9.5.3.1 (Agilent).


In order to select unmethylated spots from the normal sample, the whole Cy3 signal values were averaged, and then spots having a signal value of less than 10% of the averaged value were regarded as those unmethylated in the samples of the normal persons. As a result, 41,674 spots having a Cy3 signal value of less than 65 were selected.


In order to select the methylated spots in the samples of the bladder cancer patients from among the 41,674 spots, spots having a Cy5 signal value of more than 130 were regarded as the methylated spots in bladder cancer. As a result, 631 spots having a Cy5 signal value of more than 130 were selected. From these spots, 227 genes corresponding to the promoter region were secured as bladder cancer-specific methylated genes.


From the genes, 10 genes (CDX2, CYP1B1, VSX16, HOXA11, T, TBX5, PENK, PAQR9, LHX2, and SIM2) showing the greatest relative difference between methylation degree of the normal persons and that of the bladder cancer patients were selected, and the presence of CpG islands in the promoter region of the 10 genes was confirmed using MethPrimer. The 10 genes were secured as methylation biomarkers for diagnosis of bladder cancer. The list of the 10 genes and the relative methylation degree thereof in the urinary cells of the bladder patients relative to those of the normal persons are shown in Table 1 below.









TABLE 1







10 methylation biomarkers for diagnosis of bladder cancer










Biomarker for


Relative


bladder cancer
GenBank No.
Description
methylationa













CDX2
NM_001265
caudal type homeobox transcription factor 2
11.0


CYP1B1
NM_000104
cytochrome P450, family 1, subfamily B, polypeptide 1
14.6


VSX1
NM_199425
visual system homeobox 1 homolog, CHX10-like
33.4




(zebrafish)


HOXA11
NM_005523
homeobox A11
14.2


T
NM_003181
T, brachyury homolog (mouse)
51.4


TBX5
NM_080717
T-box 5
18.7


PENK
NM_006211
Proenkephalin
12.7


PAQR9
NM_198504
progestin and adipoQ receptor family member IX
4.1


LHX2
NM_004789
LIM Homeobox 2
5.8


SIM2
U80456
Single-minded homolog 2 (Drosophila)
9.5






aRelative methylation degree between the normal sample and the bladder patient sample, calculated by dividing the average signal (Cy5) value in the bladder cancer patient sample in CpG microarrays by the average signal (Cy5) value in the normal person sample.







Example 2: Measurement of Methylation of Biomarker Genes in Cancer Cell Lines

In order to further determine the methylation status of the 10 genes, bisulfite sequencing for each promoter was performed.


In order to modify unmethylated cytosine to uracil using bisulfite, total genomic DNA was isolated from the bladder cancer cell lines RT-4 (Korean Cell Line Bank (KCLB 30002), J82 (KCLB 30001), HT1197 (KCLB 21473) and HT1376 (KCLB 21472), and 200 ng of the genomic DNA was treated with bisulfite using the EZ DNA methylation-gold kit (Zymo Research, USA). When DNA is treated with bisulfite, unmethylated cytosine is modified to uracil, and the methylated cytosine remains without changes. The DNA treated with bisulfite was eluted in 20 μl of sterile distilled water and subjected to pyrosequencing.


PCR and sequencing primers for performing pyrosequencing for the 10 genes were designed using the PSQ assay design program (Biotage, USA). The PCR and sequencing primers for measuring the methylation of each gene are shown in Tables 2 and 3 below.









TABLE 2







Primers and conditions


















SEQ ID
CpG
Amplicon


Gene
Primer
Sequence (5′→3′)
NO:
positiona
size





CDX2
forward
TGGTGTTTGTGTTATTATTAATAG
 1
-138, -129,
129 bp



reverse
Biotin-CACCTCCTTCCCACTAAACTA
 2
-121, -118






CYP1B1
forward
GTAAGGGTATGGGAATTGA
 3
+73, +83
 90 bp



reverse
Biotin-CCCTTAAAAACCTAACAAAATC
 4
+105






VSX1
forward
GGAGTGGGATTGAGGAGATTT
 5
-1121, -1114,
 89 bp



reverse
Biotin-AAACCCAACCAACCCTCAT
 6
-1104, 1100






HOXA11
forward
AGTAAGTTTATGGGAGGGGGATT
 7
-415, -405,
243 bp



reverse
Biotin-
 8
-388





CCCCCATACAACATACTTATACTCA








T
forward
GGAGGAATGTTATTGTTTAAAGAGAT
 9
-95, -89,
326 bp



reverse
Biotin-CAACCCCTTCTAAAAAATATCC
10
-76, -71, -69






TBX5
forward
GGGTTTGGAGTTAGGTTATG
11
-645, -643,
 95 bp



reverse
Biotin-AAATCTAAACTTACCCCCAACT
12
-628, -621






PENK
forward
ATATTTTATTGTATGGGTTTTTTAATAG
13
-150, -148,
322 bp



reverse
Biotin-ACAACCTCAACAAAAAATC
14
-139, -135,
 54 bp






-133,






PAQR9
forward
Biotin-AGATAGGGGATAATTTTAT
15
-480, -475,
 54 bp



reverse
CCTCCCAAACTAAAATTT
16
-471, -469






LHX2
forward
GTAGAAGGGAAATAAGGTTGAAA
17
+5093,
233 bp



reverse
Biotin-ACTAAAACCCCAATACTCCCA
18
+5102,







+5113,







+5125, +5127






SIM2
forward
Biotin-GTGGATTTAGATTAGGATTTTGT
19
-6776, -6774,
205 bp



reverse
CACCCTCCCCAAATTCTT
20
-6747, -6744,







-6743






adistances (nucleotides) from the transcription initiation site (+1): the positions of CpG regions on the genomic DNA used in the measurement of methylation














TABLE 3







Sequences of sequencing primers for methylation


marker genes











SEQ ID


Gene
Sequence (5′→3′)
NO:





CDX2
ATT AAT AGA GTT TTG TAA ATA T
21





CYP1B1
AAG GGT ATG GGA ATT G
22





VSX1
TTT GGG ATT GGG AAG
23





HOXA11
TAG TTT AGG GTA TTT TTT ATT TAT
24





T
GTG AAA GTA ATG ATA TAG TAG AAA
25





TBX5
TTT GGG GGT TGG GGA
26





PENK
GGG TGT TTTAGG TAG TT
27





PAQR9
CCT CCC AAA CTA AAA TTT C
28





LHX2
TGG GGG TAG AGG AGA
29





SIM2
CCT CCC CAA ATT CTT C
30









20 ng of the genomic DNA modified with bisulfite was amplified by PCR. In the PCR amplification, a PCR reaction solution (20 ng of the genomic DNA modified with bisulfite, 5 μl of 10×PCR buffer (Enzynomics, Korea), 5 units of Taq polymerase (Enzynomics, Korea), 4 μl of 2.5 mM dNTP (Solgent, Korea), and 2 μl (10 pmole/μl) of PCR primers) was used, and the PCR reaction was performed in the following conditions: predenaturation at 95° C. for 5 min, and then 45 cycles of denaturation at 95° C. for 40 sec, annealing at 60° C. for 45 sec and extension at 72° C. for 40 sec, followed by final extension at 72° C. for 5 min. The amplification of the PCR product was confirmed by electrophoresis on 2.0% agarose gel.


The amplified PCR product was treated with PyroGold reagents (Biotage, USA), and then subjected to pyrosequencing using the PSQ96MA system (Biotage, USA). After the pyrosequencing, the methylation degree of the DNA was measured by calculating the methylation index. The methylation index was calculated by determining the average rate of cytosine binding to each CpG island.



FIG. 2 quantitatively shows the methylation degree of the 10 biomarkers in the bladder cancer cell lines, measured using the pyrosequencing method. As a result, it was shown that the 10 biomarkers were all methylated at high levels in at least one of the cell lines. Table 4 below shows the promoter sequences of the 10 genes.









TABLE 4







Promoter sequences of methylation marker genes










Gene
SEQ ID NO:







CDX2
31



CYP1B1
32



VSX1
33



HOXA11
34



T
35



TBX5
36



PENK
37



PAQR9
38



LHX2
39



SIM2
40










Example 3: Measurement of Methylation of Biomarker Genes in Urinary Cells of Bladder Cancer Patients

In order to verify whether the 10 genes can be used as biomarkers for diagnosis of bladder cancer, about 20 ml of the urine of each of 20 normal persons and 19 bladder cancer patients was centrifuged in a centrifuge (Hanil Science Industrial Co., Ltd., Korea) at 4,200×g for 10 minutes to isolate cells. The supernatant was discarded, and the cell precipitate was washed twice with 5 ml of PBS. Genomic DNA was isolated from the washed cells using the QIAamp DNA Mini kit (QIAGEN, USA), and 200 ng of the isolated genomic DNA was treated with bisulfite using the EZ DNA methylation-Gold kit (Zymo Research, USA). Then, the DNA was eluted in 20 μl of sterile distilled water and subjected to pyrosequencing.


20 ng of the genomic DNA converted with bisulfite was amplified by PCR. In the PCR amplification, a PCR reaction solution (20 ng of the genomic DNA modified with bisulfite, 5 μl of 10×PCR buffer (Enzynomics, Korea), 5 units of Taq polymerase (Enzynomics, Korea), 4 μl of 2.5 mM dNTP (Solgent, Korea), and 2 μL (10 pmole/μl) of PCR primers) was used, and the PCR reaction was performed in the following conditions: predenaturation at 95° C. for 5 min, and then 45 cycles of denaturation at 95° C. for 40 sec, annealing at 60° C. for 45 sec and extension at 72° C. for 40 sec, followed by final extension at 72° C. for 5 min. The amplification of the PCR product was confirmed by electrophoresis on 2.0% agarose gel.


The amplified PCR product was treated with PyroGold reagents (Biotage, USA), and then subjected to pyrosequencing using the PSQ96MA system (Biotage, USA). After the pyrosequencing, the methylation degree of the DNA was measured by calculating the methylation index thereof. The methylation index was calculated by determining the average rate of cytosine binding to each CpG region. After the methylation index of DNA in the urinary cells of the normal persons and the bladder cancer patients has been measured, a methylation index cut-off value for diagnosis of bladder cancer patients was determined through receiver operating characteristic (ROC) curve analysis.



FIGS. 3A-3D show measurement results for the methylation of the 10 biomarker genes in urinary cells.


As can be seen, the methylation degree of the genes was higher in the sample of the bladder cancer patients than in the sample of the normal persons. Meanwhile, the methylation index in the cystitis patients and the hematuria patients was similar to that in the normal control group or was rarely higher than that in the normal control group. FIGS. 4A-4E show ROC analysis results for determining cut-off values for diagnosis of bladder cancer. Also, methylation index cut-off values for the 10 biomarkers, calculated based on the ROC curve analysis results, are shown in Table 5 below.









TABLE 5







Cut-off values for bladder cancer diagnosis of 10 biomarkers










Gene
cut-off (%)a














CDX2
5.82<



CYP1B1
8.38<



VSX1
29.3<



HOXA11
8.81<



T
11.3<



TBX5
6.93<



PENK
11.57<



PAQR9
5.0<



LHX2
13.7<



SIM2
8.2<










In the analysis of the methylation of the 10 biomarkers, the methylation index of each biomarker in the clinical sample was calculated. The case in which the calculated methylation index for diagnosis of bladder cancer was higher than the cut-off value obtained through receiver operating characteristic (ROC) analysis was judged to be methylation-positive, and the case in which the calculated methylation index was lower than the cut-off value was judged to be methylation-negative.


As shown in Table 6 below and FIG. 5, when judged on the basis of the cut-off value obtained by ROC curve analysis, the urinary cells of the normal persons were methylation-negative for all the 10 biomarkers, but 12.5-62.5% of the samples of the bladder cancer patients were methylation-positive for the 10 biomarkers. Also, statistical analysis was performed and, as a result, it could be seen that 9 of the samples of the bladder cancer samples were methylation-positive for 9 of the 10 biomarkers at a significant level (p<0.01) compared to the normal person group. This suggests that 9 of the 10 methylation markers are statistically significantly methylated specifically in bladder cancer and are highly useful for diagnosing bladder cancer.









TABLE 6







Frequency of methylation-positive samples for 10 biomarkers










No. of methylation-positive samples/No. of total




samples (%)a










Gene
Normal
bladder cancer patient
P valueb













CDX2
0/31 (0)
 9/32 (28.1)
0.002


CYP1B1
0/31 (0)
16/32 (50.0)
<0.001


VSX1
0/31 (0)
14/32 (45.2)
<0.001


HOXA11
0/31 (0)
17/32 (53.1)
<0.001


T
0/31 (0)
15/32 (46.9)
<0.001


TBX5
0/31 (0)
20/32 (62.5)
<0.001


PENK
0/31 (0)
19/32 (59.4)
<0.001


PAQR9
0/31 (0)
 4/32 (12.5)
0.113


LHX2
0/17 (0)
13/24 (54.2)
<0.001


SIM2
0/17 (0)
 15/24 (62.5)0
<0.001






afrequency of methylation-positive samples; and




bp values obtained through the Chi-Square test







Example 4: Evaluation of the Ability of 6 Biomarker Panel Genes to Diagnose Bladder Cancer

Using the 10 methylation biomarkers, logistic regression analysis was performed. As a result, an optimal panel of 6 genes for diagnosing bladder cancer was established. FIG. 6A shows the methylation status of the 6 biomarkers (CYP1B1, HOXA11, SIM2, PENK, LHX2 and TBX5). Whether samples were methylation-positive or methylation-negative for the 6 genes was judged according to the method described in Example 3. As a result, it could be seen that all the normal samples were methylation-negative for the 6 genes, and only the bladder cancer samples were methylation-positive for the 6 genes. Particularly, early bladder cancer samples were also methylation-positive for the 6 genes at a high frequency, suggesting that the 6 genes are highly useful for early diagnosis of bladder cancer. When the methylation of at least one gene of the gene panel consisting of the six genes was diagnosed as bladder cancer, the sensitivity and specificity of the gene panel for early bladder cancer were as extremely high as 84.0% and 100%, respectively (FIG. 6D). Also, the sensitivity and specificity of the gene panel for advanced bladder cancer were measured to be 85.7% and 100%, respectively (FIG. 6C). In addition, the sensitivity and specificity of the gene panel for all early and advanced bladder cancers were measured to be 84.4% and 100%, respectively (FIG. 6B). This suggests that the methylation of the 6 genes is highly useful for early diagnosis of bladder cancer.


Example 5: Measurement of Methylation of Biomarker Genes Using Methylated DNA-Specific Binding Protein

In order to measure the methylation of biomarkers which are methylated specifically in bladder cancer, 100 ng of the genomic DNA of each of the bladder cancer cell lines RT24 and HT1197 was sonicated (Vibra Cell, SONICS), thus obtaining about 200-400-bp genomic DNA fragments.


To obtain only methylated DNA from the genomic DNA, MBD known to bind to methylated DNA was used. Specifically, 2 μg of 6×His-tagged MBD was pre-incubated with 500 ng of the genomic DNA of E. coli JM110 (No. 2638, Biological Resource Center, Korea Research Institute of Bioscience & Biotechnology), and then bound to Ni-NTA magnetic beads (Qiagen, USA). 100 ng of the sonicated genomic DNA was allowed to react with the beads in the presence of binding buffer solution (10 mM Tris-HCl (pH 7.5), 50 mM NaCl, 1 mM EDTA, 1 mM DTT, 3 mM MgCl2, 0.1% Triton-X100, 5% glycerol, 25 mg/ml BSA) at 4° C. for 20 minutes. Then, the beads were washed three times with 500 μl of a binding buffer solution containing 700 mM NaCl, and then methylated DNA bound to the MBD was isolated using the QiaQuick PCR purification kit (QIAGEN, USA).


Then, the DNA methylated DNA bound to the MBD was amplified by PCR using primers of SEQ ID NOS: 41 and 42 corresponding to the promoter region (from −6842 to −6775 bp) of the SIM2 gene.









SEQ ID NO: 41: 


5′-TTC TTA TTC TCA CCA GAC ATC TCA ACA CCC-3′





SEQ ID NO: 42: 


5′-ATC TCC CAT CCT CCC TCC CAC TCT C-3′






The PCR reaction was performed in the following condition: predenaturation at 94° C. for 5 min, and then 40 cycles of denaturation at 94° C. for 30 sec, annealing at 62° C. for 30 sec and extension at 72° C. for 30 sec, followed by final extension at 72° C. for 5 min. The amplification of the PCR product was confirmed by electrophoresis on 2% agarose gel.


As a result, it was seen that, for the SIM2 gene, a 168-bp amplified product was detected only in the genomic DNA of the RT24 cell line, suggesting that the gene was methylated, whereas no amplified product was detected in the HT1197 cell line, suggesting that the gene was not methylated in the HT1197 cell line (FIG. 7). Such results were consistent with the methylation measurement results obtained by the pyrosequencing method. Also, such results indicate that the use of MBD enables detection of methylated DNA.


Example 6: Evaluation of the Ability of PENK Gene to Diagnose Bladder Cancer by Using qMSP

In order to analyze the ability of PENK gene to diagnose bladder cancer, 40 sets of primers and probes, which could amplify whole CpG island of PENK gene and detect specific methylation sites were designed (Table 7), and methylation specific real time PCR (qMSP) was performed.


First of all, genome DNA of urine cells were isolated from 10 mL urines, which were obtained from normal control 20 people and 20 bladder cancer patients respectively. Treating bisulfite to the isolated genome DNA by using EZ DNA methylation-Gold kit (Zymo Research, USA) was followed by eluting with 10 μl distilled water, and then was subjected to methylation specific real time PCR (qMSP). qMSP was performed by using bisulfite treated genome DNA as a template and methylation specific primers and probes designed according to Table 7. qMSP was performed by using Rotor-Gene Q PCR equipment (Qiagen). Total 20 μl PCR reaction solution (template DNA, 2 μl; 5×AptaTaq DNA Master (Roche Diagnostics), 4 μl; PCR primers, 2 μl (2 pmole/μ), TaqMan probe, 2 μl (2 pmole/μ); D.W. 10 μl) was prepared. Total 40 times of PCR was performed with a PCR condition that treatment at 95° C. for 5 minutes is followed by treatment at 95° C. for 15 seconds under the proper annealing temperature (58° C.˜61° C.) for 1 minute. The amplification of the PCR product was confirmed by measuring the Ct (cycling threshold) value.


Methylated and non-methylated control DNA were tested with sample DNA by using EpiTect PCR control DNA set (Qiagen, cat. no. 59695). COL2A1 gene was used as an internal control (Kristensen et al., 2008). The level of methylation in respective sample was measured by Ct (cycling threshold) value, and the sensitivity and sensitivity of set of respective primers and probes were calculated with ROC curve analysis (MedCalc Program, Belgium) (Table 8).









TABLE 7







Sequences of primer and probes for PENK gene qMSP














Size of






amplification
SEQ ID


Set
Primer
Sequences (5′→3′)
product (bp)
NOs:














1
F585
TAACGTGAGTGAAT
43
44



R11
AAAACCAAAAAACG
117




Probe 11
CGTTTGTTCGTTTTTTTTTTTTTTA
45






2
F586
AACGTGAGTGAATT
46
44



R11
AAAACCAAAAAACG
116




Probe 11
CGTTTGTTCGTTTTTTTTTTTTTTA
45






3
F587
ACGTGAGTGAATTT
47
44



R11
AAAACCAAAAAACG
115




Probe 11
CGTTTGTTCGTTTTTTTTTTTTTTA
45






4
F588
CGTGAGTGAATTTG
48
44



R11
AAAACCAAAAAACG
114




Probe 11
CGTTTGTTCGTTTTTTTTTTTTTTA
45






5
F589
GTGAGTGAATTTGT
49
44



R11
AAAACCAAAAAACG
113




Probe 11
CGTTTGTTCGTTTTTTTTTTTTTTA
45






6
F590
TGAGTGAATTTGTT
50
44



R11
AAAACCAAAAAACG
112




Probe 11
CGTTTGTTCGTTTTTTTTTTTTTTA
45






7
F591
GAGTGAATTTGTTC
51
44



R11
AAAACCAAAAAACG
111




Probe 11
CGTTTGTTCGTTTTTTTTTTTTTTA
45






8
F592
AGTGAATTTGTTCG
52
44



R11
AAAACCAAAAAACG
110




Probe 11
CGTTTGTTCGTTTTTTTTTTTTTTA
45






9
F593
GTGAATTTGTTCGA
53
44



R11
AAAACCAAAAAACG
109




Probe 11
CGTTTGTTCGTTTTTTTTTTTTTTA
45






10
F594
TGAATTTGTTCGAA
54
44



R11
AAAACCAAAAAACG
108




Probe 11
CGTTTGTTCGTTTTTTTTTTTTTTA
45






11
F595
GAATTTGTTCGAAG
55
44



R11
AAAACCAAAAAACG
107




Probe 11
CGTTTGTTCGTTTTTTTTTTTTTTA
45






12
F596
AATTTGTTCGAAGT
56
44



R11
AAAACCAAAAAACG
106




Probe 11
CGTTTGTTCGTTTTTTTTTTTTTTA
45






13
F597
ATTTGTTCGAAGTT
57
44



R11
AAAACCAAAAAACG
105




Probe 11
CGTTTGTTCGTTTTTTTTTTTTTTA
45






14
F598
TTTGTTCGAAGTTT
58
44



R11
AAAACCAAAAAACG
104




Probe 11
CGTTTGTTCGTTTTTTTTTTTTTTA
45






15
F599
TTGTTCGAAGTTTG
59
44



R11
AAAACCAAAAAACG
103




Probe 11
CGTTTGTTCGTTTTTTTTTTTTTTA
45






16
F600
TGTTCGAAGTTTGT
60
44



R11
AAAACCAAAAAACG
102




Probe 11
CGTTTGTTCGTTTTTTTTTTTTTTA
45






17
F601
GTTCGAAGTTTGTT
61
44



R11
AAAACCAAAAAACG
101




Probe 11
CGTTTGTTCGTTTTTTTTTTTTTTA
45






18
F602
TTCGAAGTTTGTTT
62
44



R11
AAAACCAAAAAACG
100




Probe 11
CGTTTGTTCGTTTTTTTTTTTTTTA
45






19
F603
TCGAAGTTTGTTTT
63
44



R11
AAAACCAAAAAACG
99




Probe 11
CGTTTGTTCGTTTTTTTTTTTTTTA
45






20
F604
CGAAGTTTGTTTTT
64
44



R11
AAAACCAAAAAACG
98




Probe 11
CGTTTGTTCGTTTTTTTTTTTTTTA
45






21
F605
GAAGTTTGTTTTTG
65
44



R11
AAAACCAAAAAACG
97




Probe 11
CGTTTGTTCGTTTTTTTTTTTTTTA
45






22
F606
AAGTTTGTTTTTGT
66
44



R11
AAAACCAAAAAACG
96




Probe 11
CGTTTGTTCGTTTTTTTTTTTTTTA
45






23
F607
AGTTTGTTTTTGTT
95
67



R11
AAAACCAAAAAACG
44




Probe 11
CGTTTGTTCGTTTTTTTTTTTTTTA
45






24
F608
GTTTGTTTTTGTTG
68
44



R11
AAAACCAAAAAACG
94




Probe 11
CGTTTGTTCGTTTTTTTTTTTTTTA
45






25
F609
TTTGTTTTTGTTGA
69
44



R11
AAAACCAAAAAACG
93




Probe 11
CGTTTGTTCGTTTTTTTTTTTTTTA
45






26
F610
TTGTTTTTGTTGAG
70
44



R11
AAAACCAAAAAACG
92




Probe 11
CGTTTGTTCGTTTTTTTTTTTTTTA
45






27
F611
TGTTTTTGTTGAGC
71
44



R11
AAAACCAAAAAACG
91




Probe 11
CGTTTGTTCGTTTTTTTTTTTTTTA
45






28
F612
GTTTTTGTTGAGCG
72
44



R11
AAAACCAAAAAACG
90




Probe 11
CGTTTGTTCGTTTTTTTTTTTTTTA
45






29
F613
TTTTTGTTGAGCGG
73
44



R11
AAAACCAAAAAACG
89




Probe 11
CGTTTGTTCGTTTTTTTTTTTTTTA
45






30
F614
TTTTGTTGAGCGGG
74
44



R11
AAAACCAAAAAACG
88




Probe 11
CGTTTGTTCGTTTTTTTTTTTTTTA
45






31
F615
TTTGTTGAGCGGGT
87
75



R11
AAAACCAAAAAACG
44




Probe 11
CGTTTGTTCGTTTTTTTTTTTTTTA
45






32
F616
TTGTTGAGCGGGTT
76
44



R11
AAAACCAAAAAACG
86




Probe 11
CGTTTGTTCGTTTTTTTTTTTTTTA
45






33
F617
TGTTGAGCGGGTTT
77
44



R11
AAAACCAAAAAACG
85




Probe 11
CGTTTGTTCGTTTTTTTTTTTTTTA
45






34
F618
GTTGAGCGGGTTTG
78
44



R11
AAAACCAAAAAACG
84




Probe 11
CGTTTGTTCGTTTTTTTTTTTTTTA
45






35
F619
TTGAGCGGGTTTGG
79
44



R11
AAAACCAAAAAACG
83




Probe 11
CGTTTGTTCGTTTTTTTTTTTTTTA
45






36
F620
TGAGCGGGTTTGGG
80
44



R11
AAAACCAAAAAACG
82




Probe 11
CGTTTGTTCGTTTTTTTTTTTTTTA
45






37
F621
GAGCGGGTTTGGGG
81
44



R11
AAAACCAAAAAACG
81




Probe 11
CGTTTGTTCGTTTTTTTTTTTTTTA
45






38
F622
AGCGGGTTTGGGGA
82
44



R11
AAAACCAAAAAACG
80




Probe 11
CGTTTGTTCGTTTTTTTTTTTTTTA
45






39
F623
GCGGGTTTGGGGAC
83
84



R12
GCAAACCAAAAACG
141




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






40
F624
CGGGTTTGGGGACG
86
84



R12
GCAAACCAAAAACG
140




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






41
F625
GGGTTTGGGGACGT
87
84



R12
GCAAACCAAAAACG
139




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






42
F626
GGTTTGGGGACGTT
88
84



R12
GCAAACCAAAAACG
138




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






43
F627
GTTTGGGGACGTTT
89
84



R12
GCAAACCAAAAACG
137




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






44
F628
TTTGGGGACGTTTG
90
84



R12
GCAAACCAAAAACG
136




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






45
F629
TTGGGGACGTTTGT
91
84



R12
GCAAACCAAAAACG
135




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






46
F630
TGGGGACGTTTGTT
92
84



R12
GCAAACCAAAAACG
134




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






47
F631
GGGGACGTTTGTTC
93
84



R12
GCAAACCAAAAACG
133




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






48
F632
GGGACGTTTGTTCG
132
94



R12
GCAAACCAAAAACG
84




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






49
F633
GGACGTTTGTTCGT
95
84



R12
GCAAACCAAAAACG
131




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






50
F634
GACGTTTGTTCGTT
96
84



R12
GCAAACCAAAAACG
130




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






51
F635
ACGTTTGTTCGTTT
97
84



R12
GCAAACCAAAAACG
129




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






52
F636
CGTTTGTTCGTTTT
98
84



R12
GCAAACCAAAAACG
128




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






53
F637
GTTTGTTCGTTTTT
99
84



R12
GCAAACCAAAAACG
127




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






54
F638
TTTGTTCGTTTTTT
100
84



R12
GCAAACCAAAAACG
126




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






55
F639
TTGTTCGTTTTTTT
101
84



R12
GCAAACCAAAAACG
125




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






56
F640
TGTTCGTTTTTTTT
124
102



R12
GCAAACCAAAAACG
84




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






57
F641
GTTCGTTTTTTTTT
103
84



R12
GCAAACCAAAAACG
123




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






58
F642
TTCGTTTTTTTTTT
104
84



R12
GCAAACCAAAAACG
122




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






59
F643
TCGTTTTTTTTTTT
105
84



R12
GCAAACCAAAAACG
121




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






60
F644
CGTTTTTTTTTTTT
106
84



R12
GCAAACCAAAAACG
120




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






61
F645
GTTTTTTTTTTTTT
107
84



R12
GCAAACCAAAAACG
119




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






62
F646
TTTTTTTTTTTTTT
108
84



R12
GCAAACCAAAAACG
118




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






63
F647
TTTTTTTTTTTTTA
109
84



R12
GCAAACCAAAAACG
117




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






64
F648
TTTTTTTTTTTTAT
110
84



R12
GCAAACCAAAAACG
116




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






65
F649
TTTTTTTTTTTATA
111
84



R12
GCAAACCAAAAACG
115




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






66
F650
TTTTTTTTTTATAT
112
84



R12
GCAAACCAAAAACG
114




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






67
F651
TTTTTTTTTATATT
113
84



R12
GCAAACCAAAAACG
113




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






68
F652
TTTTTTTTATATTT
114
84



R12
GCAAACCAAAAACG
112




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






69
F653
TTTTTTTATATTTT
115
84



R12
GCAAACCAAAAACG
111




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






70
F654
TTTTTTATATTTTA
116
84



R12
GCAAACCAAAAACG
110




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






71
F655
TTTTTATATTTTAT
117
84



R12
GCAAACCAAAAACG
109




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






72
F656
TTTTATATTTTATT
118
84



R12
GCAAACCAAAAACG
108




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






73
F657
TTTATATTTTATTG
107
119



R12
GCAAACCAAAAACG
84




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






74
F658
TTATATTTTATTGT
120
84



R12
GCAAACCAAAAACG
106




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






75
F659
TATATTTTATTGTA
121
84



R12
GCAAACCAAAAACG
105




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






76
F660
ATATTTTATTGTAT
122
84



R12
GCAAACCAAAAACG
104




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






77
F661
TATTTTATTGTATG
123
84



R12
GCAAACCAAAAACG
103




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






78
F662
ATTTTATTGTATGG
124
84



R12
GCAAACCAAAAACG
102




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






79
F663
TTTTATTGTATGGG
125
84



R12
GCAAACCAAAAACG
101




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






80
F664
TTTATTGTATGGGT
126
84



R12
GCAAACCAAAAACG
100




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






81
F665
TTATTGTATGGGTT
99
127



R12
GCAAACCAAAAACG
84




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






82
F666
TATTGTATGGGTTT
128
84



R12
GCAAACCAAAAACG
98




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






83
F667
ATTGTATGGGTTTT
129
84



R12
GCAAACCAAAAACG
97




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






84
F668
TTGTATGGGTTTTT
130
84



R12
GCAAACCAAAAACG
96




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






85
F669
TGTATGGGTTTTTT
131
84



R12
GCAAACCAAAAACG
95




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






86
F670
GTATGGGTTTTTTA
132
84



R12
GCAAACCAAAAACG
94




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






87
F671
TATGGGTTTTTTAA
133
84



R12
GCAAACCAAAAACG
93




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






88
F672
ATGGGTTTTTTAAT
134
84



R12
GCAAACCAAAAACG
92




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






89
F673
TGGGTTTTTTAATA
135
84



R12
GCAAACCAAAAACG
91




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






90
F674
GGGTTTTTTAATAG
136
84



R12
GCAAACCAAAAACG
90




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






91
F675
GGTTTTTTAATAGC
137
84



R12
GCAAACCAAAAACG
89




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






92
F676
GTTTTTTAATAGCG
138
84



R12
GCAAACCAAAAACG
88




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






93
F677
TTTTTTAATAGCGT
139
84



R12
GCAAACCAAAAACG
87




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






94
F678
TTTTTAATAGCGTT
140
84



R12
GCAAACCAAAAACG
86




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






95
F679
TTTTAATAGCGTTT
141
84



R12
GCAAACCAAAAACG
85




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






96
F680
TTTAATAGCGTTTT
142
84



R12
GCAAACCAAAAACG
84




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






97
F681
TTAATAGCGTTTTT
143
84



R12
GCAAACCAAAAACG
83




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






98
F682
TAATAGCGTTTTTT
82
144



R12
GCAAACCAAAAACG
84




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






99
F683
AATAGCGTTTTTTG
145
84



R12
GCAAACCAAAAACG
81




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






100
F684
ATAGCGTTTTTTGG
146
84



R12
GCAAACCAAAAACG
80




Probe 12
TAATGTTTTGTTTTTTTCGGTTTTC
85






101
F685
TAGCGTTTTTTGGT
147
148



R13
ACCTAAAACACCCG
144




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






102
F686
AGCGTTTTTTGGTT
150
148



R13
ACCTAAAACACCCG
143




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






103
F687
GCGTTTTTTGGTTT
151
148



R13
ACCTAAAACACCCG
142




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






104
F688
CGTTTTTTGGTTTT
152
148



R13
ACCTAAAACACCCG
141




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






105
F689
GTTTTTTGGTTTTT
153
148



R13
ACCTAAAACACCCG
140




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






106
F690
TTTTTTGGTTTTTT
139
154



R13
ACCTAAAACACCCG
148




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






107
F691
TTTTTGGTTTTTTT
155
148



R13
ACCTAAAACACCCG
138




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






108
F692
TTTTGGTTTTTTTT
156
148



R13
ACCTAAAACACCCG
137




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






109
F693
TTTGGTTTTTTTTT
157
148



R13
ACCTAAAACACCCG
136




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






110
F694
TTGGTTTTTTTTTG
158
148



R13
ACCTAAAACACCCG
135




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






111
F695
TGGTTTTTTTTTGT
159
148



R13
ACCTAAAACACCCG
134




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






112
F696
GGTTTTTTTTTGTG
160
148



R13
ACCTAAAACACCCG
133




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






113
F697
GTTTTTTTTTGTGA
161
148



R13
ACCTAAAACACCCG
132




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






114
F698
TTTTTTTTTGTGAT
162
148



R13
ACCTAAAACACCCG
131




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






115
F699
TTTTTTTTGTGATT
163
148



R13
ACCTAAAACACCCG
130




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






116
F700
TTTTTTTGTGATTT
164




R13
ACCTAAAACACCCG
129
148



Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






117
F701
TTTTTTGTGATTTT
165




R13
ACCTAAAACACCCG
128
148



Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






118
F702
TTTTTGTGATTTTA
166




R13
ACCTAAAACACCCG
127
148



Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






119
F703
TTTTGTGATTTTAG
167




R13
ACCTAAAACACCCG
126
148



Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






120
F704
TTTGTGATTTTAGT
168




R13
ACCTAAAACACCCG
125
148



Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






121
F705
TTGTGATTTTAGTT
169




R13
ACCTAAAACACCCG
124
148



Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






122
F706
TGTGATTTTAGTTA
170




R13
ACCTAAAACACCCG
123
148



Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






123
F707
GTGATTTTAGTTAA
122
171



R13
ACCTAAAACACCCG
148




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






124
F708
TGATTTTAGTTAAT
172
148



R13
ACCTAAAACACCCG
121




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






125
F709
GATTTTAGTTAATG
173
148



R13
ACCTAAAACACCCG
120




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






126
F710
ATTTTAGTTAATGT
174
148



R13
ACCTAAAACACCCG
119




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






127
F711
TTTTAGTTAATGTT
175
148



R13
ACCTAAAACACCCG
118




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






128
F712
TTTAGTTAATGTTT
176
148



R13
ACCTAAAACACCCG
117




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






129
F713
TTAGTTAATGTTTT
177
148



R13
ACCTAAAACACCCG
116




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






130
F714
TAGTTAATGTTTTG
178
148



R13
ACCTAAAACACCCG
115




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






131
F715
AGTTAATGTTTTGT
114
179



R13
ACCTAAAACACCCG
148




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






132
F716
GTTAATGTTTTGTT
180
148



R13
ACCTAAAACACCCG
113




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






133
F717
TTAATGTTTTGTTT
181
148



R13
ACCTAAAACACCCG
112




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






134
F718
TAATGTTTTGTTTT
182
148



R13
ACCTAAAACACCCG
111




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






135
F719
AATGTTTTGTTTTT
183
148



R13
ACCTAAAACACCCG
110




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






136
F720
ATGTTTTGTTTTTT
184
148



R13
ACCTAAAACACCCG
109




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






137
F721
TGTTTTGTTTTTTT
185
148



R13
ACCTAAAACACCCG
108




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






138
F722
GTTTTGTTTTTTTC
186
148



R13
ACCTAAAACACCCG
107




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






139
F723
TTTTGTTTTTTTCG
187
148



R13
ACCTAAAACACCCG
106




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






140
F724
TTTGTTTTTTTCGG
188
148



R13
ACCTAAAACACCCG
105




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






141
F725
TTGTTTTTTTCGGT
189
148



R13
ACCTAAAACACCCG
104




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






142
F726
TGTTTTTTTCGGTT
190
148



R13
ACCTAAAACACCCG
103




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






143
F727
GTTTTTTTCGGTTT
191
148



R13
ACCTAAAACACCCG
102




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






144
F728
TTTTTTTCGGTTTT
192
148



R13
ACCTAAAACACCCG
101




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






145
F729
TTTTTTCGGTTTTC
193
148



R13
ACCTAAAACACCCG
100




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






146
F730
TTTTTCGGTTTTCG
194
148



R13
ACCTAAAACACCCG
99




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






147
F731
TTTTCGGTTTTCGT
195
148



R13
ACCTAAAACACCCG
98




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






148
F732
TTTCGGTTTTCGTT
97
196



R13
ACCTAAAACACCCG
148




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






149
F733
TTCGGTTTTCGTTT
197
148



R13
ACCTAAAACACCCG
96




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






150
F734
TCGGTTTTCGTTTT
198
148



R13
ACCTAAAACACCCG
95




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






151
F735
CGGTTTTCGTTTTT
199
148



R13
ACCTAAAACACCCG
94




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






152
F736
GGTTTTCGTTTTTT
200
148



R13
ACCTAAAACACCCG
93




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






153
F737
GTTTTCGTTTTTTC
201
148



R13
ACCTAAAACACCCG
92




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






154
F738
TTTTCGTTTTTTCG
202
148



R13
ACCTAAAACACCCG
91




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






155
F739
TTTCGTTTTTTCGT
203
148



R13
ACCTAAAACACCCG
90




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






156
F740
TTCGTTTTTTCGTT
89
204



R13
ACCTAAAACACCCG
148




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






157
F741
TCGTTTTTTCGTTT
205
148



R13
ACCTAAAACACCCG
88




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






158
F742
CGTTTTTTCGTTTT
206
148



R13
ACCTAAAACACCCG
87




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






159
F743
GTTTTTTCGTTTTT
207
148



R13
ACCTAAAACACCCG
86




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






160
F744
TTTTTTCGTTTTTG
208
148



R13
ACCTAAAACACCCG
85




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






161
F745
TTTTTCGTTTTTGG
209
148



R13
ACCTAAAACACCCG
84




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






162
F746
TTTTCGTTTTTGGT
210
148



R13
ACCTAAAACACCCG
83




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






163
F747
TTTCGTTTTTGGTT
211
148



R13
ACCTAAAACACCCG
82




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






164
F748
TTCGTTTTTGGTTT
212
148



R13
ACCTAAAACACCCG
81




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






165
F749
TCGTTTTTGGTTTG
213
148



R13
ACCTAAAACACCCG
80




Probe 13
CGGAATTTTGTTTTGGGTCGCGGAC
149






166
F750
CGTTTTTGGTTTGC
214
215



R14
TAAACGTAAAAACG
147




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






167
F751
GTTTTTGGTTTGCG
217
215



R14
TAAACGTAAAAACG
146




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






168
F752
TTTTTGGTTTGCGG
218
215



R14
TAAACGTAAAAACG
145




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






169
F753
TTTTGGTTTGCGGC
219
215



R14
TAAACGTAAAAACG
144




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






170
F754
TTTGGTTTGCGGCG
220
215



R14
TAAACGTAAAAACG
143




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






171
F755
TTGGTTTGCGGCGT
221
215



R14
TAAACGTAAAAACG
142




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






172
F756
TGGTTTGCGGCGTT
222
215



R14
TAAACGTAAAAACG
141




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






173
F757
GGTTTGCGGCGTTT
140
223



R14
TAAACGTAAAAACG
215




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






174
F758
GTTTGCGGCGTTTT
224
215



R14
TAAACGTAAAAACG
139




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






175
F759
TTTGCGGCGTTTTT
225
215



R14
TAAACGTAAAAACG
138




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






176
F760
TTGCGGCGTTTTTT
226
215



R14
TAAACGTAAAAACG
137




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






177
F761
TGCGGCGTTTTTTT
227
215



R14
TAAACGTAAAAACG
136




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






178
F762
GCGGCGTTTTTTTC
228
215



R14
TAAACGTAAAAACG
135




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






179
F763
CGGCGTTTTTTTCG
229
215



R14
TAAACGTAAAAACG
134




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






180
F764
GGCGTTTTTTTCGG
230
215



R14
TAAACGTAAAAACG
133




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






181
F765
GCGTTTTTTTCGGA
132
231



R14
TAAACGTAAAAACG
215




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






182
F766
CGTTTTTTTCGGAA
232
215



R14
TAAACGTAAAAACG
131




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






183
F767
GTTTTTTTCGGAAT
233
215



R14
TAAACGTAAAAACG
130




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






184
F768
TTTTTTTCGGAATT
234
215



R14
TAAACGTAAAAACG
129




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






185
F769
TTTTTTCGGAATTT
235
215



R14
TAAACGTAAAAACG
128




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






186
F770
TTTTTCGGAATTTT
236
215



R14
TAAACGTAAAAACG
127




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






187
F771
TTTTCGGAATTTTG
237
215



R14
TAAACGTAAAAACG
126




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






188
F772
TTTCGGAATTTTGT
238
215



R14
TAAACGTAAAAACG
125




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






189
F773
TTCGGAATTTTGTT
239
215



R14
TAAACGTAAAAACG
124




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






190
F774
TCGGAATTTTGTTT
240
215



R14
TAAACGTAAAAACG
123




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






191
F775
CGGAATTTTGTTTT
241
215



R14
TAAACGTAAAAACG
122




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






192
F776
GGAATTTTGTTTTG
242
215



R14
TAAACGTAAAAACG
121




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






193
F777
GAATTTTGTTTTGG
243
215



R14
TAAACGTAAAAACG
120




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






194
F778
AATTTTGTTTTGGG
244
215



R14
TAAACGTAAAAACG
119




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






195
F779
ATTTTGTTTTGGGT
245
215



R14
TAAACGTAAAAACG
118




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






196
F780
TTTTGTTTTGGGTC
246
215



R14
TAAACGTAAAAACG
117




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






197
F781
TTTGTTTTGGGTCG
247
215



R14
TAAACGTAAAAACG
116




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






198
F782
TTGTTTTGGGTCGC
115
248



R14
TAAACGTAAAAACG
215




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






199
F783
TGTTTTGGGTCGCG
249
215



R14
TAAACGTAAAAACG
114




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






200
F784
GTTTTGGGTCGCGG
250
215



R14
TAAACGTAAAAACG
113




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






201
F785
TTTTGGGTCGCGGA
251
215



R14
TAAACGTAAAAACG
112




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






202
F786
TTTGGGTCGCGGAC
252
215



R14
TAAACGTAAAAACG
111




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






203
F787
TTGGGTCGCGGACG
253
215



R14
TAAACGTAAAAACG
110




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






204
F788
TGGGTCGCGGACGT
254
215



R14
TAAACGTAAAAACG
109




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






205
F789
GGGTCGCGGACGTT
255
215



R14
TAAACGTAAAAACG
108




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






206
F790
GGTCGCGGACGTTT
107
256



R14
TAAACGTAAAAACG
215




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






207
F791
GTCGCGGACGTTTA
257
215



R14
TAAACGTAAAAACG
106




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






208
F792
TCGCGGACGTTTAG
258
215



R14
TAAACGTAAAAACG
105




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






209
F793
CGCGGACGTTTAGG
259
215



R14
TAAACGTAAAAACG
104




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






210
F794
GCGGACGTTTAGGA
260
215



R14
TAAACGTAAAAACG
103




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






211
F795
CGGACGTTTAGGAA
261
215



R14
TAAACGTAAAAACG
102




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






212
F796
GGACGTTTAGGAAA
262
215



R14
TAAACGTAAAAACG
101




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






213
F797
GACGTTTAGGAAAA
263
215



R14
TAAACGTAAAAACG
100




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






214
F798
ACGTTTAGGAAAAG
264
215



R14
TAAACGTAAAAACG
99




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






215
F799
CGTTTAGGAAAAGA
265
215



R14
TAAACGTAAAAACG
98




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






216
F800
GTTTAGGAAAAGAG
266
215



R14
TAAACGTAAAAACG
97




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






217
F801
TTTAGGAAAAGAGT
267
215



R14
TAAACGTAAAAACG
96




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






218
F802
TTAGGAAAAGAGTC
268
215



R14
TAAACGTAAAAACG
95




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






219
F803
TAGGAAAAGAGTCG
269
215



R14
TAAACGTAAAAACG
94




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






220
F804
AGGAAAAGAGTCGG
270
215



R14
TAAACGTAAAAACG
93




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






221
F805
GGAAAAGAGTCGGG
271
215



R14
TAAACGTAAAAACG
92




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






222
F806
GAAAAGAGTCGGGT
272
215



R14
TAAACGTAAAAACG
91




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






223
F807
AAAAGAGTCGGGTG
90
273



R14
TAAACGTAAAAACG
215




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






224
F808
AAAGAGTCGGGTGT
274
215



R14
TAAACGTAAAAACG
89




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






225
F809
AAGAGTCGGGTGTT
275
215



R14
TAAACGTAAAAACG
88




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






226
F810
AGAGTCGGGTGTTT
276
215



R14
TAAACGTAAAAACG
87




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






227
F811
GAGTCGGGTGTTTT
277
215



R14
TAAACGTAAAAACG
86




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






228
F812
AGTCGGGTGTTTTA
278
215



R14
TAAACGTAAAAACG
85




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






229
F813
GTCGGGTGTTTTAG
279
215



R14
TAAACGTAAAAACG
84




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






230
F814
TCGGGTGTTTTAGG
280
215



R14
TAAACGTAAAAACG
83




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






231
F815
CGGGTGTTTTAGGT
82
281



R14
TAAACGTAAAAACG
215




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






232
F816
GGGTGTTTTAGGTA
282
215



R14
TAAACGTAAAAACG
81




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






233
F817
GGTGTTTTAGGTAG
283
215



R14
TAAACGTAAAAACG
80




Probe 14
CGCGTTATTTCGGGAATCGCGAGGC
216






234
F818
GTGTTTTAGGTAGT
284
285



R15
CGAACAAAAACCCG
143




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






235
F819
TGTTTTAGGTAGTT
287
285



R15
CGAACAAAAACCCG
142




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






236
F820
GTTTTAGGTAGTTT
288
285



R15
CGAACAAAAACCCG
141




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






237
F821
TTTTAGGTAGTTTC
289
285



R15
CGAACAAAAACCCG
140




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






238
F822
TTTAGGTAGTTTCG
290
285



R15
CGAACAAAAACCCG
139




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






239
F823
TTAGGTAGTTTCGC
291
285



R15
CGAACAAAAACCCG
138




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






240
F824
TAGGTAGTTTCGCG
292
285



R15
CGAACAAAAACCCG
137




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






241
F825
AGGTAGTTTCGCGT
293
285



R15
CGAACAAAAACCCG
136




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






242
F826
GGTAGTTTCGCGTT
294
285



R15
CGAACAAAAACCCG
135




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






243
F827
GTAGTTTCGCGTTG
295
285



R15
CGAACAAAAACCCG
134




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






244
F828
TAGTTTCGCGTTGG
296
285



R15
CGAACAAAAACCCG
133




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






245
F829
AGTTTCGCGTTGGG
297
285



R15
CGAACAAAAACCCG
132




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






246
F830
GTTTCGCGTTGGGG
298
285



R15
CGAACAAAAACCCG
131




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






247
F831
TTTCGCGTTGGGGG
299
285



R15
CGAACAAAAACCCG
130




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






248
F832
TTCGCGTTGGGGGC
129
300



R15
CGAACAAAAACCCG
285




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






249
F833
TCGCGTTGGGGGCG
301
285



R15
CGAACAAAAACCCG
128




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






250
F834
CGCGTTGGGGGCGA
302
285



R15
CGAACAAAAACCCG
127




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






251
F835
GCGTTGGGGGCGAT
303
285



R15
CGAACAAAAACCCG
126




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






252
F836
CGTTGGGGGCGATC
304
285



R15
CGAACAAAAACCCG
125




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






253
F837
GTTGGGGGCGATCG
305
285



R15
CGAACAAAAACCCG
124




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






254
F838
TTGGGGGCGATCGC
306
285



R15
CGAACAAAAACCCG
123




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






255
F839
TGGGGGCGATCGCG
307
285



R15
CGAACAAAAACCCG
122




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






256
F840
GGGGGCGATCGCGT
121
308



R15
CGAACAAAAACCCG
285




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






257
F841
GGGGCGATCGCGTT
309
285



R15
CGAACAAAAACCCG
120




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






258
F842
GGGCGATCGCGTTA
310
285



R15
CGAACAAAAACCCG
119




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






259
F843
GGCGATCGCGTTAT
311
285



R15
CGAACAAAAACCCG
118




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






260
F844
GCGATCGCGTTATT
312
285



R15
CGAACAAAAACCCG
117




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






261
F845
CGATCGCGTTATTT
313
285



R15
CGAACAAAAACCCG
116




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






262
F846
GATCGCGTTATTTC
314
285



R15
CGAACAAAAACCCG
115




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






263
F847
ATCGCGTTATTTCG
315
285



R15
CGAACAAAAACCCG
114




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






264
F848
TCGCGTTATTTCGG
316
285



R15
CGAACAAAAACCCG
113




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






265
F849
CGCGTTATTTCGGG
317
285



R15
CGAACAAAAACCCG
112




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






266
F850
GCGTTATTTCGGGA
318
285



R15
CGAACAAAAACCCG
111




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






267
F851
CGTTATTTCGGGAA
319
285



R15
CGAACAAAAACCCG
110




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






268
F852
GTTATTTCGGGAAT
320
285



R15
CGAACAAAAACCCG
109




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






269
F853
TTATTTCGGGAATC
321
285



R15
CGAACAAAAACCCG
108




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






270
F854
TATTTCGGGAATCG
322
285



R15
CGAACAAAAACCCG
107




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






271
F855
ATTTCGGGAATCGC
323
285



R15
CGAACAAAAACCCG
106




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






272
F856
TTTCGGGAATCGCG
324
285



R15
CGAACAAAAACCCG
105




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






273
F857
TTCGGGAATCGCGA
104
325



R15
CGAACAAAAACCCG
285




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






274
F858
TCGGGAATCGCGAG
326
285



R15
CGAACAAAAACCCG
103




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






275
F859
CGGGAATCGCGAGG
327
285



R15
CGAACAAAAACCCG
102




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






276
F860
GGGAATCGCGAGGC
328
285



R15
CGAACAAAAACCCG
101




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






277
F861
GGAATCGCGAGGCG
329
285



R15
CGAACAAAAACCCG
100




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






278
F862
GAATCGCGAGGCGA
330
285



R15
CGAACAAAAACCCG
99




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






279
F863
AATCGCGAGGCGAT
331
285



R15
CGAACAAAAACCCG
98




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






280
F864
ATCGCGAGGCGATT
332
285



R15
CGAACAAAAACCCG
97




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






281
F865
TCGCGAGGCGATTT
96
333



R15
CGAACAAAAACCCG
285




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






282
F866
CGCGAGGCGATTTG
334
285



R15
CGAACAAAAACCCG
95




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






283
F867
GCGAGGCGATTTGA
335
285



R15
CGAACAAAAACCCG
94




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






284
F868
CGAGGCGATTTGAG
336
285



R15
CGAACAAAAACCCG
93




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






285
F869
GAGGCGATTTGAGT
337
285



R15
CGAACAAAAACCCG
92




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






286
F870
AGGCGATTTGAGTC
338
285



R15
CGAACAAAAACCCG
91




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






287
F871
GGCGATTTGAGTCG
339
285



R15
CGAACAAAAACCCG
90




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






288
F872
GCGATTTGAGTCGT
340
285



R15
CGAACAAAAACCCG
89




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






289
F873
CGATTTGAGTCGTT
341
285



R15
CGAACAAAAACCCG
88




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






290
F874
GATTTGAGTCGTTT
342
285



R15
CGAACAAAAACCCG
87




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






291
F875
ATTTGAGTCGTTTT
343
285



R15
CGAACAAAAACCCG
86




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






292
F876
TTTGAGTCGTTTTT
344
285



R15
CGAACAAAAACCCG
85




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






293
F877
TTGAGTCGTTTTTA
345
285



R15
CGAACAAAAACCCG
84




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






294
F878
TGAGTCGTTTTTAC
346
285



R15
CGAACAAAAACCCG
83




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






295
F879
GAGTCGTTTTTACG
347
285



R15
CGAACAAAAACCCG
82




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






296
F880
AGTCGTTTTTACGT
348
285



R15
CGAACAAAAACCCG
81




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






297
F881
GTCGTTTTTACGTT
349
285



R15
CGAACAAAAACCCG
80




Probe 15
TTTAAAAGTTGTCGGTCGGGAGGGC
286






298
F882
TCGTTTTTACGTTT
148
350



R16
AACCTACCTAAACG
351




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






299
F883
CGTTTTTACGTTTA
353
351



R16
AACCTACCTAAACG
147




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






300
F884
GTTTTTACGTTTAT
354
351



R16
AACCTACCTAAACG
146




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






301
F885
TTTTTACGTTTATT
355
351



R16
AACCTACCTAAACG
145




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






302
F886
TTTTACGTTTATTT
356
351



R16
AACCTACCTAAACG
144




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






303
F887
TTTACGTTTATTTA
357
351



R16
AACCTACCTAAACG
143




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






304
F888
TTACGTTTATTTAA
358
351



R16
AACCTACCTAAACG
142




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






305
F889
TACGTTTATTTAAA
359
351



R16
AACCTACCTAAACG
141




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






306
F890
ACGTTTATTTAAAA
140
360



R16
AACCTACCTAAACG
351




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






307
F891
CGTTTATTTAAAAG
361
351



R16
AACCTACCTAAACG
139




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






308
F892
GTTTATTTAAAAGT
362
351



R16
AACCTACCTAAACG
138




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






309
F893
TTTATTTAAAAGTT
363
351



R16
AACCTACCTAAACG
137




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






310
F894
TTATTTAAAAGTTG
364
351



R16
AACCTACCTAAACG
136




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






311
F895
TATTTAAAAGTTGT
365
351



R16
AACCTACCTAAACG
135




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






312
F896
ATTTAAAAGTTGTC
366
351



R16
AACCTACCTAAACG
134




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






313
F897
TTTAAAAGTTGTCG
367
351



R16
AACCTACCTAAACG
133




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






314
F898
TTAAAAGTTGTCGG
368
351



R16
AACCTACCTAAACG
132




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






315
F899
TAAAAGTTGTCGGT
369
351



R16
AACCTACCTAAACG
131




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






316
F900
AAAAGTTGTCGGTC
370
351



R16
AACCTACCTAAACG
130




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






317
F901
AAAGTTGTCGGTCG
371
351



R16
AACCTACCTAAACG
129




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






318
F902
AAGTTGTCGGTCGG
372
351



R16
AACCTACCTAAACG
128




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






319
F903
AGTTGTCGGTCGGG
373
351



R16
AACCTACCTAAACG
127




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






320
F904
GTTGTCGGTCGGGA
374
351



R16
AACCTACCTAAACG
126




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






321
F905
TTGTCGGTCGGGAG
375
351



R16
AACCTACCTAAACG
125




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






322
F906
TGTCGGTCGGGAGG
376
351



R16
AACCTACCTAAACG
124




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






323
F907
GTCGGTCGGGAGGG
123
377



R16
AACCTACCTAAACG
351




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






324
F908
TCGGTCGGGAGGGC
378
351



R16
AACCTACCTAAACG
122




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






325
F909
CGGTCGGGAGGGCG
379
351



R16
AACCTACCTAAACG
121




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






326
F910
GGTCGGGAGGGCGG
380
351



R16
AACCTACCTAAACG
120




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






327
F911
GTCGGGAGGGCGGG
381
351



R16
AACCTACCTAAACG
119




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






328
F912
TCGGGAGGGCGGGG
382
351



R16
AACCTACCTAAACG
118




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






329
F913
CGGGAGGGCGGGGT
383
351



R16
AACCTACCTAAACG
117




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






330
F914
GGGAGGGCGGGGTT
384
351



R16
AACCTACCTAAACG
116




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






331
F915
GGAGGGCGGGGTTT
115
385



R16
AACCTACCTAAACG
351




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






332
F916
GAGGGCGGGGTTTT
386
351



R16
AACCTACCTAAACG
114




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






333
F917
AGGGCGGGGTTTTA
387
351



R16
AACCTACCTAAACG
113




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






334
F918
GGGCGGGGTTTTAG
388
351



R16
AACCTACCTAAACG
112




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






335
F919
GGCGGGGTTTTAGA
389
351



R16
AACCTACCTAAACG
111




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






336
F920
GCGGGGTTTTAGAA
390
351



R16
AACCTACCTAAACG
110




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






337
F921
CGGGGTTTTAGAAA
391
351



R16
AACCTACCTAAACG
109




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






338
F922
GGGGTTTTAGAAAG
392
351



R16
AACCTACCTAAACG
108




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






339
F923
GGGTTTTAGAAAGG
393
351



R16
AACCTACCTAAACG
107




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






340
F924
GGTTTTAGAAAGGA
394
351



R16
AACCTACCTAAACG
106




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






341
F925
GTTTTAGAAAGGAG
395
351



R16
AACCTACCTAAACG
105




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






342
F926
TTTTAGAAAGGAGT
396
351



R16
AACCTACCTAAACG
104




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






343
F927
TTTAGAAAGGAGTA
397
351



R16
AACCTACCTAAACG
103




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






344
F928
TTAGAAAGGAGTAT
398
351



R16
AACCTACCTAAACG
102




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






345
F929
TAGAAAGGAGTATT
399
351



R16
AACCTACCTAAACG
101




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






346
F930
AGAAAGGAGTATTT
400
351



R16
AACCTACCTAAACG
100




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






347
F931
GAAAGGAGTATTTT
401
351



R16
AACCTACCTAAACG
99




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






348
F932
AAAGGAGTATTTTT
98
402



R16
AACCTACCTAAACG
351




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






349
F933
AAGGAGTATTTTTG
403
351



R16
AACCTACCTAAACG
97




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






350
F934
AGGAGTATTTTTGC
404
351



R16
AACCTACCTAAACG
96




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






351
F935
GGAGTATTTTTGCG
405
351



R16
AACCTACCTAAACG
95




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






352
F936
GAGTATTTTTGCGG
406
351



R16
AACCTACCTAAACG
94




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






353
F937
AGTATTTTTGCGGG
407
351



R16
AACCTACCTAAACG
93




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






354
F938
GTATTTTTGCGGGT
408
351



R16
AACCTACCTAAACG
92




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






355
F939
TATTTTTGCGGGTT
409
351



R16
AACCTACCTAAACG
91




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






356
F940
ATTTTTGCGGGTTT
90
410



R16
AACCTACCTAAACG
351




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






357
F941
TTTTTGCGGGTTTT
411
351



R16
AACCTACCTAAACG
89




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






358
F942
TTTTGCGGGTTTTT
412
351



R16
AACCTACCTAAACG
88




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






359
F943
TTTGCGGGTTTTTG
413
351



R16
AACCTACCTAAACG
87




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






360
F944
TTGCGGGTTTTTGT
414
351



R16
AACCTACCTAAACG
86




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






361
F945
TGCGGGTTTTTGTT
415
351



R16
AACCTACCTAAACG
85




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






362
F946
GCGGGTTTTTGTTC
416
351



R16
AACCTACCTAAACG
84




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






363
F947
CGGGTTTTTGTTCG
417
351



R16
AACCTACCTAAACG
83




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






364
F948
GGGTTTTTGTTCGA
418
351



R16
AACCTACCTAAACG
82




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






365
F949
GGTTTTTGTTCGAC
419
351



R16
AACCTACCTAAACG
81




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






366
F950
GTTTTTGTTCGACG
420
351



R16
AACCTACCTAAACG
80




Probe 16
AGGTTGTCGCGGCGAGGGTTTTGTC
352






367
F951
TTTTTGTTCGACGA
421
422



R17
CGCCATAAACTACG
116




Probe 17
GCGTTTAGGTAGGTTCGAAGTACGC
423






368
F952
TTTTGTTCGACGAT
424
422



R17
CGCCATAAACTACG
115




Probe 17
GCGTTTAGGTAGGTTCGAAGTACGC
423






369
F953
TTTGTTCGACGATT
425
422



R17
CGCCATAAACTACG
114




Probe 17
GCGTTTAGGTAGGTTCGAAGTACGC
423






370
F954
TTGTTCGACGATTT
426
422



R17
CGCCATAAACTACG
113




Probe 17
GCGTTTAGGTAGGTTCGAAGTACGC
423






371
F955
TGTTCGACGATTTT
427
422



R17
CGCCATAAACTACG
112




Probe 17
GCGTTTAGGTAGGTTCGAAGTACGC
423






372
F956
GTTCGACGATTTTT
428
422



R17
CGCCATAAACTACG
111




Probe 17
GCGTTTAGGTAGGTTCGAAGTACGC
423






373
F957
TTCGACGATTTTTT
110
429



R17
CGCCATAAACTACG
422




Probe 17
GCGTTTAGGTAGGTTCGAAGTACGC
423






374
F958
TCGACGATTTTTTG
430
422



R17
CGCCATAAACTACG
109




Probe 17
GCGTTTAGGTAGGTTCGAAGTACGC
423






375
F959
CGACGATTTTTTGT
431
422



R17
CGCCATAAACTACG
108




Probe 17
GCGTTTAGGTAGGTTCGAAGTACGC
423






376
F960
GACGATTTTTTGTT
432
422



R17
CGCCATAAACTACG
107




Probe 17
GCGTTTAGGTAGGTTCGAAGTACGC
423






377
F961
ACGATTTTTTGTTG
433
422



R17
CGCCATAAACTACG
106




Probe 17
GCGTTTAGGTAGGTTCGAAGTACGC
423






378
F962
CGATTTTTTGTTGA
434
422



R17
CGCCATAAACTACG
105




Probe 17
GCGTTTAGGTAGGTTCGAAGTACGC
423






379
F963
GATTTTTTGTTGAG
435
422



R17
CGCCATAAACTACG
104




Probe 17
GCGTTTAGGTAGGTTCGAAGTACGC
423






380
F964
ATTTTTTGTTGAGG
436
422



R17
CGCCATAAACTACG
103




Probe 17
GCGTTTAGGTAGGTTCGAAGTACGC
423






381
F965
TTTTTTGTTGAGGT
102
437



R17
CGCCATAAACTACG
422




Probe 17
GCGTTTAGGTAGGTTCGAAGTACGC
423






382
F966
TTTTTGTTGAGGTT
438
422



R17
CGCCATAAACTACG
101




Probe 17
GCGTTTAGGTAGGTTCGAAGTACGC
423






383
F967
TTTTGTTGAGGTTG
439
422



R17
CGCCATAAACTACG
100




Probe 17
GCGTTTAGGTAGGTTCGAAGTACGC
423






384
F968
TTTGTTGAGGTTGT
440
422



R17
CGCCATAAACTACG
99




Probe 17
GCGTTTAGGTAGGTTCGAAGTACGC
423






385
F969
TTGTTGAGGTTGTC
441
422



R17
CGCCATAAACTACG
98




Probe 17
GCGTTTAGGTAGGTTCGAAGTACGC
423






386
F970
TGTTGAGGTTGTCG
442
422



R17
CGCCATAAACTACG
97




Probe 17
GCGTTTAGGTAGGTTCGAAGTACGC
423






387
F971
GTTGAGGTTGTCGC
443
422



R17
CGCCATAAACTACG
96




Probe 17
GCGTTTAGGTAGGTTCGAAGTACGC
423






388
F972
TTGAGGTTGTCGCG
444
422



R17
CGCCATAAACTACG
95




Probe 17
GCGTTTAGGTAGGTTCGAAGTACGC
423






389
F973
TGAGGTTGTCGCGG
445
422



R17
CGCCATAAACTACG
94




Probe 17
GCGTTTAGGTAGGTTCGAAGTACGC
423






390
F974
GAGGTTGTCGCGGC
446
422



R17
CGCCATAAACTACG
93




Probe 17
GCGTTTAGGTAGGTTCGAAGTACGC
423






391
F975
AGGTTGTCGCGGCG
447
422



R17
CGCCATAAACTACG
92




Probe 17
GCGTTTAGGTAGGTTCGAAGTACGC
423






392
F976
GGTTGTCGCGGCGA
448
422



R17
CGCCATAAACTACG
91




Probe 17
GCGTTTAGGTAGGTTCGAAGTACGC
423






393
F977
GTTGTCGCGGCGAG
449
422



R17
CGCCATAAACTACG
90




Probe 17
GCGTTTAGGTAGGTTCGAAGTACGC
423






394
F978
TTGTCGCGGCGAGG
450
422



R17
CGCCATAAACTACG
89




Probe 17
GCGTTTAGGTAGGTTCGAAGTACGC
423






395
F979
TGTCGCGGCGAGGG
451
422



R17
CGCCATAAACTACG
88




Probe 17
GCGTTTAGGTAGGTTCGAAGTACGC
423






396
F980
GTCGCGGCGAGGGT
452
422



R17
CGCCATAAACTACG
87




Probe 17
GCGTTTAGGTAGGTTCGAAGTACGC
423






397
F981
TCGCGGCGAGGGTT
453
422



R17
CGCCATAAACTACG
86




Probe 17
GCGTTTAGGTAGGTTCGAAGTACGC
423






398
F982
CGCGGCGAGGGTTT
85
454



R17
CGCCATAAACTACG
422




Probe 17
GCGTTTAGGTAGGTTCGAAGTACGC
423






399
F984a
TCGGGTGTTTTATGTAGTTTCGC
455
456



R19a
ACGACTCAAATCGTCTCGCG
72




Probe 18
TGGGGGCGATCGCGTTATTTCGG
457






acomprising inosine nucleotide







As a result of evaluating methylation of PENK gene using urine cell DNA from normal and bladder cancer patients, it was found that the high sensitivity of PENK gene for bladder cancer diagnosis was 75% (15/20)˜90.0% (18/20) and the specificity of the PENK gene was 85% (3/20)˜95% (1/20). Such results suggest that the PENK methylation biomarker gene is highly useful for early diagnosis of bladder cancer.









TABLE 8







Evaluation of ability to diagnose bladder cancer using PENK gene










Set of primers

Sensitivity (%),
Specificity (%),


and probes
Cut-off (Ct)
n = 20
n = 20













1
<32.1
60
60


2
<32.0
60
60


3
<32.3
55
60


4
<32.1
40
65


5
<32.0
45
65


6
<32.5
60
70


7
<32.5
50
65


8
<32.2
55
70


9
<32.3
60
70


10
<32.5
45
60


11
<32.0
45
65


12
<32.1
45
65


13
<32.0
40
60


14
<32.2
55
60


15
<32.3
50
70


16
<32.5
50
70


17
<32.0
60
65


18
<32.3
60
70


19
<32.1
45
70


20
<32.0
50
70


21
<32.5
50
60


22
<32.5
55
60


23
<32.5
60
65


24
<32.2
45
65


25
<32.3
40
60


26
<32.5
40
60


27
<32.0
45
60


28
<32.1
45
65


29
<32.0
45
65


30
<32.2
45
60


31
<32.3
45
65


32
<32.5
55
60


33
<32.0
50
60


34
<32.3
40
65


35
<32.1
60
65


36
<32.0
50
65


37
<32.3
50
60


38
<32.2
40
70


39
<32.3
55
65


40
<32.4
55
70


41
<32.0
60
70


42
<32.5
40
70


43
<32.0
50
65


44
<32.1
45
65


45
<32.0
45
70


46
<32.1
50
65


47
<32.3
55
70


48
<32.0
40
70


49
<32.1
55
65


50
<32.1
60
60


51
<32.3
45
65


52
<32.5
55
60


53
<32.2
50
70


54
<32.3
45
70


55
<32.5
55
65


56
<32.0
50
60


57
<32.2
60
60


58
<32.3
40
65


59
<32.0
60
60


60
<32.5
55
65


61
<32.5
40
60


62
<32.5
50
60


63
<32.2
45
65


64
<32.5
45
65


65
<32.0
55
65


66
<32.1
40
65


67
<32.5
60
60


68
<32.0
55
70


69
<32.1
45
70


70
<32.5
40
70


71
<32.0
50
65


72
<32.3
50
60


73
<32.5
60
60


74
<32.2
40
65


75
<32.3
50
65


76
<32.5
55
60


77
<32.0
50
65


78
<32.2
55
65


79
<32.3
55
60


80
<32.0
40
60


81
<32.5
55
60


82
<32.5
50
65


83
<32.5
55
70


84
<32.2
50
70


85
<32.3
60
65


86
<32.0
55
60


87
<32.2
45
60


88
<32.3
50
65


89
<32.5
45
65


90
<32.0
60
60


91
<32.3
55
65


92
<32.1
40
70


93
<32.0
55
70


94
<32.3
55
60


95
<32.4
50
60


96
<32.0
45
60


97
<32.1
50
65


98
<32.3
50
65


99
<32.5
40
60


100
<32.2
60
65


101
<32.3
45
60


102
<32.5
55
70


103
<32.0
55
65


104
<32.2
50
60


105
<32.3
60
70


106
<32.0
45
65


107
<32.5
50
65


108
<32.5
60
65


109
<32.5
50
70


110
<32.2
55
65


111
<32.0
45
60


112
<32.1
55
60


113
<32.0
50
60


114
<32.1
40
65


115
<32.3
40
60


116
<32.0
45
70


117
<32.1
50
70


118
<32.5
50
70


119
<32.3
55
65


120
<32.2
40
60


121
<32.0
45
65


122
<32.1
40
70


123
<32.0
45
65


124
<32.1
45
70


125
<32.3
50
65


126
<32.0
50
65


127
<32.1
55
65


128
<32.5
45
70


129
<32.0
60
60


130
<32.5
60
60


131
<32.2
50
65


132
<32.3
40
70


133
<32.5
55
60


134
<32.0
60
70


135
<32.3
45
60


136
<32.1
50
65


137
<32.0
50
65


138
<32.3
45
60


139
<32.2
55
65


140
<32.3
40
65


141
<32.4
60
65


142
<32.0
60
70


143
<32.5
55
70


144
<32.0
50
60


145
<32.1
55
65


146
<32.0
45
70


147
<32.1
40
60


148
<32.3
40
60


149
<32.0
60
60


150
<32.1
50
70


151
<32.1
45
65


152
<32.3
55
70


153
<32.5
60
70


154
<32.2
55
65


155
<32.3
55
60


156
<32.5
50
60


157
<32.0
40
60


158
<32.2
60
65


159
<32.3
45
60


160
<32.0
55
60


161
<32.5
50
65


162
<32.5
40
70


163
<32.5
45
70


164
<32.2
40
65


165
<32.5
40
60


166
<32.0
45
70


167
<32.1
60
60


168
<32.5
45
70


169
<32.0
55
65


170
<32.1
40
65


171
<32.5
60
70


172
<32.0
55
65


173
<32.3
50
70


174
<32.5
45
70


175
<32.2
60
65


176
<32.3
60
65


177
<32.5
60
65


178
<32.0
60
60


179
<32.2
55
65


180
<32.3
55
60


181
<32.0
50
70


182
<32.5
40
65


183
<32.5
45
60


184
<32.5
50
60


185
<32.2
40
60


186
<32.3
45
70


187
<32.0
60
65


188
<32.2
60
70


189
<32.3
55
60


190
<32.5
50
60


191
<32.0
40
60


192
<32.3
45
60


193
<32.1
40
70


194
<32.0
40
70


195
<32.3
55
65


196
<32.4
50
70


197
<32.0
85
95


198
<32.1
85
90


199
<32.3
75
90


200
<32.0
80
90


201
<32.0
90
85


202
<32.5
80
90


203
<32.1
80
85


204
<32.3
85
90


205
<32.5
90
85


206
<32.3
85
90


207
<32.4
80
90


208
<32.1
80
85


209
<32.2
85
90


210
<32.0
80
90


211
<32.5
80
90


212
<32.2
85
90


213
<32.5
85
90


214
<32.3
85
90


215
<32.2
85
90


216
<32.5
80
90


217
<32.3
85
85


218
<32.5
90
85


219
<32.1
85
85


220
<32.1
90
85


221
<32.0
90
80


222
<32.5
90
80


223
<32.2
85
90


224
<32.1
75
95


225
<32.0
75
95


226
<32.5
85
85


227
<32.5
75
90


228
<32.2
75
90


229
<32.3
85
90


230
<32.0
75
90


231
<32.3
75
90


232
<32.5
75
95


233
<32.0
75
95


234
<32.5
85
90


235
<32.0
80
90


236
<32.5
75
90


237
<32.4
80
95


238
<32.0
80
90


239
<32.3
85
90


240
<32.1
85
90


241
<32.3
75
90


242
<32.3
85
90


243
<32.3
85
85


244
<32.5
80
90


245
<32.2
85
90


246
<32.2
75
90


247
<32.2
90
85


248
<32.5
90
80


249
<32.3
85
95


250
<32.2
80
90


251
<32.3
75
90


252
<32.0
90
85


253
<32.3
85
90


254
<32.3
85
85


255
<32.5
80
90


256
<32.0
75
90


257
<32.0
85
85


258
<32.5
80
90


259
<32.0
75
95


260
<32.2
85
90


261
<32.5
75
95


262
<32.3
85
90


263
<32.2
80
90


264
<32.0
75
90


265
<32.5
80
95


266
<32.0
80
95


267
<32.0
80
85


268
<32.3
85
85


269
<32.3
75
90


270
<32.4
80
90


271
<32.0
90
85


272
<32.5
85
90


273
<32.0
90
85


274
<32.3
85
85


275
<32.5
90
80


276
<32.5
90
80


277
<32.2
90
85


278
<32.1
80
95


279
<32.5
80
85


280
<32.0
85
85


281
<32.2
75
90


282
<32.0
80
90


283
<32.3
85
90


284
<32.4
80
90


285
<32.1
85
90


286
<32.3
85
90


287
<32.2
80
90


288
<32.5
80
90


289
<32.2
85
90


290
<32.5
75
95


291
<32.1
85
90


292
<32.5
75
95


293
<32.0
75
90


294
<32.0
90
85


295
<32.0
85
85


296
<32.3
85
85


297
<32.1
90
85


298
<32.3
75
90


299
<32.5
80
90


300
<32.0
80
90


301
<32.1
85
85


302
<32.5
75
95


303
<32.5
75
90


304
<32.0
80
90


305
<32.5
90
80


306
<32.1
75
95


307
<32.0
85
90


308
<32.0
90
85


309
<32.3
85
85


310
<32.1
85
90


311
<32.5
75
95


312
<32.1
85
90


313
<32.5
75
95


314
<32.3
75
90


315
<32.5
75
90


316
<32.0
80
95


317
<32.3
85
90


318
<32.5
80
95


319
<32.0
80
90


320
<32.0
85
85


321
<32.5
80
90


322
<32.5
50
70


323
<32.0
60
65


324
<32.2
50
65


325
<32.1
40
65


326
<32.0
45
60


327
<32.2
60
60


328
<32.1
60
65


329
<32.3
50
60


330
<32.0
55
65


331
<32.3
45
70


332
<32.0
45
65


333
<32.1
45
70


334
<32.3
40
65


335
<32.0
40
60


336
<32.5
55
60


337
<32.3
60
65


338
<32.0
60
60


339
<32.5
50
65


340
<32.0
40
60


341
<32.3
55
70


342
<32.0
50
70


343
<32.3
45
70


344
<32.0
55
65


345
<32.3
50
60


346
<32.2
50
60


347
<32.3
60
60


348
<32.2
55
65


349
<32.5
50
70


350
<32.0
55
70


351
<32.1
60
65


352
<32.3
45
60


353
<32.0
60
65


354
<32.3
45
60


355
<32.1
40
70


356
<32.1
40
60


357
<32.3
60
65


358
<32.2
55
60


359
<32.1
45
60


360
<32.1
55
65


361
<32.3
55
65


362
<32.0
50
70


363
<32.5
45
65


364
<32.0
40
70


365
<32.1
40
65


366
<32.0
45
60


367
<32.5
45
60


368
<32.0
60
70


369
<32.3
60
60


370
<32.1
60
70


371
<32.0
55
65


372
<32.3
50
65


373
<32.0
55
60


374
<32.5
55
70


375
<32.1
50
70


376
<32.2
60
65


377
<32.0
45
60


378
<32.2
45
60


379
<32.0
40
70


380
<32.0
45
60


381
<32.5
40
70


382
<32.3
50
60


383
<32.0
50
60


384
<32.0
60
70


385
<32.1
60
65


386
<32.1
45
60


387
<32.5
40
70


388
<32.5
55
65


389
<32.5
60
65


390
<32.2
50
60


391
<32.3
55
60


392
<32.2
60
60


393
<32.3
60
60


394
<32.5
45
70


395
<32.0
50
65


396
<32.2
55
60


397
<32.5
45
60


398
<32.5
45
65


399
<32.1
85
90









INDUSTRIAL APPLICABILITY

As described above in detail, the present invention provides a kit and nucleic acid chip for diagnosing bladder cancer, which can detect the methylation of CpG islands of bladder cancer-specific marker genes. It is possible to diagnose bladder cancer at an early stage of transformation using the diagnostic kit or nucleic acid chip of the present invention, thus enabling early diagnosis of bladder cancer, and the diagnostic kit or nucleic acid chip can diagnose bladder cancer in a more accurate and rapid manner compared to a conventional method.


Although the present invention has been described in detail with reference to the specific features, it will be apparent to those skilled in the art that this description is only for a preferred embodiment and does not limit the scope of the present invention. Thus, the substantial scope of the present invention will be defined by the appended claims and equivalents thereof.

Claims
  • 1. A method for detecting CpG methylation of PENK (proenkephalin gene), the method comprising the steps of: (a) isolating a genomic DNA from a clinical sample;(b) treating the genomic DNA from step (a) with bisulfite; and(c) determining hypermethylation of the CpG of the PENK gene in the bisulfite-treated genomic DNA from step (b) by using primer(s) to amplify a methylated CpG of the bisulfite-treated PENK gene.
  • 2. The method according to claim 1, wherein step (c) is performed by one selected from the group consisting of PCR, methylation specific PCR, real-time methylation specific PCR, PCR using a methylated DNA-specific binding protein, quantitative PCR, pyrosequencing, and bisulfite sequencing.
  • 3. The method according to claim 1, wherein step (c) comprises examining a CpG methylation of a promoter or exon region of PENK in the clinical sample.
  • 4. The method according to claim 3, wherein the promoter comprises a DNA sequence represented in SEQ ID NO: 37.
  • 5. The method according to claim 1, wherein the method further comprises the step of examining CpG methylation of a gene selected from the group consisting of TBX5—T-box 5; CDX2—caudal type homeobox transcription factor 2; CYP1B1—cytochrome P450, family 1, subfamily B, polypeptide 1; VSX1—visual system homeobox 1 homolog, CHX10-like (zebrafish); HOXA11—homeobox A11; T—T, brachyury homolog (mouse); PAQR9—progestin and adipoQ receptor family member IV; and LHX2—LIM Homeobox 2.
  • 6. The method according to claim 5, wherein the step of examining comprises examining CpG methylation of a promoter or exon region of the gene selected from the group consisting of TBX5; CDX2; CYP1B1; VSX1; HOXA11; T; PAQR9; and LHX2.
  • 7. The method according to claim 1, wherein the method further comprises the step of contacting at least one nucleic acid isolated from the clinical sample with an agent capable of determining a CpG methylation status of PENK gene.
  • 8. The method according to claim 1, wherein the primer(s) for amplifying a methylated CpG of PENK comprises at least one or more CpG dinucleotide in a region which hybridizes to the methylated CpG of PENK.
  • 9. The method according to claim 1, wherein the primer(s) for amplifying a methylated CpG of PENK comprises sequence(s) having a homology of 50% or more with sequence(s) selected from the group consisting of SEQ ID NOs: 43-44, 46-84, 86-148, 150-215, 217-285, 287-351, 353-422, 424-456.
  • 10. The method according to claim 8, further comprising probe(s) capable of hybridizing with a methylated CpG of PENK comprising at least one or more CpG dinucleotide in a region which hybridizes to the methylated CpG of PENK.
  • 11. The method according to claim 8, further comprising probe(s) capable of hybridizing with a methylated CpG of PENK comprising sequence(s) having a homology of 50% or more with sequence(s) selected from the group consisting of SEQ ID NOs: 45, 85, 149, 216, 286, 352, 423 and 457.
  • 12. A method for detecting CpG methylation of PENK—proenkephalin gene for bladder carcinoma or bladder cell proliferative disorder diagnosis, the method comprising the steps of: (a) isolating a genomic DNA from a clinical sample;(b) treating the genomic DNA from step (a) with bisulfite; and(c) determining hypermethylation of the CpG of the PENK gene in the bisulfite-treated genomic DNA from step (b) by using primer(s) to amplify a methylated CpG of the bisulfite-treated PENK gene, wherein a bladder carcinoma or bladder cell proliferative disorder is detected in the human subject based on increased CpG methylation of the PENK gene relative to that of a control.
  • 13. The method according to claim 12, wherein step (c) is performed by one selected from the group consisting of PCR, methylation specific PCR, real-time methylation specific PCR, PCR using a methylated DNA-specific binding protein, quantitative PCR, pyrosequencing, and bisulfite sequencing.
  • 14. The method according to claim 13, wherein the clinical sample is tissue, cell, blood, urine, serum or plasma from a patient suspected of cancer or a subject to be diagnosed.
  • 15. The method according to claim 12, wherein step (c) comprises examining a CpG methylation of a promoter or exon region of PENK in the clinical sample.
  • 16. The method according to claim 13, wherein the promoter comprises a DNA sequence represented in SEQ ID NO: 37.
  • 17. The method according to claim 12, wherein the method further comprises the step of examining CpG methylation of a gene selected from the group consisting of TBX5—T-box 5; CDX2—caudal type homeobox transcription factor 2; CYP1B1—cytochrome P450, family 1, subfamily B, polypeptide 1; VSX1—visual system homeobox 1 homolog, CHX10-like (zebrafish); HOXA11—homeobox A11; T—T, brachyury homolog (mouse); PAQR9—progestin and adipoQ receptor family member IV; and LHX2—LIM Homeobox 2.
  • 18. The method according to claim 17, wherein the step of examining comprises examining CpG methylation of a promoter or exon region of the gene selected from the group consisting of TBX5; CDX2; CYP1B1; VSX1; HOXA11; T; PAQR9; and LHX2.
  • 19. The method according to claim 12, wherein the method further comprises the step of contacting at least one nucleic acid isolated from the clinical sample with an agent capable of determining a CpG methylation status of PENK gene.
  • 20. The method according to claim 12, wherein the primer(s) for amplifying a methylated CpG of PENK comprises at least one or more CpG dinucleotide in a region which hybridizes to the methylated CpG of PENK.
  • 21. The method according to claim 12, wherein the primer(s) for amplifying a methylated CpG of PENK comprises sequence(s) having a homology of 50% or more with sequence(s) selected from the group consisting of SEQ ID NOs: 43-44, 46-84, 86-148, 150-215, 217-285, 287-351, 353-422, 424-456.
  • 22. The method according to claim 20, further comprising probe(s) capable of hybridizing with a methylated CpG of PENK comprising at least one or more CpG dinucleotide in a region which hybridizes to the methylated CpG of PENK.
  • 23. The method according to claim 20, further comprising probe(s) capable of hybridizing with a methylated CpG of PENK comprising sequence(s) having a homology of 50% or more with sequence(s) selected from the group consisting of SEQ ID NOs: 45, 85, 149, 216, 286, 352, 423 and 457.
Priority Claims (1)
Number Date Country Kind
10-2007-0124015 Nov 2007 KR national
CROSS-REFERENCE TO RELATED APPLICATIONS

This is a continuation-in-part application under 35 USC 120 of U.S. patent application Ser. No. 15/016,366 filed on Feb. 5, 2016, which in turn is a continuation-in-part application of U.S. patent application Ser. No. 13/627,519, now U.S. Pat. No. 9,359,646, filed on Sep. 26, 2012, which in turn is a divisional application of U.S. patent application Ser. No. 12/744,491 filed on Jun. 24, 2010 entitled “DIAGNOSIS KIT AND CHIP FOR BLADDER CANCER USING BLADDER CANCER SPECIFIC METHYLATION MARKER GENE” in the name of Sung Wan A N, et al, which is a U.S. national stage application under the provisions of 35 U.S.C. §371 of International Patent Application No. PCT/KR2008/007081 filed on Dec. 1, 2008, which claims priority of Korean Patent Application No. 10-2007-0124015 filed on Nov. 30, 2007, all of which are hereby incorporated by reference herein in their entireties.

Divisions (1)
Number Date Country
Parent 12744491 Jun 2010 US
Child 13627519 US
Continuation in Parts (2)
Number Date Country
Parent 15016366 Feb 2016 US
Child 15585716 US
Parent 13627519 Sep 2012 US
Child 15016366 US