Patent Application
20200124606
The present disclosure relates to a method for providing diagnostic information for biliary tract cancer and an apparatus for diagnosing biliary tract cancer.
Cancer is a disease in which functions of normal cells are hindered by indefinite proliferation of cells. Representative examples of cancer include lung cancer, gastric cancer (GC), breast cancer (BRC), colorectal cancer (CRC), biliary tract cancer, and ovarian cancer (OVC), and so on; however, cancer can occur virtually in any tissues.
A lot of efforts have been made for early diagnosis of cancer, and for biliary tract cancers, there are abdominal CT, CA19-9 Electrochemiluminescence immunoassay (ECLIA), Alpha-fetoprotein test, and so on. However, a diagnosis method that has a high level of accuracy and is noninvasive has not been developed yet.
An aspect of the present disclosure is directed to providing a method for providing diagnostic information for biliary tract cancer and an apparatus for diagnosing biliary tract cancer.
According to an aspect of the present disclosure, there is provided a method for providing diagnostic information for biliary tract cancer including obtaining biological samples; measuring concentration of a marker for predicting biliary tract cancer in the biological samples; and providing diagnostic information for biliary tract cancer using the measured concentration of the marker. The marker includes Nudifloramide.
The marker may further include at least one of LPC 18:0 and fibrinogen alpha chain.
Criterion concentration of the Nudifloramide for biliary tract cancer diagnosis may be 220 pg/μl to 320 pg/μl.
Criterion concentration of the fibrinogen alpha chain may be 130 pg/μl to 200 pg/μl.
Concentration of the LPC 18:0 may be measured using a mass spectrometer, and criterion concentration of the LPC 18:0 for biliary tract cancer diagnosis may be 1,500,000 au to 2,000,000 au.
In the step of providing information, determination of whether or not biliary tract cancer may be made based on a certain concentration of Nudifloramide and fibrinogen alpha chain or higher and a certain concentration of the LPC 18:0 or less.
The biological samples may include serum.
The concentration may be measured by mass spectrometry.
According to an aspect of the present disclosure, there is provided an apparatus for diagnosing biliary tract cancer including an input unit configured to input mass spectrum data detected in biological samples; and a diagnosis unit configured to calculate concentration of a marker for prediction of biliary tract cancer from the mass spectrum data and determine diagnostic information for biliary tract cancer on basis of the calculated concentration. The marker includes Nudifloramide.
The marker may further include at least one of LPC 18:0 and fibrinogen alpha chain.
Criterion concentration of the Nudifloramide for biliary tract cancer diagnosis may be 220 pg/μl to 320 pg/μl.
According to another aspect of the present disclosure, there is provided a method for biliary tract cancer diagnosis including obtaining biological samples, measuring concentration of a marker for prediction of biliary tract cancer in the biological samples, and diagnosing biliary tract cancer based on the measured concentration of the marker. The marker includes Nudifloramide.
The marker may further include at least one of LPC 18:0 and fibrinogen alpha chain.
Criterion concentration of the Nudifloramide for biliary tract cancer diagnosis may be 220 pg/μl to 320 pg/μl.
Criterion concentration of the fibrinogen alpha chain for biliary tract cancer diagnosis may be 130 pg/μl to 200 pg/μl.
Concentration of the LPC 18:0 may be measured using a mass spectrometer, and criterion concentration of the LPC 18:0 for biliary tract cancer diagnosis may be 1,500,000 au to 2,000,000 au.
In the step of diagnosing biliary tract cancer, determination of whether or not biliary tract cancer may be made based on a certain concentration of the Nudifloramide and fibrinogen alpha chain or higher and based on a certain concentration of the LPC 18:0 or less.
The biological samples may include serum.
The concentration may be measured by mass spectrometry.
A method for providing diagnostic information for biliary tract cancer and an apparatus for diagnosing biliary tract cancer according to embodiments of the present disclosure may have a high level of accuracy and be noninvasive.
In the present disclosure, the term “biological samples” includes samples such as whole blood, serum, plasma, urine, stool, sputum, saliva, tissues, cells, cell extracts, in vitro cell cultures but is not limited thereto.
The present disclosure is based on that Nudifloramide has been found to be useful as a marker of biliary tract cancer.
The formal title of Nudifloramide is N-Methyl-2-pyridoxone-5-carboxamide; 1,6-Dihydro-1-methyl-6-oxonicotinamide; 3-Carbamoyl-1-methyl-6-pyridone, and the structural formula is the following:
As the marker of biliary tract cancer, lysophosphatidylcholine (LPC) 18:0 and/or fibrinogen alpha chain (FAC) may be further used.
Biological samples, for example, a concentration of a marker in serum (concentration value), is measured, and diagnosis as to whether it is biliary tract cancer can be made from the measured concentration. The measurement of concentration, which is not limited to the following however, may be performed using a mass spectrometer, and concentrations of each marker are measured using arbitrary unit (“au”) values which correspond to markers measured by the mass spectrometer.
LPC 18:0 and fibrinogen alpha chain (FAC) serves of improvement of specificity, positive prediction value (PPV) and/or negative prediction value (NPV) of diagnosis result.
In the diagnosis of biliary tract cancer, regarding Nudifloramide and FAC, it is determined as biliary tract cancer if concentrations of Nudifloramide and FAC are higher than or equal to each certain concentration, and regarding LPC 18:0, it is determined as biliary tract cancer if concentration of LPC 18:0 is less than or equal to a certain concentration.
Regarding Nudifloramide, the certain concentration that is a criterion of biliary tract cancer diagnosis may be in range of 150 pg/μl to 500 pg/μl, 200 pg/μl to 350 pg/μl, 220 pg/μl to 320 pg/μl, or 250 pg/μl to 300 pg/μl.
Regarding FAC, the certain concentration that is a criterion of biliary tract cancer may be in range of 100 pg/μl to 250 pg/μl, 130 pg/μl to 200 pg/μl, or 150 pg/μl to 180 pg/μl.
Regarding LPC 18:0, the certain concentration that is a criterion of biliary tract cancer is au value of mass spectrometer and may be in range of 1,000,000 to U.S. Pat. Nos. 2,500,000, 1,500,000 to 2,000,000, or 1,600,000 to 1,800,000.
Meanwhile, the ranges of the certain concentration above are values under conditions according to experimental examples of the present disclosure. If a specific concentration range is out of the above-mentioned range using other sampling conditions, pretreatment conditions, or other equipment but if it will be within the range of a certain concentration by following the conditions of the present disclosure, it should be understood that it belongs to the scope of right of the present disclosure.
The following will be described in detail with reference to the drawings.
The accompanying drawings are merely illustrations to provide more details of the technical ideas of the present description and the ideas of the present description should not be limited to the accompanying drawings.
An input unit 100 inputs mass spectrum data detected in biological samples (hereinafter referred to as “diagnosis target data”).
A diagnosis unit 200 measures concentration of a marker from diagnosis target data and generates diagnostic information for biliary tract cancer based on the measured concentration. That is, the diagnosis unit 200 determines the biliary tract cancer positive or negative with respect to diagnosis target data. In this process, the diagnosis unit 200 may use Nudifloramide concentration alone or further use at least one of concentrations of LPC 18:0 and fibrinogen alpha chain.
In the diagnosis unit 200, criterion concentrations have been set for respective markers, and criterion concentrations may be changed depending on various information of a diagnosis target person, such as age, gender, whether to have other cancers, and so on.
An output unit 300 may output diagnostic information for biliary tract cancer and use a display.
The present disclosure will be explained in more detail through experimental examples below.
Obtaining Serum
Serum was obtained from 92 patients with biliary tract cancer, 34 patients with pancreatic cancer, 100 patients with lung cancer, 30 patients with gastric cancer, 3 patients with ovarian cancer, and a normal control group of 340 people.
Extracting Serum
Serum of patients with biliary tract caner, patients with other types of cancers, and a normal control group was extracted using modified Bligh and Dyer method. The detailed method is described in the below.
After 1 μl of distilled water was added to 50 μl of serum, 2 μl of methanol and 0.9 μl of dichloromethane were added.
After mixing well, it was left on ice for 30 minutes, and then 1 μl of distilled water and 0.9 μl of dichloromethane were added.
After that, centrifugation was performed at 1,500 rpm for 10 minutes at room temperature and supernatant was separated, and dried with nitrogen gas.
Quantitative Analysis (Concentration Measurement)
Extraction sample 5 μl was injected to Nexera X2 LC system (Shimadzu) and a marker was separated using concentration gradient of a solvent to be analyzed (solvent A, 0.1% FA in water; solvent B, 100% ACN; with 1% solvent B for 1.5 min, 1 to 25% B for 4.5 min, 25 to 45% B for 2 min, 45 to 90% B for 2 min, 90% B for 4 min, 90 to 1% B for 0.5 min and 5.5 min in 1% B), and then a quantitative analysis was performed using Triple TOF 5600+system (SCIEX) mass spectrometer in positive ion MRM mode.
Nudifloramide
Concentration distribution of Nudifloramide in respective cancers and normal controls are as in
over
less
Based on the determination result in Table 1, the sensitivity, specificity, PPV, and NPV of biliary cancer based on 270 pg/μl of Nudifloramide are as follows:
Sensitivity: 80.43% (74/92)
Specificity: 91.71% ((28+310+98+28+56)/(34+340+100+30+63))
Positive Prediction Value (PPV): 61.16% (74/(74+6+30+2+2+7))
Negative Prediction Value (NPV) 96.65% ((28+310+98+28+56)/(18+28+310+98+28+56))
These results indicate that the use of Nudifloramide alone enables high sensitivity, specificity, PPV, and NPV.
LPC 18:0
The concentration distribution of LPC 18:0 of each cancer and normal controls are as in
Based on the determination results of Table 2, the sensitivity, specificity, PPV, and NPV of pancreatic cancer based on mass spectrometer 1,000,000 au of LPC 18:0 are as follows:
Sensitivity: 97.06% (33/34)
Specificity: 82.08% ((39+329+92+17+36)/(92+340+100+30+63))
Positive Prediction Value (PPV): 22.76% (33/(53+33+11+8+13+27))
Negative Prediction Value (NPV): 99.81% (1/(39+1+329+92+17+36))
The results obtained when changing the criterion of LPC 18:0 to mass spectrometer 1,700,000 au are shown in
Based on determination result of Table 3, the sensitivity, specificity, PPV, and NPV of pancreatic cancer based on mass spectrometer 1,700,000 au of LPC 18:0 are as follows:
Sensitivity: 100% (34/34)
Specificity: 61.44% ((18+266+64+11+25)/(92+340+100+30+63))
Positive Prediction Value (PPV): 12.36% (34/(74+34+74+36+19+38))
Negative Prediction Value (NPV) 100% ((18+266+64+11+25)/(18+0+266+64+11+25))
From the above results, it can be seen that LPC 18:0 is a useful marker for pancreatic cancer. In addition, when criterion concentration of LPC 18:0 is high, it can be used as a marker for not only pancreatic cancer but also biliary tract cancer as indicated in the below.
Nudifloramide+LPC 18:0
The determination results considering the concentration of both two markers by setting the concentration criterion of Nudifloramide as 270 pg/μl and setting the concentration criterion of LPC 18:0 as mass spectrometer 1,700,000 au are shown in Table 4. In the below table, “YES” means a case which meets both the condition of less than Nudifloramide 270 pg/μl and the condition of LPC 18:0, and “NO” means a case which meets neither of two conditions.
The determination results of Table 4 shows that the sensitivity, specificity, PPV, and NPV of biliary tract cancer less than Nudifloramide 270 pg/μl and over LPC 18:0 1,700,000 are as follows:
Sensitivity: 63.04% (58/92)
Specificity: 97.35% (28+337+99+30+58)/(34+340+100+30+63))
Positive Prediction Value (PPV): 79.45% (58/(58+6+3+1+0+5))
Negative Prediction Value (NPV) 94.18% ((28+337+99+30+58)/(34+28+337+99+30+58))
When considering both Nudifloramide and LPC 18:0 as indicated in the above results, sensitivity of biliary tract cancer screening is somewhat reduced, but specificity, PPV, and NPV are all increased for clinical use.
FAC
The concentration distribution of FAC in each cancer and normal controls is shown in
Based on the determination results in Table 5, sensitivity, specificity, PPV, and NPV of biliary tract cancer based on FAC 167 pg/μl are as follows:
Sensitivity: 53.26% (49/92)
Specificity: 79.18% ((11+321+34+25+58)/(34+340+100+30+63))
Positive Prediction Value (PPV): 29.34% (49/(49+23+19+66+5+5))
Negative Prediction Value (NPV) ((11+321+34+25+58)/(43+11+321+34+25+58))
Nudifloramide+LPC 18:0+FAC
When considering all of Nudifloramide, LPC 18:0, and FAC, sensitivity, specificity, PPV, and NPV are shown in Table 6, where the criterion concentrations are Nudifloramide 270 pg/μl, LPC 18:0 1,700,000 au, and FAC 167 pg/μl.
When considering all of Nudifloramide, LPC 18:0, and FAC as indicated in the above results, sensitivity of biliary tract cancer screening is somewhat reduced, but specificity, PPV, and NPV are all increased for clinical use.
The above-described embodiments are illustrative of the present description, and the present description is not limited thereto. It will be understood by those skilled in the art that various changes in form and details may be made therein without departing from the spirit and scope of the invention as defined by the appended claims.
Other features and aspects will be apparent from the following detailed description, the drawings, and the claims.
| Number | Date | Country | Kind |
|---|---|---|---|
| 10-2016-0073340 | Jun 2016 | KR | national |
| Filing Document | Filing Date | Country | Kind |
|---|---|---|---|
| PCT/KR2017/005394 | 5/24/2017 | WO | 00 |
