开发一种用于早期诊断胰腺导管腺癌的专用多标志物面板。
Development of a Fit-For-Purpose Multi-Marker Panel for Early Diagnosis of Pancreatic Ductal Adenocarcinoma.
机构信息
Bertis R&D Division, Bertis Inc, Gyeonggi-do, Republic of Korea.
Bertis Inc, Seoul, Republic of Korea.
出版信息
Mol Cell Proteomics. 2024 Sep;23(9):100824. doi: 10.1016/j.mcpro.2024.100824. Epub 2024 Aug 5.
Pancreatic ductal adenocarcinoma (PDAC) suffers from a lack of an effective diagnostic method, which hampers improvement in patient survival. Carbohydrate antigen 19-9 (CA19-9) is the only FDA-approved blood biomarker for PDAC, yet its clinical utility is limited due to suboptimal performance. Liquid chromatography-mass spectrometry (LC-MS) has emerged as a burgeoning technology in clinical proteomics for the discovery, verification, and validation of novel biomarkers. A plethora of protein biomarker candidates for PDAC have been identified using LC-MS, yet few has successfully transitioned into clinical practice. This translational standstill is owed partly to insufficient considerations of practical needs and perspectives of clinical implementation during biomarker development pipelines, such as demonstrating the analytical robustness of proposed biomarkers which is critical for transitioning from research-grade to clinical-grade assays. Moreover, the throughput and cost-effectiveness of proposed assays ought to be considered concomitantly from the early phases of the biomarker pipelines for enhancing widespread adoption in clinical settings. Here, we developed a fit-for-purpose multi-marker panel for PDAC diagnosis by consolidating analytically robust biomarkers as well as employing a relatively simple LC-MS protocol. In the discovery phase, we comprehensively surveyed putative PDAC biomarkers from both in-house data and prior studies. In the verification phase, we developed a multiple-reaction monitoring (MRM)-MS-based proteomic assay using surrogate peptides that passed stringent analytical validation tests. We adopted a high-throughput protocol including a short gradient (<10 min) and simple sample preparation (no depletion or enrichment steps). Additionally, we developed our assay using serum samples, which are usually the preferred biospecimen in clinical settings. We developed predictive models based on our final panel of 12 protein biomarkers combined with CA19-9, which showed improved diagnostic performance compared to using CA19-9 alone in discriminating PDAC from non-PDAC controls including healthy individuals and patients with benign pancreatic diseases. A large-scale clinical validation is underway to demonstrate the clinical validity of our novel panel.
胰腺导管腺癌(PDAC)缺乏有效的诊断方法,这阻碍了患者生存率的提高。糖类抗原 19-9(CA19-9)是唯一获得 FDA 批准用于 PDAC 的血液生物标志物,但由于其性能不理想,其临床应用受到限制。液相色谱-质谱联用(LC-MS)技术已成为临床蛋白质组学中一种新兴的技术,用于发现、验证和验证新的生物标志物。已经使用 LC-MS 技术鉴定了大量 PDAC 的蛋白质生物标志物候选物,但很少有成功转化为临床实践。这种转化停滞部分归因于在生物标志物开发管道中对实际需求和临床实施观点的考虑不足,例如证明拟议生物标志物的分析稳健性,这对于从研究级到临床级测定的转变至关重要。此外,从生物标志物管道的早期阶段就应同时考虑拟议测定的通量和成本效益,以增强在临床环境中的广泛采用。在这里,我们通过整合分析稳健的生物标志物以及采用相对简单的 LC-MS 方案,开发了一种用于 PDAC 诊断的多功能多标志物面板。在发现阶段,我们全面调查了来自内部数据和先前研究的潜在 PDAC 生物标志物。在验证阶段,我们使用通过严格分析验证测试的替代肽开发了一种基于多重反应监测(MRM)-MS 的蛋白质组学测定法。我们采用了高通量方案,包括短梯度(<10 分钟)和简单的样品制备(无耗尽或富集步骤)。此外,我们还使用血清样本开发了我们的测定法,血清样本通常是临床环境中首选的生物样本。我们基于我们最终的 12 种蛋白质生物标志物组合 CA19-9 开发了预测模型,与单独使用 CA19-9 相比,该模型在区分 PDAC 与非 PDAC 对照(包括健康个体和患有良性胰腺疾病的患者)方面显示出了更好的诊断性能。正在进行大规模的临床验证,以证明我们新型面板的临床有效性。