Shadfan Basil H, Simmons Archana R, Simmons Glennon W, Ho Andy, Wong Jorge, Lu Karen H, Bast Robert C, McDevitt John T
Department of Chemistry, Rice University, Houston, Texas.
Department of Chemistry, Rice University, Houston, Texas. Department of Bioengineering, Rice University, Houston, Texas.
Cancer Prev Res (Phila). 2015 Jan;8(1):37-48. doi: 10.1158/1940-6207.CAPR-14-0248. Epub 2014 Nov 11.
Point-of-care (POC) diagnostic platforms have the potential to enable low-cost, large-scale screening. As no single biomarker is shed by all ovarian cancers, multiplexed biomarker panels promise improved sensitivity and specificity to address the unmet need for early detection of ovarian cancer. We have configured the programmable bio-nano-chip (p-BNC)-a multiplexable, microfluidic, modular platform-to quantify a novel multi-marker panel comprising CA125, HE4, MMP-7, and CA72-4. The p-BNC is a bead-based immunoanalyzer system with a credit-card-sized footprint that integrates automated sample metering, bubble and debris removal, reagent storage and waste disposal, permitting POC analysis. Multiplexed p-BNC immunoassays demonstrated high specificity, low cross-reactivity, low limits of detection suitable for early detection, and a short analysis time of 43 minutes. Day-to-day variability, a critical factor for longitudinally monitoring biomarkers, ranged between 5.4% and 10.5%, well below the biologic variation for all four markers. Biomarker concentrations for 31 late-stage sera correlated well (R(2) = 0.71 to 0.93 for various biomarkers) with values obtained on the Luminex platform. In a 31 patient cohort encompassing early- and late-stage ovarian cancers along with benign and healthy controls, the multiplexed p-BNC panel was able to distinguish cases from controls with 68.7% sensitivity at 80% specificity. Utility for longitudinal biomarker monitoring was demonstrated with prediagnostic plasma from 2 cases and 4 controls. Taken together, the p-BNC shows strong promise as a diagnostic tool for large-scale screening that takes advantage of faster results and lower costs while leveraging possible improvement in sensitivity and specificity from biomarker panels.
即时检测(POC)诊断平台具有实现低成本、大规模筛查的潜力。由于并非所有卵巢癌都会释放单一生物标志物,因此多重生物标志物检测组合有望提高敏感性和特异性,以满足卵巢癌早期检测这一未被满足的需求。我们已配置了可编程生物纳米芯片(p-BNC)——一种可多重检测的微流控模块化平台——来定量检测由CA125、人附睾蛋白4(HE4)、基质金属蛋白酶-7(MMP-7)和癌抗原72-4(CA72-4)组成的新型多标志物组合。p-BNC是一种基于微珠的免疫分析仪系统,占地面积与信用卡大小相当,集成了自动样品计量、气泡和碎片清除、试剂储存及废物处理功能,可进行即时检测分析。多重p-BNC免疫分析显示出高特异性、低交叉反应性、适用于早期检测的低检测限以及43分钟的短分析时间。日常变异性是纵向监测生物标志物的关键因素,在5.4%至10.5%之间,远低于所有四种标志物的生物学变异。31份晚期血清的生物标志物浓度与在Luminex平台上获得的值具有良好的相关性(各种生物标志物的R² = 0.71至0.93)。在一个包含早期和晚期卵巢癌以及良性和健康对照的31名患者队列中,多重p-BNC检测组合能够以80%的特异性将病例与对照区分开来,敏感性为68.7%。对2例病例和4例对照的诊断前血浆进行分析,证明了该检测组合在纵向生物标志物监测方面的实用性。综上所述,p-BNC作为一种诊断工具,在大规模筛查中具有很大的前景,它利用了更快的检测结果和更低的成本,同时利用生物标志物检测组合可能提高的敏感性和特异性。