PROSTATE CANCER DIAGNOSTIC METHOD AND MEANS

Information

  • Patent Application
  • 20190094228
  • Publication Number
    20190094228
  • Date Filed
    March 03, 2017
    8 years ago
  • Date Published
    March 28, 2019
    6 years ago
Abstract
A method is provided of diagnosing prostate cancer or the risk of prostate cancer in a patient by detecting antibodies against the following marker proteins or a selection of at least 2 or at least 20% of the marker proteins of any List provided herein in a patient, including the step of detecting antibodies binding the marker proteins in a sample of the patient; and systems and kits for such methods.
Description

The present invention discloses a method of diagnosing prostate cancer by using specific markers from a set, having diagnostic power for prostate cancer diagnosis and distinguishing prostate cancer in diverse samples.


Neoplasms and cancer are abnormal growths of cells. Cancer cells rapidly reproduce despite restriction of space, nutrients shared by other cells, or signals sent from the body to stop re-production. Cancer cells are often shaped differently from healthy cells, do not function properly, and can spread into many areas of the body. Abnormal growths of tissue, called tumours, are clusters of cells that are capable of growing and dividing uncontrollably. Tumours can be benign (noncancerous) or malignant (cancerous). Benign tumours tend to grow slowly and do not spread. Malignant tumours can grow rapidly, invade and destroy nearby normal tissues, and spread throughout the body. Malignant cancers can be both locally invasive and metastatic. Locally invasive cancers can invade the tissues surrounding it by sending out “fingers” of cancerous cells into the normal tissue. Metastatic cancers can send cells into other tissues in the body, which may be distant from the original tumour. Cancers are classified according to the kind of fluid or tissue from which they originate, or according to the location in the body where they first developed. All of these parameters can effectively have an influence on the cancer characteristics, development and progression and subsequently also cancer treatment. Therefore, reliable methods to classify a cancer state or cancer type, taking diverse parameters into consideration is desired.


In cancer-patients serum-antibody profiles change, as well as autoantibodies against the cancerous tissue are generated. Those profile-changes are highly potential of tumour associated antigens as markers for early diagnosis of cancer. The immunogenicity of tumour associated antigens is conferred to mutated amino acid sequences, which expose an altered non-self-epitope. Other explanations for its immunogenicity include alternative splicing, expression of embryonic proteins in adulthood, deregulation of apoptotic or necrotic processes and abnormal cellular localizations (e.g. nuclear proteins being secreted). Other explanations are also implicated of this immunogenicity, including alternative splicing, expression of embryonic proteins in adulthood, deregulation of apoptotic or necrotic processes, abnormal cellular localizations (e.g. nuclear proteins being secreted). Examples of epitopes of the tumour-restricted antigens, encoded by intron sequences (i.e. partially unspliced RNA were translated) have been shown to make the tumour associated antigen highly immunogenic. However until today technical prerequisites per-forming an efficient marker screen were lacking.


WO 02/081638 A2 and US 2007/099209 A1 relate to nucleic acid protein expression profiles in prostate cancer. WO 2009/138392 A described peptide markers in prostate cancer. EP 2000543 A2 relates to genetic expression profiling in prostate cancer.


An object of the present invention is therefore to provide improved markers and the diagnostic use thereof for the treatment of prostate carcinoma.


The provision of specific markers permits a reliable diagnosis and stratification of patients with prostate carcinoma, in particular by means of a protein biochip.


The invention therefore relates to the use of marker proteins for the diagnosis of prostate carcinoma, wherein at least one marker protein is selected from the marker proteins of List 4 or any other marker list presented herein. The markers of List 4 are (identified by Genesymbol): OXA1L, GOLM1, NRXN2, PAPSS1, GNAI2, FTSJD2, CERS1, FNTB, MYO19, ADCK3, DHCR24, TUBGCP2, LRFN5, PSA, ATAT1, SH3BGRL, LARP1, NPC2 (includes EG:10577), UNK, ATRX, PSMA7, LCMT1, VPS37D, MITD1, CRYGD, AKR1B1, PRKAR1B, ALKBH2, CCL2, GNAI2, MTF2 (includes EG:17765), RHOG, ARMCX1, LSM12 (includes EG:124801), WDR1, RSBN1L, LAMB2, DEDD2, NEUROD6, KRT8, STX6, MDFI, FBXW5, CYHR1, MGEA5, FAHD2B, EDC4, PSD, RPL36A, ZNF238, PIK3IP1, PPIA, PRKD2, DCP1A, LCAT, MYO1F, GSTM3, PRIC285, CRABP2, CCDC136, CSF1R, ARHGAP25, IDH2, NPM1, PAF1 (includes EG:361531), HNRPDL, COPZ1, PSMC3, PRDM8, ZNF514, UBR4, WDR73, RHOB, C19orf25, MMP14, LTBP3, NUP88, DPP9, SPSB3, TSKU, TNFAIP8L2, SYS1 (includes EG:336339), RPL37A, GSTM4, PKNOX1, DRAP1, HN1, BAG6, HSPA9, LRRC47, XRCC1 (includes EG:22594), CUX1, COPS6, NSUN5P1, PSAP, LSM14B, NCBP2, SDHA, FAM98C, MAD2L1, PPP2R1A, COL4A1, CYFIP1, PRDX5, FAM220A, RPS7, EZR, EXOSC8, FAM20C, SRA1, ETS2, SLA, SERPINA1, LARS, SLIT1, FHL1 (includes EG:14199), PTPRA, ELAVL3, BBIP1, HNRNPH1, PLXNA1, PPP2R1A, IVNS1ABP, PRDX1, THOC3, PELI1, PHF2, OCIAD2, PAK6, FIS1 (includes EG:288584), IL16, IDH1, SRSF1, PABPC1, C8orf33, ARHGEF18, ACTR1B, ANKS3, ZC3H12A, PCBP1, LCK, SRM, STMN4, EPC1, NLRP1, PTOV1, C12orf51, WDR1, TCF19, ZXDC, VARS, HTATIP2, PCM1, ATCAY, PRDX3, NSD1, DUS1L, GABARAP, FAM21A/FAM21C, SPRY1, ADAR, KNDC1, HMGN2, AHCTF1, NFKB1, DCHS1, CARHSP1, CORO7/CORO7-PAM16, SSR4, KIAA1109, ABT1, PCDH7, AXIN1, TPX2, SH2B1, RPS4Y1, AKR1C4, PAM, UNC13B, HLA-C, NUDT16L1, ZNF462, NPC2 (includes EG:10577), PUM1, EDF1, COMT, PSMB10, LSM14B, SNF8, CTSW, MTUS1, ARID5A, PSMC4, KIAA0753, SFTPB, EPS15L1, ABHD8, HK1, DNM2, WASL, VPS18, ASF1B, VAV2, PPAP2B, HDAC2, SNRPD3, MICU1, C1orf131, NTAN1, SCG5, REC8 (includes EG:290227), LRPPRC, PPDX, ENO1, PCDHB14, WASL, PLA2G2A, THOC3, PAFAH1B3, PTK7, SERBP1, HNRNPA1, RASGRP2, NUP88, FAM118B, TNKS1BP1, H19, NECAP2, TK1, PLBD1, CFL1, ITGA3, ZNF668, CDKN2D, RHOT2, AKT2, NARFL, PPP2R3B, ABTB1, EMILIN1, TBC1D9B, PKM, ADNP, PPP1R12A, MRC2, PPIL1, TNKS1BP1, FGB, PPIE, SRSF4, BLOC1S1, CNPY3, IRF3, WRB, TOP2B, PDXDC1, CRAT, TCERG1, CAPZB, BABAM1, HSPA5, CNOT3, EIF3C/EIF3CL, IL17RA, DUT, GIPC1, OGFR, LMTK2, BIRC2, LCP2, CDC37, FOSB, ARFRP1, GSTP1, MYH9 (includes EG:17886), MTCH1, PSMB5, HIST3H2A, PIK3R5, NCKAP5L, C9orf86, DDX39B, TINAGL1, RGS1, INPPL1, MAN2C1, PRKCZ, DDOST, EHD1, USP5, PLEC, SLC35A2, HARS, SMG8, RPL10A, ARHGDIA, C22orf46, KRBA1, NFATC3, ATP5D, COPE, SMYD4, E2F1, KDM3A, PIK3R2, CLIC1, USP28, MORF4L1, POLR2G, TRIM78P, COG4, RHOT2, TACC2, YWHAE, IP6K2, IKBKB, RPA3, AKR1B1, CACNA1E, POTEE/POTEF, KLHL23/PHOSPHO2-KLHL23, MEPCE, EIF5A, WDR1, DOCKS, PLXNB2, NR4A1, RPL4, MBD1, VCP, H19, RARA, CDH2, KIF2A, FXYD5, PPA1, EEF1G, RIC8A, ZNF12, B4GALT2, NONO, FNDC4, SMARCC2, CYR61, PPP1CA, NDUFS2, OBFC1, WASH1/WASH5P, HSPA4, PBXIP1, WASH1/WASH5P, PLCG1, HMGB2, GTF2F1, UBC, CELF3, KIF1A, KARS, RNF216, TGS1, NFIX, SGSH, PLEKHO1, TAOK2, MLL5, LAMB1, ZNF431, C17orf28, BAZ1B, UHRF2, ATP5SL, PEX7, TSC2, TMSB10/TMSB4X, HNRNPA1, LIMS2, TBC1D13, UROD, KLF4, BZW2, SULF2, HLA-E, PRRC2A, TBC1D2, H3F3A/H3F3B, GRK6, HIP1R, ARPC5L, NFKB2, SF3B2, PSMC3, ARPC1B, NEUROD2, MGA, Clorf122, SYNE2, NOA1, INPP5F, CDK5RAP3, PABPC1, MDN1, LARP4B, UBE3C, HAGH, NIN, HDAC10, RPS4Y2, GMIP, CCDC88C, ATP1B3, SPOCK2, CYFIP2, TAF1C, WDR25, BAZ1A, NFKBIA, HLA-B, TYK2, C19orf6, SERBP1, SLC25A3, QARS, PPP1R9B, DOCK2, AP2S1, DIS3L, CCNB1IP1, ZNF761, SMARCC2, MKS1 (includes EG:287612), FCHO1, TYMP, COQ6, TELO2, XPNPEP3, TXNDC11, TRIO, HIVEP3, CD44, KPNB1, PCBP2, NPEPL1, PLCB2, FBXO6, PRMT1, ATXN7L2, TADA3, MRPL38 (includes EG:303685), PTBP1, MAGED4/MAGED4B, SEC16A, SLC35B2, ADAMTS10, ZNF256, GBAS, DNMT3A, KCNJ14, PEPD, PITRM1, LSM14A, NDUFV1, TOX2, CAD, HCFC1, WDR11, POLR2J4, TOLLIP, SUGP1, CHGA, HDAC1, HSP90AB1, KLF5, SNX9, UQCRC1, GALK1, KIAA1731, HSPG2, TLN1, COPS6, TMED3, DUS2L, PPP1R9B, LOC407835, TNRC6B, PKM, DAK, VDAC1, LRP4, ULK3, PHKB, NBEA, GTF3C1, IVNS1ABP, AHCY, WDR82, HACL1, GOLGA4, USP22, KIF2A, APOBEC3A, TTC27, TMEM131, YWHAQ, SEC24B, ZNF439, HTRA1, WDTC1, LARP7, BIN3, PTPRO, GET4, SUPV3L1, TUBB2B, EEFSEC, DHX34, PDZD4, MYCBP2, BRD9, GATA1, USP39, DFFA, USP7, ATP8B3, UBE2N, C17orf28, EIF3C/EIF3CL, IMPDH1, SART3, ANXA1. The expression of any of these markers and the emergence of auto-antibodies in a patient are indicators for prostate cancer. Antibodies can be detected according to the invention.


Although the detection of a single marker can be sufficient to indicate a risk for prostate cancer, it is preferred to use more than one marker, e.g. 2, 3, 4, 5, 6, 7, 8, 9, 10, 11 or 12 or more markers in combination, especially if combined with statistical analysis. Means for statistical analysis can e.g. be provided on a computer-readable memory device for operation on a computer. Such analysis means, e.g. a computer program, may be capable to analyse marker measurement data and comparison to evaluate a risk of prostate cancer. From a diagnostic point of view, a single autoantigen based diagnosis can be improved by increasing sensitivity and specificity by using a panel of markers where multiple auto-antibodies are being detected simultaneously. Auto-antibodies in a sample can be detected by binding to the marker proteins or their antigenic fragments or epitopes. Particular preferred combinations are of markers within one of the marker lists 1 to 13, 3p1, 3p2, 3p3 as identified further herein.


The inventive markers are suitable protein antigens that are overexpressed in tumours. The markers usually cause an antibody reaction in a patient. Therefore, the most convenient method to detect the presence of these markers in a patient is to detect (auto) antibodies against these marker proteins in a sample from the patient, especially a body fluid sample, such as blood, plasma or serum.


To detect an antibody in a sample it is possible to use marker proteins as binding agents and subsequently to detect bound antibodies. It is not necessary to use the entire marker proteins but it is sufficient to use antigenic fragments that are bound by the antibodies. “Antigenic fragment” herein relates to a fragment of the marker protein that causes an immune reaction against said marker protein in a human, especially a male. Preferred antigenic fragments of any one of the inventive marker proteins are the fragments of the clones as identified by the UniqueID or cloneID. Such antigenic fragments may be antigenic in a plurality of humans, such as at least 5, or at least 10 individuals.


“Diagnosis” for the purposes of this invention means the positive determination of prostate carcinoma by means of the marker proteins according to the invention as well as the assignment of the patients to prostate carcinoma. The term “diagnosis” covers medical diagnostics and examinations in this regard, in particular in-vitro diagnostics and laboratory diagnostics, likewise proteomics and peptide blotting. Further tests can be necessary to be sure and to exclude other diseases. The term “diagnosis” therefore likewise covers the differential diagnosis of prostate carcinoma by means of the marker proteins according to the invention and the risk or prognosis of prostate carcinoma.


The invention and any marker described herein can be used to distinguish between normal benign prostate hyperplasia and prostate cancer. A positive result in distinguishing said indications can prompt a further cancer test, in particular more invasive tests than a blood test such as a biopsy. Especially preferred the invention is combined with a PSA test.


The inventive markers are preferably grouped in sets of high distinctive value. Such a grouping can be according to lists 3p1, 3p2, 3p3, 5-13.


In particular embodiments, the invention provides the method of diagnosing prostate cancer or the risk of prostate cancer in a patient by detecting at least 2, 3, 4, 5, 6 or more or any number as disclosed above, of the marker proteins selected from the markers of each List 1-13, 3p1, 3p2 or 3p2 in a patient comprising the step of detecting antibodies binding said marker proteins, detecting said marker proteins or antigenic fragments thereof in a sample of the patient. Also provided is a method of diagnosing prostate cancer or the risk of prostate cancer in a patient by detecting at least 20%, preferably at least 30%, especially preferred at least 40%, at least 50%, at least 60%, at least 70%, at least 80% at least 90% or all of the marker proteins selected from the markers of each List 1-13, 3p1, 3p2, 3p3 in a patient comprising the step of detecting antibodies binding said marker proteins, detecting said marker proteins or antigenic fragments thereof in a sample of the patient.


Especially preferred is a combination of detecting at least 2, 3, 4, 5, 6 or more of the markers of List 1, which are OXA1L, GOLM1, NRXN2, PAPSS1, GNAI2, FTSJD2, CERS1, FNTB, MYO19, ADCK3, SDHA, FAM184A. Especially preferred, in any set for detection of the invention, markers SDHA and/or FAM184A are used. These markers proved to have the highest versatility independent of detection platform, e.g. microarray detection or ELISA. These sets allow especially good results when combined with a PSA test. In particular preferred is a combination of OXA1L and GOLM1, which can be further combined with any one or more marker of List 1, e.g. NRXN2, PAPSS1, GNAI2, FTSJD2, CERS1, FNTB, MYO19, ADCK3, SDHA, FAM184A or with any one or more of the markers of List 4. Also preferred is a combination of detecting at least 2, 3, 4, 5, 6 or more of the markers of List 5, which are ATAT1, CCDC136, CDK5RAP3, GOLGA4, HCFC1, HLA-C, HNRNPA1, MYO19, NONO, PLEC, PPP1R9B, SNX9, SULF2, USP5, WDR1 and ZC3H12A. These markers resulted in very good prostate vs. benign classification.


Also preferred is a combination of detecting at least 2, 3, 4, 5, 6 or more of the markers of List 6, which are ARID5A, EIF3C, FCHO1, HAGH, IVNS1ABP, KLHL23, LARP7, NDUFS2, PLXNB2, SMARCC2, TOLLIP, TRIO and WDR11. These markers resulted in very good prostate vs. benign classification.


Also preferred is a combination of detecting at least 2, 3, 4, 5, 6 or more of the markers of List 7, which are AKR1C4, B4GALT2, BRD9, COPS6, EEFSEC, HCFC1, MYO1F, NBEA, NEUROD2, PPP1CA, PSMC4, RASGRP2, RPA3, SMG8, SUGP1, TMEM131 and TUBB2B. These markers resulted in very good prostate vs. benign classification.


Also preferred is a combination of detecting at least 2, 3, 4, 5, 6 or more of the markers of List 8, which are NRXN2, GNAI2, PAPSS1, CERS1, GOLM1, MYO19, ADCK3, FAM184A, FNTB, SDHA. These markers resulted in very good discriminatory power.


Also preferred is a combination of detecting at least 2, 3, 4, 5, 6 or more of the markers of List 9, which are PSMA7, PSA, NRXN2, PAPSS1, FAM20C, NUP88, PTOV1, DRAP1, ASF1B, CAPZB, PCBP1, PPP1R12A, PSMC4, LTBP3, FNTB, EDC4, SSR4, SMARCC2, LAMB2, GOLM1. These markers resulted in very good discriminatory power.


Also preferred is a combination of detecting at least 2, 3, 4, 5, 6 or more of the markers of List 10, which are PSMC4, DNMT3A, TGS1, NRXN2, GRK6, TBC1D2, ZNF431, DUS2L, MGA, LSM14. These markers resulted in very good discriminatory power.


Also preferred is a combination of detecting at least 2, 3, 4, 5, 6 or more of the markers of List 11, which are PLEC, RPL36A, HSP90AB1, UBR4, NRXN2, ABTB1, GSTP1, HARS, ARFRP1, USP5. These markers resulted in very good discriminatory power.


Also preferred is a combination of detecting at least 2, 3, 4, 5, 6 or more of the markers of List 12, which are HIST3H2A, RPS4Y2, HAGH, HNRPDL, COPZ1, CRAT, GET4, SUPV3L1, ACTR1B, UBE3C. These markers resulted in very good discriminatory power.


Also preferred is a combination of detecting at least 2, 3, 4, 5, 6 or more of the markers of List 13, which are PSMA7, PSA, NRXN2, PAPSS1, PLXNB2, FAM20C, TOLLIP, LSM14B, KDM3A, SYNE2. These markers resulted in very good discriminatory power.


Also preferred is a combination of detecting at least 2, 3, 4, 5, 6, 7, 8, 9, 10 or more of the markers of List 3p1, which are. This list is given in the examples. List 3p1 is a part of list 3 and the markers performed remarkably well. Indeed any combination of markers of list 3p1. A random permutation analysis, i.e. repeated random picks of markers of this list showed even with low marker amounts exceptional classification rates (See FIG. 11).


Also preferred is a combination of detecting at least 2, 3, 4, 5, 6, 7, 8, 9, 10 or more of the markers of List 3p2, which are. This list is given in the examples. List 3p2 is a part of list 3 and the markers performed remarkably well. Indeed any combination of markers of list 3p2. A random permutation analysis, i.e. repeated random picks of markers of this list showed even with low marker amounts exceptional classification rates (See FIG. 12).


Also preferred is a combination of detecting at least 2, 3, 4, 5, 6, 7, 8, 9, 10 or more of the markers of List 3p3, which are. This list is given in the examples. List 3p3 is a part of list 3 and the markers performed remarkably well. Indeed any combination of markers of list 3p3. A random permutation analysis, i.e. repeated random picks of markers of this list showed even with low marker amounts exceptional classification rates (See FIG. 13).


In particular preferred are the markers as shown in FIGS. 1 to 6, which were evaluated according to a best subset selection from the indicated list of origin. From left to right, additional markers are added to the ones on the left and each incremental marker addition substantially increases classification accuracy. Preferably, the invention provides at least 2, 3, 4, 5, 6 or more markers from any set as disclosed in any of FIGS. 1 to 6. Preferably, the at least 2, 3, 4, 5, 6 or more markers are picked from the markers shown left to right as shown in the figures.


“Marker” or “marker proteins” are diagnostic indicators found in a patient and are detected, directly or indirectly by the inventive methods. Indirect detection is preferred. In particular, all of the inventive markers have been shown to cause the production of (auto)antigens in cancer patients or patients with a risk of developing cancer. The easiest way to detect these markers is thus to detect these (auto)antibodies in a blood or serum sample from the patient. Such antibodies can be detected by binding to their respective antigen in an assay. Such antigens are in particular the marker proteins themselves or antigenic fragments thereof. Suitable methods exist in the art to specifically detect such antibody-antigen reactions and can be used according to the invention. Preferably the entire antibody content of the sample is normalized (e.g. diluted to a pre-set concentration) and applied to the antigens. Preferably the IgG, IgM, IgD, IgA or IgE antibody fraction, is exclusively used. Preferred antibodies are IgG. Preferably the subject is a human, in particular a male.


Some markers are more preferred than others. Especially preferred markers are those which are represented at least 2, at least 3, at least 4, at least 5, at least 6, times in any one of lists 1 to 13, 3p1, 3p2, 3p3. These markers are preferably used in any one of the inventive methods or sets.


The present invention also relates to a method of selecting such at least 2 markers (or more as given above) or at least 20% of the markers (or more as given above) of any one of the inventive sets with high specificity. Such a method includes comparisons of signal data for the inventive markers of any one of the inventive markers sets, especially as listed in lists 1 to 13, with said signal data being obtained from control samples of known prostate cancer conditions or indications and further statistically comparing said signal data with said conditions thereby obtaining a significant pattern of signal data capable of distinguishing the conditions of the known control samples.


In particular, the control samples may comprise one or more cancerous control (preferably at least 5, or at least 10 cancerous controls) and a healthy or non-cancerous control (preferably at least 5, or at least 10 healthy controls). Preferably 2 different indications are selected that shall be distinguished


The control samples can be used to obtain a marker dependent signal pattern as indication classifier. Such a signal pattern can be obtained by routine statistical methods, such as binary tree methods. Common statistical methods calculate a (optionally multi-dimensional) vector within the multitude of control data signal values as diagnostically significant distinguishing parameter that can be used to distinguish one or more indications from other one or more indications. The step usually comprises the step of “training” a computer software with said control data. Such pre-obtained training data or signal data can be provided on a computer-readable medium to a practitioner who performs the inventive diagnosis.


Preferably, the method comprises optimizing the selection process, e.g. by selecting alternative or additional markers and repeating said comparison with the controls signals, until a specificity and/or sensitivity of at least 75% is obtained, preferably of at least 80%, at least 85%, at least 90%, at least 95%.


Binding events can be detected as known in the art, e.g. by using labelled secondary antibodies. Such labels can be enzymatic, fluorescent, radioactive or a nucleic acid sequence tag. Such labels can also be provided on the binding means, e.g. the antigens as described in the previous paragraph. Nucleic acid sequence tags are especially preferred labels since they can be used as sequence code that not only leads to quantitative information but also to a qualitative identification of the detection means (e.g. antibody with certain specificity). Nucleic acid sequence tags can be used in known methods such as Immuno-PCR. In multiplex assays, usually qualitative information is tied to a specific location, e.g. spot on a microarray. With qualitative information provided in the label, it is not necessary to use such localized immunoassays. In is possible to perform the binding reaction of the analyte and the detection means, e.g. the serum antibody and the labelled antigen, independent of any solid supports in solution and obtain the sequence information of the detection means bound to its analyte. A binding reaction allows amplification of the nucleic acid label in a detection reaction, followed by determination of the nucleic acid sequence determination. With said determined sequence the type of detection means can be determined and hence the marker (analyte, e.g. serum antibody with tumour associated antigen specificity).


Preferably the inventive method further comprises detecting PSA in a sample from a patient comprising the step of said marker protein or antigenic fragments thereof in a sample of the patient. PSA protein can be detected according to any standard test known. The PSA blood test is the current standard for prostate cancer diagnosis, and has an accuracy of about 60-66% if used alone. Surprisingly, the accuracy can be substantially increased if combined with any other marker or list combination according to the invention. The other markers are preferably tested by detecting auto-antibodies, contrary to PSA, which is preferably tested by determining blood, plasma or serum PSA protein that is bound directly to a detection agent, like an affinity capturing agent. Both, PSA protein (see example 5 and references therein) or nucleic acids (McDermed et al., 2012, Clinical Chemistry 58(4): 732-740) can be detected in the sample. PSA protein in the sample can be detected by an affinity assay, preferably with an immobilized affinity capturing agent. An affinity capturing agent is e.g. an antibody or functional fragment thereof. Immobilization is preferably on a solid support, e.g. a microtiter well, a microarray plate or a bead. Such a PSA capturing agent and preferably also a secondary antibody to PSA with a label can be used in the inventive method or provided in the inventive kit. Nucleic acids are preferably detected by a hybridization probe, with optional amplification, especially preferred is immune-PCR.


In preferred embodiments of the invention the step of detecting antibodies binding said marker proteins, detecting said marker proteins or antigenic fragments thereof comprises comparing said detection signal with detection signals of a benign prostate hyperplasia controls and comparing said detection signals, wherein an increase in the detection signal indicates prostate cancer or said risk of prostate cancer.


In preferred embodiments of the invention the step of detecting antibodies binding said marker proteins, detecting said marker proteins or antigenic fragments thereof comprises comparing said detection signal with detection signals of a cancerous control and comparing said detection signals. In particular preferred, especially in cases of using more marker sets of 2 or more markers as mentioned above, a statistical analysis of the control is performed, wherein the controls are used to obtain a marker dependent signal pattern as indication classifier and the marker dependent signals of the sample to be analysed is compared with and/or fitted onto said pattern thereby obtaining information of the diagnosed condition or indication. Such statistical analysis is usually dependent on the used analytical platform that was used to obtain the signal data, given that signal data may vary from platform to platform. Such platforms are e.g. different microarray or solution based setups (with different labels or analytes—such as antigen fragments—for a particular marker). Thus the statistical method can be used to calibrate each platform to obtain diagnostic information with high sensitivity and specificity. The step usually comprises the step of “training” a computer software with said control data. Alternatively, pre-obtained training data can be used. Such pre-obtained training data or signal data can be provided on a computer-readable medium to a practitioner.


In further embodiments a detection signal from the sample of a patient in amplitude of at least 60%, preferably at least 80%, of the cancerous control indicates prostate cancer or said risk of prostate cancer.


Usually not all of the inventive markers or detection agents may lead to a signal. Nevertheless only a fraction of the signals is suitable to arrive at a diagnostic decision. In preferred embodiments of the invention a detection signal in at least 60%, preferably at least 70%, least 75%, at least 85%, or in particular preferred at least 95%, even more preferred all, of the used markers indicates prostate cancer or said risk of prostate cancer.


The present diagnostic methods further provide necessary therapeutic information to decide on a surgical intervention. Therefore the present invention also provides a method of treating a patient comprising prostate cancer or according to any aspect or embodiment of the invention and removing said prostate cancer. “Stratification or therapy control” for the purposes of this invention means that the method according to the invention renders possible decisions for the treatment and therapy of the patient, whether it is the hospitalization of the patient, the use, effect and/or dosage of one or more drugs, a therapeutic measure or the monitoring of a course of the disease and the course of therapy or etiology or classification of a disease, e.g., into a new or existing subtype or the differentiation of diseases and the patients thereof.


One skilled in the art is familiar with expression libraries, they can be produced according to standard works, such as Sambrook et al, “Molecular Cloning, A laboratory handbook, 2nd edition (1989), CSH press, Cold Spring Harbor, N.Y. Expression libraries are also preferred which are tissue-specific (e.g., human tissue, in particular human organs). Members of such libraries can be used as inventive antigen for use as detection agent to bind analyte antibodies. Furthermore included according to the invention are expression libraries that can be obtained by exon-trapping. A synonym for expression library is expression bank. Also preferred are protein biochips or corresponding expression libraries that do not exhibit any redundancy (so-called: Uniclone® library) and that may be produced, for example, according to the teachings of WO 99/57311 and WO 99/57312. These preferred Uniclone libraries have a high portion of non-defective fully expressed proteins of a cDNA expression library. Within the context of this invention, the antigens can be obtained from organisms that can also be, but need not be limited to, transformed bacteria, recombinant phages, or transformed cells from mammals, insects, fungi, yeasts, or plants. The marker antigens can be fixed, spotted, or immobilized on a solid support. Alternatively, it is also possible to perform an assay in solution, such as an Immuno-PCR assay.


In a further aspect, the present invention provides a kit of diagnostic agents suitable to detect any marker or marker combination as described above, preferably wherein said diagnostic agents comprise marker proteins or antigenic fragments thereof suitable to bind antibodies in a sample, especially preferred wherein said diagnostic agents are immobilized on a solid support or in solution, especially when said markers are each labelled with a unique label, such as a unique nucleic acid sequence tag. The inventive kit may further comprise detection agents, such as secondary antibodies, in particular anti-human antibodies, and optionally also buffers and dilution reagents.


The invention therefore likewise relates to the object of providing a diagnostic device or an assay, in particular a protein biochip, ELISA or Immuno-PCR assay, which permits a diagnosis or examination for prostate carcinoma.


Additionally, the marker proteins (as binding moieties for antibody detection) can be present in the respective form of a fusion protein, which contains, for example, at least one affinity epitope or tag. The tag may be one such as contains c-myc, his tag, arg tag, FLAG, alkaline phosphatase, VS tag, T7 tag or strep tag, HAT tag, NusA, S tag, SBP tag, thioredoxin, DsbA, a fusion protein, preferably a cellulose-binding domain, green fluorescent protein, maltose-binding protein, calmodulin-binding protein, glutathione S-transferase, or lacZ, a nanoparticle or a nucleic acid sequence tag. Such a nucleic acid sequence can be e.g. DNA or RNA, preferably DNA.


In all of the embodiments, the term “solid support” covers embodiments such as a filter, a membrane, a magnetic or fluorophore-labeled bead, a silica wafer, glass, metal, ceramics, plastics, a chip, a target for mass spectrometry, a matrix, a bead or microtiter well. However, a filter is preferred according to the invention.


As a filter, furthermore PVDF, nitrocellulose, or nylon is preferred (e.g., Immobilon P Millipore, Protran Whatman, Hybond N+ Amersham).


In another preferred embodiment of the arrangement according to the invention, the arrangement corresponds to a grid with the dimensions of a microtiter plate (8-12 wells strips, 96 wells, 384 wells, or more), a silica wafer, a chip, a target for mass spectrometry, or a matrix.


Another method for detection of the markers is an immunosorbent assay, such as ELISA. When detecting autoantibodies, preferably the marker protein or at least an epitope containing fragment thereof, is bound to a solid support, e.g. a microtiter well. The autoantibody of a sample is bound to this antigen or fragment. Bound autoantibodies can be detected by secondary antibodies with a detectable label, e.g. a fluorescence label. The label is then used to generate a signal in dependence of binding to the autoantibodies. The secondary antibody may be an antihuman antibody if the patient is human or be directed against any other organism in dependence of the patient sample to be analysed. The kit may comprise means for such an assay, such as the solid support and preferably also the secondary antibody. Preferably the secondary antibody binds to the Fc part of the (auto) antibodies of the patient. Also possible is the addition of buffers and washing or rinsing solutions. The solid support may be coated with a blocking compound to avoid unspecific binding.


Preferably the inventive kit also comprises non-diagnostic control proteins, which can be used for signal normalization. These control proteins bind to moieties, e.g. proteins or antibodies, in the sample of a diseased patient same as in a benign prostate hyperplasia controls. In addition to the inventive marker proteins any number, but preferably at least 2 controls can be used in the method or in the kit.


Preferably the inventive kit is limited to a particular size. According to these embodiments of the invention the kit comprises at most 3000 diagnostic agents, preferably at most 2500 diagnostic agents, at most 2000 diagnostic agents, at most 1500 diagnostic agents, at most 1200 diagnostic agents, at most 1000 diagnostic agents, at most 800 diagnostic agents, at most 500 diagnostic agents, at most 300 diagnostic agents, at most 200 diagnostic agents, at most 100 diagnostic agents, such as marker proteins or antigenic fragments thereof.


In especially preferred embodiments of the invention the kit further comprises a computer-readable medium or a computer program product, such as a computer readable memory devices like a flash storage, CD-, DVD- or BR-disc or a hard drive, comprising signal data for the control samples with known conditions selected from cancer and/or of benign prostate hyperplasia controls, and/or calibration or training data for analysing said markers provided in the kit for diagnosing prostate cancer or distinguishing conditions or indications selected from benign prostate hyperplasia controls.


The kit may also comprise normalization standards, that result in a signal independent of a benign prostate hyperplasia controls condition and cancerous condition. Such normalization standards can be used to obtain background signals. Such standards may be specific for ubiquitous antibodies found in a human, such as antibodies against common bacteria such as E. coli. Preferably the normalization standards include positive and negative (leading to no specific signal) normalization standards.


Preferred embodiments of the invention that is described herein are defined as follows:


1. Method of diagnosing prostate cancer or the risk of prostate cancer in a patient by detecting the following marker proteins or a selection of at least 2 or at least 20% of the marker proteins selected from OXA1L, GOLM1, NRXN2, PAPSS1, GNAI2, FTSJD2, CERS1, FNTB, MYO19, ADCK3, SDHA, FAM184A (List 1) in a patient, comprising the step of detecting antibodies binding said marker proteins, detecting said marker proteins or antigenic fragments thereof in a sample of the patient.


2. Method of diagnosing prostate cancer or the risk of prostate cancer in a patient by detecting at least 2 or at least 20% of the marker proteins selected from the markers of any one of List 2, 3, 4 or any combination thereof in a patient, comprising the step of detecting antibodies binding said marker proteins, detecting said marker proteins or antigenic fragments thereof in a sample of the patient.


3. Method according to 2 comprising detecting a marker protein selected from any one of Lists 5, 6, 7, 8, 9, 10, 11, 12 or 13 in a patient, comprising the step of detecting antibodies binding said marker protein, detecting said marker protein or antigenic fragments thereof in a sample of the patient.


4. Method according to 2 comprising detecting at least 2 or at least 20% of the marker proteins selected from the markers of any one of Lists 5, 6, 7, 8, 9, 10, 11, 12 or 13 in a patient, comprising the step of detecting antibodies binding said marker proteins, detecting said marker proteins or antigenic fragments thereof in a sample of the patient.


5. Method according to 2 comprising detecting at least 2 or at least 20% of the marker proteins selected from the markers of any one of Lists 3p1, 3p2, 3p3 in a patient, comprising the step of detecting antibodies binding said marker proteins, detecting said marker proteins or antigenic fragments thereof in a sample of the patient.


6. Method according to any one of 1 to 5, comprising detecting at least markers SDHA and/or FAM184A in a patient, comprising the step of detecting antibodies binding said marker proteins, detecting said marker proteins or antigenic fragments thereof in a sample of the patient.


7. Method according to any one of 1 to 6, further comprising detecting PSA in a sample from a patient comprising the step of said marker protein or antigenic fragments thereof in a sample of the patient.


8. Method according to 7, wherein PSA protein in the sample is detected by an affinity assay, preferably with an immobilized affinity capturing agent.


9. The method of any one of 1 to 8, wherein the step of detecting antibodies binding said marker proteins, detecting said marker proteins or antigenic fragments thereof comprises comparing said detection signal with detection signals of a healthy control and comparing said detection signals, wherein an increase in the detection signal indicates prostate cancer.


10. The method of any one of 1 to 9, a) wherein the step of detecting antibodies binding said marker proteins, detecting said marker proteins or antigenic fragments thereof comprises comparing said detection signal with detection signals of one or more known prostate cancer control sample, preferably wherein the control signals are used to obtain a marker dependent signal pattern as indication classifier and the marker dependent signals of the patient is compared with and/or fitted onto said pattern, thereby obtaining information of the diagnosed condition.


11. The method of any one of 1 to 10, a) wherein the step of detecting antibodies binding said marker proteins, detecting said marker proteins or antigenic fragments thereof comprises comparing said detection signal with detection signals of a cancerous control and comparing said detection signals, wherein a detection signal from the sample of the patient in amplitude of at least 60%, preferably at least 80%, of the cancerous control indicates prostate cancer; or b) wherein a detection signal in at least 60%, preferably at least 75%, of the used markers indicates prostate cancer.


12. The method of treating a patient comprising prostate cancer, comprising detecting cancer according to any one of 1 to 11 and removing said prostate cancer or treating prostate cancer cells of said patient by anti-cancer therapy, preferably with a chemo- or radiotherapeutic agent.


13. A kit of diagnostic agents suitable to detect any marker or marker combination as defined in 1 to 9, preferably wherein said diagnostic agents comprise marker proteins or antigenic fragments thereof suitable to bind antibodies in a sample, especially preferred wherein said diagnostic agents are immobilized on a solid support, optionally further comprising a computer-readable medium or a computer program product, comprising signal data for control samples with known conditions selected from cancer, and/or calibration or training data for analysing said markers provided in the kit for diagnosing prostate cancer or distinguishing conditions selected from healthy conditions, cancer.


14. The kit of 13 comprising a labelled secondary antibody, preferably for detecting an Fc part of antibodies of the patient.


15. The kit of 13 or 14 comprising at most 3000 diagnostic agents, preferably at most 2500 diagnostic agents, at most 2000 diagnostic agents, at most 1500 diagnostic agents, at most 1200 diagnostic agents, at most 1000 diagnostic agents, at most 800 diagnostic agents, at most 500 diagnostic agents, at most 300 diagnostic agents, at most 200 diagnostic agents, at most 100 diagnostic agents.


The present invention is further illustrated by the following figures and examples, without being limited to these embodiments of the invention.





FIGURES


FIG. 1 shows the best subset selection for List 8.



FIG. 2 shows the best subset selection for List 9.



FIG. 3 shows the best subset selection for List 10.



FIG. 4 shows the best subset selection for List 11.



FIG. 5 shows the best subset selection for List 12.



FIG. 6 shows the best subset selection for List 13.



FIG. 7 shows a permutation analysis of the markers of List 1.



FIG. 8 shows a permutation analysis of the markers of List 2.



FIG. 9 shows a permutation analysis of the markers of List 3.



FIG. 10 shows a permutation analysis of the markers of List 4.



FIG. 11 shows a permutation analysis of the markers of List 3p1.



FIG. 12 shows a permutation analysis of the markers of List 3p2.



FIG. 13 shows a permutation analysis of the markers of List 3p3.





EXAMPLES
Example 1: Patient Samples

Biomarker screening has been performed with serum samples from a test set of serum samples derived from 49 individuals with confirmed prostate-carcinoma and 49 benign prostate hyperplasia controls (n=98). All these individuals have been elucidated either by histologically verified PCa cases (prostateoscopy) and hospital-based controls with benign prostate hyperplasia in which the presence of PCa was excluded either clinically (13/49 or 27%) or histologically (36/49 or 73%).


Example 2: Immunoglobuline (IgG) Purification from the Serum or Plasma Samples

The patient serum or plasma samples were stored at −80° C. before they were put on ice to thaw them for IgG purification using Melon Gel 96-well Spin Plate according the manufacturer's instructions (Pierce). In short, 10 μl of thawed sample was diluted in 90 μl of the equilibrated purification buffer on ice, then transferred onto Melon Gel support and incubated on a plate shaker at 500 rpm for 5 minutes. Centrifugation at 1,000×g for 2 minutes was done to collect the purified IgG into the collection plate.


Protein concentrations of the collected IgG samples were measured by absorbance measures at 280 nm using an Epoch Micro-Volume Spectrophotometer System (Biotec, USA). IgG-concentrations of all samples were concentration-adjusted and 0.4 mg/ml of samples were diluted 1:1 in PBS2× buffer with TritonX 0.2% and 6% skim milk powder for microarray analyses.


Example 3: Microarray Design

A protein-chip named “16 k protein chip” from 15,417 human cDNA expression clones derived from the Unipex cDNA expression library plus technical controls was generated. Using this 16 k protein chip candidate markers were used to identify autoantibody profiles suitable for unequivocal distinction of prostate cancer and benign prostate hyperplasia controls.


Protein-microarray generation and processing was using the Unipex cDNA expression library for recombinant protein expression in E. coli. His-tagged recombinant proteins were purified using Ni-metal chelate chromatography and proteins were spotted in duplicates for generation of the microarray using ARChipEpoxy slides.


Example 4: Preparation, Processing and Analyses of Protein Microarrays

The microarray with printed duplicates of the protein marker candidates was blocked with DIG Easy Hyb (Roche) in a stirred glass tank for 30 minutes. Blocked slides were washed 3× for 5 minutes with fresh PBSTritonX 0.1% washing buffer with agitation. The slides were rinsed in distilled water for 15 seconds to complete the washing step and remove leftovers from the washing buffer. Arrays were spun dry at 900 rpm for 2 minutes. Microarrays were processed using the Agilent Microarray Hybridisation Chambers (Agilent) and Agilent's gasket slides filled with 490 μl of the prepared sample mixture and processed in a hybridization oven for 4h at RT with a rotation speed of 12. During this hybridization time the samples were kept under permanent rotating conditions to assure a homolog dispensation.


After the hybridization was done, the microarray slides were washed 3× with the PBSTritonX 0.1% washing buffer in the glass tank with agitation for 5 minutes and rinsed in distilled water for about 15 seconds. Then, slides were dried by centrifugation at 900 rpm for 2 minutes. IgG bound onto the features of the protein-microarrays were detected by incubation with cy5 conjugated Alexa Fluor® 647 Goat Anti-Human IgG (H+L) (Invitrogen, Lofer, Austria), diluted in 1:10,000 in PBSTritonX 0.1% and 3% skim milk powder using rotating conditions for 1 h, with a final washing step as outlined above. Microarrays were then scanned and fluorescent data extracted from images (FIG. 1) using the GenePixPro 6.0 software (AXON).


Example 5: PSA Testing

Prostate-specific antigen (PSA) is a 33-kDa glycoprotein with serine protease activity, found in large amounts in the prostate and seminal plasma. PSA measurement is widely accepted and the current diagnostic standard tool for prostatic cancer diagnostics (Stamey et al., 1987 N Engl J Med 1987; 317:909-15; Hudson et al., 1991 J Urol 1991; 145:802-6).


The PSA ELISA test is based on the principle of a solid phase enzyme-linked immunosorbent assay. The assay system utilizes a PSA antibody directed against intact PSA for solid phase immobilization (on the microtiter wells). A monoclonal anti-PSA antibody conjugated to horseradish peroxidase (HRP) is in the antibody-enzyme conjugate solution. The test sample was allowed to react first with the immobilized rabbit antibody at room temperature for 60 minutes. The wells were washed to remove any unbound antigen. The monoclonal anti-PSA-HRP conjugate was then reacted with the immobilized antigen for 60 minutes at room temperature resulting in the PSA molecules being sandwiched between the solid phase and enzyme-linked antibodies.


The wells were washed to remove unbound-labeled antibodies. A solution of TMB Reagent was added and incubated at room temperature for 20 minutes, resulting in the development of a blue color. The color development was stopped with the addition of Stop Solution changing the color to yellow. The concentration of PSA is directly proportional to the color intensity of the test sample. Absorbance is measured spectrophotometrically. The results are reported as nanograms of PSA per milliliter (ng/mL) of blood. Sample signal data was calibrated with a set of standard concentrations.


Example 6: Data Analysis and Permutation Analysis

Data were 1) quantil normalised and alternatively 2) normalised with Combat transformation for removal of batch effects, when samples were processed on microarrays in 3 different runs; data analyses was conducted using BRB array tools (web at linus.nci.nih.gov/BRB-ArrayTools.html) upon quantile normalized data, and the R software upon the 2 different normalization strategies (quantil and Combat DWD normalized) followed by missing value imputation (Trevor Hastie, Robert Tibshirani, Balasubramanian Narasimhan and Gilbert Chu. impute: impute: Imputation for microarray data. R package version 1.42.0.).


For identification of tumour marker profiles and classifier markers, class prediction analyses applying cross-validation was used. Classifiers were built for distinguishing both classes of samples denoted “Carc” carcinoma patients, and “Contr” individuals with benign prostate hyperplasia.


Due to the large redundancy of genes/proteins involved in biological processes (such as tumorigenesis), redundant lists of genes are covered, of which a subset can be used for classification. To show how many randomly chosen markers are necessary for the task of classifying tumor versus control, random sets of 1, 2, 3, . . . markers are drawn from the marker lists and the classification accuracy in cross-validation is reported. Results are shown in FIG. 7-13.


Example 7: Results Summary

For distinguishing 1) Controls vs Carcinomas, after different normalization strategies (quantil and Combat DWD normalized) followed by missing value imputation, the best 10 classifiers were chosen from claim 3, run 1. It was also shown that using only isolated or only 2 markers from the present classifier sets enables correct classification of 1000 (Example 9.7). Therefore the marker-lists, subsets and single markers (antigens; proteins; peptides) are of particular diagnostic values.


In addition it has already been shown that peptides deduced from proteins or seroreactive antigens can be used for diagnostics and in the published setting even improve classification success (Syed 2012; Journal of Molecular Biochemistry; Vol 1, No 2, www.jmolbiochem.com/index.php/JmolBiochem/article/view/54).


Example 8: Group Results

Several lists of marker sets have been identified. All markers are grouped in List 4 recited above. Smaller marker selections portions are provided in Lists 2, 3, 3p1, 3p2 and 3p3. All markers are grouped together in List 4. Lists 3p1, 3p2 and 3p3 were pooled in list 3.


List 2: 268 Marker Proteins Given by their Gene Symbol.


OXA1L, GOLM1, NRXN2, PAPSS1, GNAI2, FTSJD2, CERS1, FNTB, MYO19, ADCK3, DHCR24, TUBGCP2, LRFN5, PSA, ATAT1, SH3BGRL, LARP1, NPC2 (includes EG:10577), UNK, ATRX, PSMA7, LCMT1, VPS37D, MITD1, CRYGD, AKR1B1, PRKAR1B, ALKBH2, CCL2, GNAI2, MTF2 (includes EG:17765), RHOG, ARMCX1, LSM12 (includes EG:124801), WDR1, RSBN1L, LAMB2, DEDD2, NEUROD6, KRT8, STX6, MDFI, FBXW5, CYHR1, MGEA5, FAHD2B, EDC4, PSD, RPL36A, ZNF238, PIK3IP1, PPIA, PRKD2, DCP1A, LCAT, MYO1F, GSTM3, PRIC285, CRABP2, CCDC136, CSF1R, ARHGAP25, IDH2, NPM1, PAF1 (includes EG:361531), HNRPDL, COPZ1, PSMC3, PRDM8, ZNF514, UBR4, WDR73, RHOB, C19orf25, MMP14, LTBP3, NUP88, DPP9, SPSB3, TSKU, TNFAIP8L2, SYS1 (includes EG:336339), RPL37A, GSTM4, PKNOX1, DRAP1, HN1, BAG6, HSPA9, LRRC47, XRCC1 (includes EG:22594), CUX1, COPS6, NSUN5P1, PSAP, LSM14B, NCBP2, SDHA, FAM98C, MAD2L1, PPP2R1A, COL4A1, CYFIP1, PRDX5, FAM220A, RPS7, EZR, EXOSC8, FAM20C, SRA1, ETS2, SLA, SERPINA1, LARS, SLIT1, FHL1 (includes EG:14199), PTPRA, ELAVL3, BBIP1, HNRNPH1, PLXNA1, PPP2R1A, IVNS1ABP, PRDX1, THOC3, PELI1, PHF2, OCIAD2, PAK6, FIS1 (includes EG:288584), IL16, IDH1, SRSF1, PABPC1, C8orf33, ARHGEF18, ACTR1B, ANKS3, ZC3H12A, PCBP1, SRM, STMN4, EPC1, NLRP1, PTOV1, C12orf51, WDR1, TCF19, ZXDC, VARS, HTATIP2, PCM1, ATCAY, PRDX3, NSD1, DUS1L, GABARAP, FAM21A/FAM21C, SPRY1, ADAR, KNDC1, HMGN2, AHCTF1, NFKB1, DCHS1, CARHSP1, CORO7/CORO7-PAM16, SSR4, KIAA1109, ABT1, PCDH7, AXIN1, TPX2, SH2B1, RPS4Y1, AKR1C4, PAM, UNC13B, HLA-C, NUDT16L1, ZNF462, NPC2 (includes EG:10577), PUM1, EDF1, COMT, PSMB10, LSM14B, SNF8, CTSW, MTUS1, ARID5A, PSMC4, KIAA0753, EPS15L1, ABHD8, HK1, DNM2, WASL, VPS18, ASF1B, VAV2, PPAP2B, HDAC2, SNRPD3, MICU1, Clorf131, NTAN1, SCG5, REC8 (includes EG:290227), LRPPRC, PPDX, ENO1, PCDHB14, PLA2G2A, THOC3, PAFAH1B3, PTK7, SERBP1, HNRNPA1, RASGRP2, NUP88, FAM118B, TNKS1BP1, H19, NECAP2, PLBD1, CFL1, ITGA3, ZNF668, CDKN2D, RHOT2, AKT2, NARFL, PPP2R3B, ABTB1, EMILIN1, TBC1D9B, PKM, ADNP, PPP1R12A, MRC2, PPIL1, TNKS1BP1, FGB, PPIE, SRSF4, BLOC1S1, CNPY3, IRF3, WRB, TOP2B, PDXDC1, TCERG1, CAPZB, BABAM1, HSPA5, CNOT3, EIF3C/EIF3CL, IL17RA, OGFR, BIRC2, LCP2, GSTP1, MYH9 (includes EG:17886), PIK3R5, NCKAP5L, RGS1, MAN2C1, EHD1, USP5, PLEC, SLC35A2, RPL10A, ARHGDIA, COPE, KDM3A, SMARCC2


List 3: 282 Marker Proteins Given by their Gene Symbol.


NRXN2, CERS1, MYO19, LRFN5, ATAT1, KRT8, FBXW5, MGEA5, RPL36A, PRKD2, DCP1A, MYO1F, ARHGAP25, HNRPDL, COPZ1, UBR4, WDR73, SPSB3, LRRC47, NSUN5P1, MAD2L1, SLA, FHL1 (includes EG:14199), IDH1, IL16, SRSF1, ZC3H12A, ACTR1B, LCK, VARS, SPRY1, SSR4, TPX2, RPS4Y1, ARID5A, PSMC4, SFTPB, WASL, RASGRP2, TK1, RHOT2, PPP2R3B, ABTB1, PPIL1, IRF3, CRAT, EIF3C/EIF3CL, DUT, GIPC1, LMTK2, CDC37, LCP2, FOSB, ARFRP1, GSTP1, MTCH1, PSMB5, HIST3H2A, PIK3R5, C9orf86, DDX39B, TINAGL1, INPPL1, MAN2C1, PRKCZ, DDOST, USP5, PLEC, HARS, RPL10A, C22orf46, KRBA1, NFATC3, ATP5D, SMYD4, E2F1, PIK3R2, CLIC1, USP28, MORF4L1, POLR2G, TRIM78P, COG4, RHOT2, TACC2, YWHAE, IP6K2, IKBKB, AKR1B1, CACNA1E, POTEE/POTEF, KLHL23/PHOSPHO2-KLHL23, MEPCE, EIF5A, DOCKS, PLXNB2, NR4A1, RPL4, MBD1, VCP, H19, RARA, CDH2, KIF2A, FXYD5, PPA1, EEF1G, RIC8A, ZNF12, B4GALT2, FNDC4, CYR61, OBFC1, WASH1/WASH5P, HSPA4, PBXIP1, WASH1/WASH5P, PLCG1, HMGB2, GTF2F1, UBC, CELF3, KIF1A, KARS, RNF216, TGS1, NFIX, SGSH, PLEKHO1, TAOK2, MLL5, LAMB1, ZNF431, C17orf28, BAZ1B, UHRF2, ATP5SL, PEX7, TSC2, TMSB10/TMSB4X, LIMS2, TBC1D13, UROD, KLF4, BZW2, SULF2, HLA-E, PRRC2A, TBC1D2, H3F3A/H3F3B, GRK6, HIP1R, ARPC5L, NFKB2, SF3B2, PSMC3, ARPC1B, MGA, Clorf122, SYNE2, NOA1, INPP5F, CDK5RAP3, PABPC1, MDN1, LARP4B, UBE3C, HAGH, NIN, HDAC10, RPS4Y2, GMIP, CCDC88C, ATP1B3, SPOCK2, CYFIP2, TAF1C, WDR25, BAZ1A, NFKBIA, HLA-B, TYK2, C19orf6, SERBP1, SLC25A3, QARS, PPP1R9B, DOCK2, AP2S1, DIS3L, CCNB1IP1, ZNF761, MKS1 (includes EG:287612), FCHO1, TYMP, COQ6, TELO2, XPNPEP3, TXNDC11, HIVEP3, CD44, KPNB1, PCBP2, NPEPL1, PLCB2, FBXO6, PRMT1, ATXN7L2, TADA3, MRPL38 (includes EG:303685), PTBP1, MAGED4/MAGED4B, SEC16A, SLC35B2, ADAMTS10, ZNF256, GBAS, DNMT3A, KCNJ14, PEPD, PITRM1, LSM14A, NDUFV1, TOX2, CAD, HCFC1, WDR11, POLR2J4, TOLLIP, CHGA, HDAC1, HSP90AB1, KLF5, UQCRC1, GALK1, KIAA1731, HSPG2, TLN1, TMED3, DUS2L, LOC407835, TNRC6B, PKM, DAK, VDAC1, LRP4, ULK3, PHKB, NBEA, GTF3C1, IVNS1ABP, AHCY, WDR82, HACL1, USP22, KIF2A, APO-BEC3A, TTC27, YWHAQ, SEC24B, ZNF439, HTRA1, WDTC1, LARP7, BIN3, PTPRO, GET4, SUPV3L1, DHX34, PDZD4, MYCBP2, GATA1, USP39, DFFA, USP7, ATP8B3, UBE2N, C17orf28, EIF3C/EIF3CL, IMPDH1, SART3, ANXA1.


Each of these markers has a high correct classification accuracy if taken alone. Classification accuracy is given in the following table by their AUC (area-under-curve) classification values:









TABLE 1







Clone wise AUC classification of the markers of list 2










SYMBOL
AUC













1
OXA1L
0.8088


2
GOLM1
0.8034


3
NRXN2
0.8013


4
PAPSS1
0.7972


5
GNAI2
0.7968


6
FTSJD2
0.7959


7
CERS1
0.7905


8
FNTB
0.7893


9
MYO19
0.7880


10
ADCK3
0.7859


11
DHCR24
0.7822


12
TUBGCP2
0.7805


13
LRFN5
0.7793


14
PSA
0.7768


15
ATAT1
0.7759


16
SH3BGRL
0.7738


17
LARP1
0.7738


18
NPC2
0.7730


19
UNK
0.7726


20
ATRX
0.7722


21
PSMA7
0.7718


22
LCMT1
0.7705


23
VPS37D
0.7697


24
MITD1
0.7680


25
CRYGD
0.7676


26
AKR1B1
0.7672


27
PRKAR1B
0.7668


28
ALKBH2
0.7659


29
CCL2
0.7655


30
GNAI2
0.7655


31
MTF2
0.7634


32
RHOG
0.7626


33
ARMCX1
0.7626


34
LSM12
0.7622


35
WDR1
0.7618


36
RSBN1L
0.7618


37
LAMB2
0.7613


38
DEDD2
0.7605


39
NEUROD6
0.7601


40
KRT8
0.7601


41
STX6
0.7589


42
MDFI
0.7584


43
FBXW5
0.7580


44
CYHR1
0.7568


45
MGEA5
0.7559


46
FAHD2B
0.7551


47
EDC4
0.7551


48
PSD
0.7543


49
RPL36A
0.7539


50
ZNF238
0.7539


51
PIK3IP1
0.7539


52
PPIA
0.7534


53
PRKD2
0.7530


54
DCP1A
0.7518


55
LCAT
0.7505


56
MYO1F
0.7497


57
GSTM3
0.7493


58
PRIC285
0.7493


59
CRABP2
0.7493


60
CCDC136
0.7489


61
CSF1R
0.7476


62
ARHGAP25
0.7472


63
IDH2
0.7472


64
NPM1
0.7472


65
PAF1
0.7472


66
HNRPDL
0.7468


67
COPZ1
0.7468


68
PSMC3
0.7468


69
PRDM8
0.7464


70
ZNF514
0.7464


71
UBR4
0.7443


72
WDR73
0.7439


73
RHOB
0.7434


74
C19orf25
0.7434


75
MMP14
0.7430


76
LTBP3
0.7430


77
NUP88
0.7426


78
DPP9
0.7426


79
SPSB3
0.7426


80
TSKU
0.7414


81
TNFAIP8L2
0.7414


82
SYS1
0.7409


83
RPL37A
0.7409


84
GSTM4
0.7409


85
PKNOX1
0.7405


86
DRAP1
0.7397


87
HN1
0.7397


88
BAG6
0.7397


89
HSPA9
0.7389


90
LRRC47
0.7384


91
XRCC1
0.7380


92
CUX1
0.7376


93
COPS6
0.7372


94
NSUN5P1
0.7372


95
PSAP
0.7364


96
LSM14B
0.7359


97
NCBP2
0.7351


98
SDHA
0.7351


99
FAM98C
0.7343


100
MAD2L1
0.7343


101
PPP2R1A
0.7339


102
COL4A1
0.7339


103
CYFIP1
0.7334


104
PRDX5
0.7330


105
FAM220A
0.7326


106
RPS7
0.7326


107
EZR
0.7322


108
EXOSC8
0.7309


109
FAM20C
0.7309


110
SRA1
0.7305


111
ETS2
0.7305


112
SLA
0.7293


113
SERPINA1
0.7289


114
LARS
0.7284


115
SLIT1
0.7280


116
FHL1
0.7280


117
PTPRA
0.7276


118
ELAVL3
0.7276


119
BBIP1
0.7276


120
HNRNPH1
0.7272


121
PLXNA1
0.7272


122
PPP2R1A
0.7268


123
IVNS1ABP
0.7264


124
PRDX1
0.7264


125
THOC3
0.7259


126
PELI1
0.7259


127
PHF2
0.7255


128
OCIAD2
0.7251


129
PAK6
0.7251


130
FIS1
0.7247


131
IL16
0.7243


132
IDH1
0.7243


133
SRSF1
0.7243


134
PABPC1
0.7239


135
C8orf33
0.7239


136
ARHGEF18
0.7234


137
ACTR1B
0.7234


138
ANKS3
0.7234


139
ZC3H12A
0.7234


140
PCBP1
0.7230


141
SRM
0.7222


142
STMN4
0.7222


143
EPC1
0.7222


144
NLRP1
0.7222


145
PTOV1
0.7218


146
C12orf51
0.7218


147
WDR1
0.7218


148
TCF19
0.7214


149
ZXDC
0.7209


150
VARS
0.7209


151
HTATIP2
0.7205


152
PCM1
0.7205


153
ATCAY
0.7205


154
PRDX3
0.7205


155
NSD1
0.7201


156
DUS1L
0.7197


157
GABARAP
0.7197


158
FAM21A
0.7197


159
SPRY1
0.7193


160
ADAR
0.7193


161
KNDC1
0.7193


162
HMGN2
0.7189


163
AHCTF1
0.7189


164
NFKB1
0.7185


165
DCHS1
0.7185


166
CARHSP1
0.7180


167
CORO7
0.7180


168
SSR4
0.7176


169
KIAA1109
0.7176


170
ABT1
0.7172


171
PCDH7
0.7172


172
AXIN1
0.7164


173
TPX2
0.7164


174
SH2B1
0.7160


175
RPS4Y1
0.7160


176
AKR1C4
0.7160


177
PAM
0.7160


178
UNC13B
0.7155


179
HLA-C
0.7147


180
NUDT16L1
0.7147


181
ZNF462
0.7143


182
NPC2
0.7143


183
PUM1
0.7143


184
EDF1
0.7143


185
COMT
0.7139


186
PSMB10
0.7139


187
LSM14B
0.7139


188
SNF8
0.7130


189
CTSW
0.7130


190
MTUS1
0.7126


191
ARID5A
0.7122


192
PSMC4
0.7122


193
KIAA0753
0.7122


194
EPS15L1
0.7122


195
ABHD8
0.7118


196
HK1
0.7118


197
DNM2
0.7118


198
WASL
0.7118


199
VPS18
0.7110


200
ASF1B
0.7110


201
VAV2
0.7110


202
PPAP2B
0.7110


203
HDAC2
0.7110


204
SNRPD3
0.7110


205
MICU1
0.7105


206
C1orf131
0.7105


207
NTAN1
0.7105


208
SCG5
0.7101


209
REC8
0.7097


210
LRPPRC
0.7097


211
PPOX
0.7093


212
ENO1
0.7089


213
PCDHB14
0.7085


214
PLA2G2A
0.7080


215
THOC3
0.7080


216
PAFAH1B3
0.7080


217
PTK7
0.7080


218
SERBP1
0.7080


219
HNRNPA1
0.7080


220
RASGRP2
0.7076


221
NUP88
0.7072


222
FAM118B
0.7072


223
TNKS1BP1
0.7072


224
H19
0.7072


225
NECAP2
0.7064


226
PLBD1
0.7055


227
CFL1
0.7055


228
ITGA3
0.7055


229
ZNF668
0.7055


230
CDKN2D
0.7051


231
RHOT2
0.7047


232
AKT2
0.7043


233
NARFL
0.7039


234
PPP2R3B
0.7039


235
ABTB1
0.7030


236
EMILIN1
0.7030


237
TBC1D9B
0.7030


238
PKM
0.7026


239
ADNP
0.7026


240
PPP1R12A
0.7022


241
MRC2
0.7018


242
PPIL1
0.7018


243
TNKS1BP1
0.7014


244
FGB
0.7014


245
PPIE
0.7010


246
SRSF4
0.7005


247
BLOC1S1
0.7001


248
CNPY3
0.6985


249
IRF3
0.6985


250
WRB
0.6980


251
TOP2B
0.6968


252
PDXDC1
0.6968


253
TCERG1
0.6943


254
CAPZB
0.6935


255
BABAM1
0.6930


256
HSPA5
0.6930


257
CNOT3
0.6918


258
EIF3C
0.6914


259
IL17RA
0.6914


260
OGFR
0.6893


261
BIRC2
0.6880


262
LCP2
0.6880


263
GSTP1
0.6868


264
MYH9
0.6860


265
PIK3R5
0.6843


266
NCKAP5L
0.6843


267
RGS1
0.6830


268
MAN2C1
0.6801


269
EHD1
0.6797


270
USP5
0.6793


271
PLEC
0.6793


272
SLC35A2
0.6789


273
RPL10A
0.6768


274
ARHGDIA
0.6760


275
COPE
0.6735


276
KDM3A
0.6718


277
SMARCC2
0.6460
















TABLE 2







Clone wise AUC classification of the markers of list 3










SYMBOL
AUC













1
NRXN2
0.8013


2
CERS1
0.7905


3
MYO19
0.7880


4
LRFN5
0.7793


5
ATAT1
0.7759


6
KRT8
0.7601


7
FBXW5
0.7580


8
MGEA5
0.7559


9
RPL36A
0.7539


10
PRKD2
0.7530


11
DCP1A
0.7518


12
MYO1F
0.7497


13
ARHGAP25
0.7472


14
HNRPDL
0.7468


15
COPZ1
0.7468


16
UBR4
0.7443


17
WDR73
0.7439


18
SPSB3
0.7426


19
LRRC47
0.7384


20
NSUN5P1
0.7372


21
MAD2L1
0.7343


22
SLA
0.7293


23
FHL1
0.7280


24
IDH1
0.7243


25
IL16
0.7243


26
SRSF1
0.7243


27
ZC3H12A
0.7234


28
ACTR1B
0.7234


29
LCK
0.7222


30
VARS
0.7209


31
SPRY1
0.7193


32
SSR4
0.7176


33
TPX2
0.7164


34
RPS4Y1
0.7160


35
ARID5A
0.7122


36
PSMC4
0.7122


37
SFTPB
0.7122


38
WASL
0.7085


39
RASGRP2
0.7076


40
TK1
0.7060


41
RHOT2
0.7047


42
PPP2R3B
0.7039


43
ABTB1
0.7030


44
PPIL1
0.7018


45
IRF3
0.6985


46
CRAT
0.6955


47
EIF3C
0.6914


48
DUT
0.6905


49
GIPC1
0.6897


50
LMTK2
0.6889


51
CDC37
0.6880


52
LCP2
0.6880


53
FOSB
0.6880


54
ARFRP1
0.6876


55
GSTP1
0.6868


56
MTCH1
0.6860


57
PSMB5
0.6851


58
HIST3H2A
0.6847


59
PIK3R5
0.6843


60
C9orf86
0.6839


61
DDX39B
0.6835


62
TINAGL1
0.6830


63
INPPL1
0.6822


64
MAN2C1
0.6801


65
PRKCZ
0.6797


66
DDOST
0.6797


67
USP5
0.6793


68
PLEC
0.6793


69
HARS
0.6781


70
RPL10A
0.6768


71
C22orf46
0.6747


72
KRBA1
0.6743


73
NFATC3
0.6743


74
ATP5D
0.6743


75
SMYD4
0.6735


76
E2F1
0.6731


77
PIK3R2
0.6706


78
CLIC1
0.6701


79
USP28
0.6697


80
MORF4L1
0.6693


81
POLR2G
0.6689


82
TRIM78P
0.6685


83
COG4
0.6672


84
RHOT2
0.6668


85
TACC2
0.6668


86
YWHAE
0.6664


87
IP6K2
0.6664


88
IKBKB
0.6656


89
AKR1B1
0.6626


90
CACNA1E
0.6626


91
POTEE
0.6626


92
KLHL23
0.6622


93
MEPCE
0.6614


94
EIF5A
0.6593


95
DOCK9
0.6581


96
PLXNB2
0.6581


97
NR4A1
0.6576


98
RPL4
0.6576


99
MBD1
0.6560


100
VCP
0.6551


101
H19
0.6535


102
RARA
0.6535


103
CDH2
0.6514


104
KIF2A
0.6510


105
FXYD5
0.6506


106
PPA1
0.6497


107
EEF1G
0.6493


108
RIC8A
0.6493


109
ZNF12
0.6485


110
B4GALT2
0.6472


111
FNDC4
0.6468


112
CYR61
0.6443


113
OBFC1
0.6426


114
WASH1
0.6422


115
HSPA4
0.6418


116
PBXIP1
0.6418


117
WASH1
0.6418


118
PLCG1
0.6410


119
HMGB2
0.6410


120
GTF2F1
0.6406


121
UBC
0.6397


122
CELF3
0.6393


123
KIF1A
0.6389


124
KARS
0.6385


125
RNF216
0.6385


126
TGS1
0.6381


127
NFIX
0.6381


128
SGSH
0.6368


129
PLEKHO1
0.6368


130
TAOK2
0.6364


131
MLL5
0.6347


132
LAMB1
0.6347


133
ZNF431
0.6347


134
C17orf28
0.6343


135
BAZ1B
0.6343


136
UHRF2
0.6335


137
ATP5SL
0.6318


138
PEX7
0.6318


139
TSC2
0.6318


140
TMSB10
0.6310


141
LIMS2
0.6306


142
TBC1D13
0.6302


143
UROD
0.6302


144
KLF4
0.6293


145
BZW2
0.6289


146
SULF2
0.6277


147
HLA-E
0.6277


148
PRRC2A
0.6272


149
TBC1D2
0.6252


150
H3F3A
0.6227


151
GRK6
0.6227


152
HIP1R
0.6222


153
ARPC5L
0.6210


154
NFKB2
0.6210


155
SF3B2
0.6193


156
PSMC3
0.6185


157
ARPC1B
0.6185


158
MGA
0.6177


159
C1orf122
0.6177


160
SYNE2
0.6177


161
NOA1
0.6168


162
INPP5F
0.6168


163
CDK5RAP3
0.6168


164
PABPC1
0.6168


165
MDN1
0.6147


166
LARP4B
0.6139


167
UBE3C
0.6139


168
HAGH
0.6127


169
NIN
0.6122


170
HDAC10
0.6122


171
RPS4Y2
0.6118


172
GMIP
0.6118


173
CCDC88C
0.6102


174
ATP1B3
0.6077


175
SPOCK2
0.6064


176
CYFIP2
0.6064


177
TAF1C
0.6056


178
WDR25
0.6052


179
BAZ1A
0.6047


180
NFKBIA
0.6043


181
HLA-B
0.6035


182
TYK2
0.6027


183
C19orf6
0.6027


184
SERBP1
0.6022


185
SLC25A3
0.6018


186
QARS
0.6018


187
PPP1R9B
0.6018


188
DOCK2
0.6014


189
AP2S1
0.6006


190
DIS3L
0.6006


191
CCNB1IP1
0.5998


192
ZNF761
0.5993


193
MKS1
0.5956


194
FCHO1
0.5956


195
TYMP
0.5948


196
COQ6
0.5948


197
TELO2
0.5935


198
XPNPEP3
0.5927


199
TXNDC11
0.5914


200
HIVEP3
0.5902


201
CD44
0.5898


202
KPNB1
0.5868


203
PCBP2
0.5864


204
NPEPL1
0.5856


205
PLCB2
0.5852


206
FBXO6
0.5848


207
PRMT1
0.5835


208
ATXN7L2
0.5814


209
TADA3
0.5793


210
MRPL38
0.5789


211
PTBP1
0.5785


212
MAGED4
0.5781


213
SEC16A
0.5764


214
SLC35B2
0.5764


215
ADAMTS10
0.5756


216
ZNF256
0.5748


217
GBAS
0.5739


218
DNMT3A
0.5731


219
KCNJ14
0.5718


220
PEPD
0.5718


221
PITRM1
0.5706


222
LSM14A
0.5706


223
NDUFV1
0.5702


224
TOX2
0.5689


225
CAD
0.5685


226
HCFC1
0.5673


227
WDR11
0.5668


228
POLR2J4
0.5656


229
TOLLIP
0.5656


230
CHGA
0.5652


231
HDAC1
0.5643


232
HSP90AB1
0.5639


233
KLF5
0.5618


234
UQCRC1
0.5614


235
GALK1
0.5610


236
KIAA1731
0.5589


237
HSPG2
0.5589


238
TLN1
0.5577


239
TMED3
0.5569


240
DUS2L
0.5564


241
LOC407835
0.5556


242
TNRC6B
0.5556


243
PKM
0.5552


244
DAK
0.5552


245
VDAC1
0.5539


246
LRP4
0.5535


247
ULK3
0.5523


248
PHKB
0.5506


249
NBEA
0.5506


250
GTF3C1
0.5498


251
IVNS1ABP
0.5498


252
AHCY
0.5485


253
WDR82
0.5464


254
HACL1
0.5452


255
USP22
0.5402


256
KIF2A
0.5385


257
APOBEC3A
0.5385


258
TTC27
0.5369


259
YWHAQ
0.5360


260
SEC24B
0.5356


261
ZNF439
0.5352


262
HTRA1
0.5339


263
WDTC1
0.5339


264
LARP7
0.5335


265
BIN3
0.5319


266
PTPRO
0.5314


267
GET4
0.5310


268
SUPV3L1
0.5298


269
DHX34
0.5231


270
PDZD4
0.5219


271
MYCBP2
0.5214


272
GATA1
0.5169


273
USP39
0.5165


274
DFFA
0.5152


275
USP7
0.5144


276
ATP8B3
0.5144


277
UBE2N
0.5131


278
C17orf28
0.5102


279
EIF3C
0.5094


280
IMPDH1
0.5077


281
SART3
0.5040


282
ANXA1
0.5015









These markers are especially potent when used in combination with other markers. FIGS. 7-10 show a random permutation analysis of these markers when taken alone or in any combination of 2, 3, 4 or more markers.


When splitting the markers of list 3 into the following subgroups, even higher correct classification results from low numbers of random markers of these lists were obtained (see FIG. 11-13). The subgroups are:


List 3p1:

NRXN2, LRFN5, KRT8, FBXW5, MGEA5, DCP1A, MYO1F, ARHGAP25, WDR73, NSUN5P1, FHL1 (includes EG:14199), IDH1, VARS, SPRY1, PSMC4, SFTPB, WASL, RASGRP2, TK1, RHOT2, PPP2R3B, PPIL1, GIPC1, LMTK2, CDC37, FOSB, PIK3R5, C22orf46, NFATC3, E2F1, MORF4L1, YWHAE, CACNA1E, RPL4, VCP, RARA, KIF2A, EEF1G, B4GALT2, PBXIP1, GTF2F1, RNF216, TGS1, NFIX, TAOK2, MLL5, ZNF431, TMSB10/TMSB4X, LIMS2, PRRC2A, TBC1D2, GRK6, PSMC3, MGA, Clorf122, MDN1, LARP4B, NIN, CCDC88C, SPOCK2, NFKBIA, C19orf6, DOCK2, AP2S1, COQ6, TXNDC11, HIVEP3, PLCB2, PTBP1, DNMT3A, KCNJ14, LSM14A, CHGA, KLF5, GALK1, DUS2L, NBEA, WDR82, USP22, KIF2A, BIN3, PTPRO, USP39, UBE2N, ANXA1.


List 3p2:

NRXN2, MYO19, ATAT1, RPL36A, UBR4, SPSB3, LRRC47, IL16, ZC3H12A, LCK, TPX2, RPS4Y1, ABTB1, IRF3, EIF3C/EIF3CL, DUT, LCP2, ARFRP1, GSTP1, DDX39B, MAN2C1, PRKCZ, USP5, PLEC, HARS, RPL10A, KRBA1, CLIC1, USP28, POLR2G, TRIM78P, RHOT2, TACC2, IP6K2, IKBKB, EIF5A, NR4A1, MBD1, CDH2, FXYD5, RIC8A, FNDC4, OBFC1, HMGB2, UBC, SGSH, LAMB1, UHRF2, PEX7, TSC2, TBC1D13, SULF2, HLA-E, HIP1R, NFKB2, SF3B2, ARPC1B, SYNE2, CDK5RAP3, CYFIP2, BAZ1A, HLA-B, TYK2, SERBP1, DIS3L, ZNF761, TYMP, XPNPEP3, CD44, SEC16A, PEPD, HCFC1, HSP90AB1, UQCRC1, TLN1, DAK, PHKB, GTF3C1, HTRA1, DFFA, ATP8B3, UBE2N.


List 3p3:

CERS1, KRT8, PRKD2, HNRPDL, COPZ1, MAD2L1, SLA, SRSF1, ACTR1B, SSR4, ARID5A, CRAT, MTCH1, PSMB5, HIST3H2A, C9orf86, TINAGL1, INPPL1, DDOST, ATP5D, SMYD4, PIK3R2, COG4, AKR1B1, POTEE/POTEF, KLHL23/PHOSPHO2-KLHL23, MEPCE, DOCKS, PLXNB2, H19, PPA1, ZNF12, CYR61, WASH1/WASH5P, HSPA4, WASH1/WASH5P, PLCG1, CELF3, KIF1A, KARS, PLEKHO1, C17orf28, BAZ1B, ATP5SL, UROD, KLF4, BZW2, H3F3A/H3F3B, ARPC5L, NOA1, INPP5F, PABPC1, UBE3C, HAGH, HDAC10, RPS4Y2, GMIP, ATP1B3, TAF1C, WDR25, SLC25A3, QARS, PPP1R9B, CCNB1IP1, MKS1 (includes EG:287612), FCHO1, TELO2, KPNB1, PCBP2, NPEPL1, FBXO6, PRMT1, ATXN7L2, TADA3, MRPL38 (includes EG:303685), MAGED4/MAGED4B, SLC35B2, ADAMTS10, ZNF256, GBAS, PITRM1, NDUFV1, TOX2, CAD, WDR11, POLR2J4, TOLLIP, HDAC1, KI-AA1731, HSPG2, TMED3, LOC407835, TNRC6B, PKM, VDAC1, LRP4, ULK3, IVNS1ABP, AHCY, HACL1, APOBEC3A, TTC27, YWHAQ, SEC24B, ZNF439, WDTC1, LARP7, GET4, SUPV3L1, DHX34, PDZD4, MYCBP2, GATA1, USP39, USP7, C17orf28, EIF3C/EIF3CL, IMPDH1, SART3.


Example 9: Detailed Results
Example 9.1: “Carc Vs. Contr”—Top 10 Genes Selected by their AUC Value

The following markers were identified according to this example (Quantil-normalised data):


List 1: 12 Marker Proteins Given by their Gene Symbol:


OXA1L, GOLM1, NRXN2, PAPSS1, GNAI2, FTSJD2, CERS1, FNTB, MYO19, ADCK3, SDHA, FAM184A
















SYMBOL
AUC



















OXA1L
0.80883



GOLM1
0.803415



NRXN2
0.801333



PAPSS1
0.797168



GNAI2
0.796751



FTSJD2
0.795918



CERS1
0.790504



FNTB
0.789254



MYO19
0.788005



ADCK3
0.785923



SDHA
0.73511



FAM184A
0.556018










Example 9.2: “Carc Vs Contr”—8 Greedy Pairs Algorithm->1NN 100%

The following markers were identified according to this example (Quantil-normalised data):


List 5: 16 Marker Proteins Given by their Gene Symbol:


ATAT1, CCDC136, CDK5RAP3, GOLGA4, HCFC1, HLA-C, HNRNPA1, MYO19, NONO, PLEC, PPP1R9B, SNX9, SULF2, USP5, WDR1 and ZC3H12A.


The “greedy pairs” strategy was used for class prediction of the first 36 (18 carcinoma; 18 control) samples of run2, and it was possible to very efficiently build a classifier for distinguishing “Carc” versus “Contr”. Using “8 greedy pairs” of features on arrays, the 1-Nearest Neighbour Predictor (1-NN) enabled correct classification of 100% of samples.


Greedy pairs algorithm was used to select 8 pairs of genes. Repeated 1 times K-fold (K=20) cross-validation method was used to compute misclassification rate.


Performance of Classifiers During Cross-Validation.






















Diagonal




Bayesian



Compound
Linear



Support
Compound



Covariate
Discriminant

3-Nearest
Nearest
Vector
Covariate



Predictor
Analysis
1-Nearest
Neighbors
Centroid
Machines
Predictor



Correct?
Correct?
Neighbor
Correct?
Correct?
Correct?
Correct?























Mean percent
92
94
100
94
92
94
94


of correct


classification:









Performance of the 1-Nearest Neighbor Classifier:



















Class
Sensitivity
Specificity
PPV
NPV






















Case
1
1
1
1



Control
1
1
1
1










Example 9.3: “Carc Vs. Contr”—p<5e-06→100%

The following markers were identified according to this example (Quantil-normalised data):


List 6: 13 Marker Proteins Given by their Gene Symbol:


ARID5A, EIF3C, FCHO1, HAGH, IVNS1ABP, KLHL23, LARP7, NDUFS2, PLXNB2, SMARCC2, TOLLIP, TRIO and WDR11.


Genes significantly different between the classes at 5e-06 significance level were used for class prediction for the first (14 carcinoma; 14 control) samples of run3, and it was possible to very efficiently build classifiers for distinguishing “Contr” versus “Carc”. The Diagonal Linear Discriminant Analysis (DLDA) and 3-Nearest Neighbor Predictor (3-NN) enabled best correct classification of 100% of samples.


Genes significantly different between the classes at 5e-06 significance level were used to select genes. Leave-one-out cross-validation method was used to compute misclassification rate.


Performance of Classifiers During Cross-Validation.






















Diagonal




Bayesian



Compound
Linear



Support
Compound



Covariate
Discriminant

3-Nearest
Nearest
Vector
Covariate



Predictior
Analysis
1-Nearest
Neighbors
Centroid
Machines
Predictor



Correct?
Correct?
Neighbor
Correct?
Correct?
Correct?
Correct?























Mean percent
96
100
96
100
96
93
96


of correct


classification:









Performance of the Diagonal Linear Discriminant Analysis Classifier:



















Class
Sensitivity
Specificity
PPV
NPV






















Case
1
1
1
1



Control
1
1
1
1










Performance of the 3-Nearest Neighbors Classifier:



















Class
Sensitivity
Specificity
PPV
NPV






















Case
1
1
1
1



Control
1
1
1
1










Example 9.4: “Carc Vs. Contr”— p<0.000005→91%

The following markers were identified according to this example (Quantil-normalised data):


List 7: 17 Marker Proteins Given by their Gene Symbol:


AKR1C4, B4GALT2, BRD9, COPS6, EEFSEC, HCFC1, MYO1F, NBEA, NEU-ROD2, PPP1CA, PSMC4, RASGRP2, RPA3, SMG8, SUGP1, TMEM131 and TUBB2B.


As in the previous example, genes significantly different between the classes at 5e-06 significance level were used for class prediction for the first 35 (18 carcinoma; 17 control) samples of run 1, and it was possible to very efficiently build classifiers for distinguishing “Carc” versus “Contr”. The 1-Nearest Neighbor Predictor (1-NN) enabled best correct classification of 91% of samples.


Genes significantly different between the classes at 5e-06 significance level were used to select genes. Leave-one-out cross-validation method was used to compute misclassification rate.


Performance of Classifiers During Cross-Validation.






















Diagonal




Bayesian



Compound
Linear



Support
Compound



Covariate
Discriminant

3-Nearest
Nearest
Vector
Covariate



Predictor
Analysis
1-Nearest
Neighbors
Centroid
Machines
Predictor



Correct?
Correct?
Neighbor
Correct?
Correct?
Correct?
Correct?























Mean percent
89
86
91
89
89
86
90


of correct


classification:









Performance of the 1-Nearest Neighbor Classifier:



















Class
Sensitivity
Specificity
PPV
NPV






















Case
1
0.824
0.857
1



Control
0.824
1
1
0.857










Example 9.5: “Carc Vs. Contr”—Best Discriminatory Power

The top ten genes (by AUC value) discriminating between the classes from claim 1 were used for search of the best discriminatory power. A best subset selection was created by starting with the best discriminator (by cross-validated prediction accuracy using SVM) and sequentially adding new features from claim 1 which most improve classification accuracy. This was repeated for the first 10 features.
















SYMBOL
CV accuracy



















NRXN2
74.31973



GNAI2
80.13605



PAPSS1
86.90476



CERS1
89.52381



GOLM1
93.60544



MYO19
93.91156



ADCK3
95.81633



FAM184A
95.57823



FNTB
95.57823



SDHA
94.79592











List 8: 10 Marker Proteins Given by their Gene Symbol:


NRXN2, GNAI2, PAPSS1, CERS1, GOLM1, MYO19, ADCK3, FAM184A, FNTB, SDHA (see FIG. 1 for accuracy of best subset selection)


Example 9.6: “Carc Vs. Contr”—Best Discriminatory Power

The top ten genes (by AUC value) discriminating between the classes from claim 2 were used for search of the best discriminatory power. A best subset selection was created by starting with the best discriminator (by cross-validated prediction accuracy using SVM) and sequentially adding new features from claim 2 which most improve classification accuracy. The following is the list of the best subset selection. This was repeated for the first 20 features.
















Symbol
CV accuracy (SVM)



















PSMA7
74.38776



PSA
83.60544



NRXN2
89.82993



PAPSS1
94.4898



FAM20C
95.47619



NUP88
98.26531



PTOV1
99.69388



DRAP1
99.96599



ASF1B
99.96599



CAPZB
100



PCBP1
100



PPP1R12A
100



PSMC4
100



LTBP3
100



FNTB
99.96599



EDC4
99.7619



SSR4
99.72789



SMARCC2
99.79592



LAMB2
99.96599











List 9: 19 Marker Proteins Given by their Gene Symbol:


PSMA7, PSA, NRXN2, PAPSS1, FAM20C, NUP88, PTOV1, DRAP1, ASF1B, CAPZB, PCBP1, PPP1R12A, PSMC4, LTBP3, FNTB, EDC4, SSR4, SMARCC2, LAMB2, GOLM1 (see FIG. 2 for accuracy of best subset selection)


Example 9.7: “Carc Vs. Contr”—Best Discriminatory Power

Genes significantly different between the classes from claim 3, run 1 were used for search of the best discriminatory power. The following is the list of the best subset selection.
















Symbol
CV accuracy (SVM)



















PSMC4
93.33333



DNMT3A
100



TGS1
100



NRXN2
100



GRK6
100



TBC1D2
100



ZNF431
100



DUS2L
100



MGA
100











List 10: 9 Marker Proteins Given by their Gene Symbol.


PSMC4, DNMT3A, TGS1, NRXN2, GRK6, TBC1D2, ZNF431, DUS2L, MGA, LSM14A (see FIG. 3 for accuracy of best subset selection)


Example 9.8: “Carc Vs. Contr”—Best Discriminatory Power

Genes significantly different between the classes from claim 3, run 2 were used for search of the best discriminatory power. The following is the list of the best subset selection.
















Symbol
CV accuracy (SVM)



















PLEC
93.2381



RPL36A
94.47619



HSP90AB1
99.42857



UBR4
100



NRXN2
100



ABTB1
100



GSTP1
100



HARS
100



ARFRP1
100



USP5
100











List 11: 10 Marker Proteins Given by their Gene Symbol:


PLEC, RPL36A, HSP90AB1, UBR4, NRXN2, ABTB1, GSTP1, HARS, ARFRP1, USP5 (see FIG. 4 for accuracy of best subset selection)


Example 9.9: “Carc Vs. Contr”—Best Discriminatory Power

Genes significantly different between the classes from claim 3, run 3 were used for search of the best discriminatory power. The following is the list of the best subset selection.
















Symbol
CV accuracy (SVM)



















HIST3H2A
97.02381



RPS4Y2
100



HAGH
100



HNRPDL
100



COPZ1
100



CRAT
100



GET4
100



SUPV3L1
100



ACTR1B
100



UBE3C
100











List 12: 10 Marker Proteins Given by their Gene Symbol:


HIST3H2A, RPS4Y2, HAGH, HNRPDL, COPZ1, CRAT, GET4, SUPV3L1, ACTR1B, UBE3C (see FIG. 5 for accuracy of best subset selection)


Example 9.10: “Carc Vs. Contr”—Best Discriminatory Power

Genes significantly different between the classes from claim 4 were used for search of the best discriminatory power. The following is the list of the best subset selection.
















Symbol
CV accuracy (SVM)



















PSMA7
74.42177



PSA
83.60544



NRXN2
89.42177



PAPSS1
94.42177



PLXNB2
96.15646



FAM20C
97.92517



TOLLIP
99.69388



LSM14B
99.96599



KDM3A
100



SYNE2
99.96599











List 13: 10 Marker Proteins Given by their Gene Symbol:


PSMA7, PSA, NRXN2, PAPSS1, PLXNB2, FAM20C, TOLLIP, LSM14B, KDM3A, SYNE2 (see FIG. 6 for accuracy of best subset selection).

Claims
  • 1. A method of diagnosing prostate cancer or the risk of prostate cancer in a patient by detecting antibodies against the following marker proteins or a selection of at least 2 or at least 20% of the marker proteins selected from OXA1L, GOLM1, NRXN2, PAPSS1, GNAI2, FTSJD2, CERS1, FNTB, MYO19, ADCK3, SDHA, FAM184A (List 1) in a patient, comprising the step of detecting antibodies binding said marker proteins in a sample of the patient.
  • 2. The method of diagnosing prostate cancer or the risk of prostate cancer in a patient by detecting antibodies against at least 2 or at least 20% of the marker proteins selected from the markers of any one of List 2, 3, 4 or any combination thereof in a patient, comprising the step of detecting antibodies binding said marker proteins in a sample of the patient.
  • 3. The method according to claim 2 comprising detecting an antibody against a marker protein selected from any one of Lists 5, 6, 7, 8, 9, 10, 11, 12 or 13 in a patient, comprising the step of detecting antibodies binding said marker protein in a sample of the patient.
  • 4. The method according to claim 2 comprising detecting antibodies against at least 2 or at least 20% of the marker proteins selected from the markers of any one of Lists 5, 6, 7, 8, 9, 10, 11, 12 or 13 in a patient, comprising the step of detecting antibodies binding said marker proteins in a sample of the patient.
  • 5. The method according to claim 2 comprising detecting antibodies against at least 2 or at least 20% of the marker proteins selected from the markers of any one of Lists 3p1, 3p2, 3p3 in a patient, comprising the step of detecting antibodies binding said marker proteins in a sample of the patient.
  • 6. The method according to claim 1, comprising detecting at least markers SDHA and/or FAM184A in a patient, comprising the step of detecting antibodies binding said marker proteins in a sample of the patient.
  • 7. The method according to claim 1, further comprising detecting PSA in a sample from a patient comprising the step of said marker protein or antigenic fragments thereof in a sample of the patient.
  • 8. The method according to claim 7, wherein PSA protein in the sample is detected by an affinity assay, preferably with an immobilized affinity capturing agent.
  • 9. The method of claim 1, wherein the step of detecting antibodies binding said marker proteins comprises comparing said detection signal with detection signals of a healthy control and comparing said detection signals, wherein an increase in the detection signal indicates prostate cancer.
  • 10. The method of claim 1, wherein the step of detecting antibodies binding said marker proteins comprises comparing said detection signal with detection signals of one or more known prostate cancer control sample, preferably wherein the control signals are used to obtain a marker dependent signal pattern as indication classifier and the marker dependent signals of the patient is compared with and/or fitted onto said pattern, thereby obtaining information of the diagnosed condition.
  • 11. The method of claim 1, wherein the step of detecting antibodies binding said marker proteins comprises comparing said detection signal with detection signals of a cancerous control and comparing said detection signals, wherein a detection signal from the sample of the patient in amplitude of at least 60%, preferably at least 80%, of the cancerous control indicates prostate cancer; or b) wherein a detection signal in at least 60%, preferably at least 75%, of the used markers indicates prostate cancer.
  • 12. The method of treating a patient comprising prostate cancer, comprising detecting cancer according to claim 1 and removing said prostate cancer or treating prostate cancer cells of said patient by anti-cancer therapy, preferably with a chemo- or radiotherapeutic agent.
  • 13. A kit of diagnostic agents suitable to detect antibodies against any marker or marker combination as defined in claim 1, wherein said diagnostic agents comprise marker proteins or antigenic fragments thereof suitable to bind antibodies in a sample, preferably wherein said diagnostic agents are immobilized on a solid support, optionally further comprising a computer-readable medium or a computer program product, comprising signal data for control samples with known conditions selected from cancer, and/or calibration or training data for analysing said markers provided in the kit for diagnosing prostate cancer or distinguishing conditions selected from healthy conditions, cancer.
  • 14. The kit of claim 13 comprising a labelled secondary antibody, preferably for detecting an Fc part of antibodies of the patient.
  • 15. The kit of claim 13 comprising at most 3000 diagnostic agents, preferably at most 2500 diagnostic agents, at most 2000 diagnostic agents, at most 1500 diagnostic agents, at most 1200 diagnostic agents, at most 1000 diagnostic agents, at most 800 diagnostic agents, at most 500 diagnostic agents, at most 300 diagnostic agents, at most 200 diagnostic agents, at most 100 diagnostic agents.
Priority Claims (1)
Number Date Country Kind
16158770.4 Mar 2016 EP regional
PCT Information
Filing Document Filing Date Country Kind
PCT/EP2017/054979 3/3/2017 WO 00