CN116411072A - Limb-end type melanoma diagnosis and treatment marker combination and application thereof - Google Patents

Limb-end type melanoma diagnosis and treatment marker combination and application thereof Download PDF

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CN116411072A
CN116411072A CN202211694419.2A CN202211694419A CN116411072A CN 116411072 A CN116411072 A CN 116411072A CN 202211694419 A CN202211694419 A CN 202211694419A CN 116411072 A CN116411072 A CN 116411072A
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melanoma
acromioclavicular
apoe
detection
marker combination
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CN116411072B (en
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薛瑞栋
李航
张宁
刘恒康
高嘉雯
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Peking University First Hospital
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Abstract

The invention discloses an acromion type melanoma diagnosis and treatment marker combination and application thereof. The tumor diagnosis and treatment marker combination can be used for preparing products for evaluating the malignancy degree of the acromioclavicular melanoma, predicting the prognosis of a patient and targeting treatment. The invention screens out candidate gene combinations APOE and CD163 by adopting high-throughput sequencing and bioinformatics methods, and verifies that the diagnosis and treatment marker combination has good correlation with the malignancy degree and prognosis of acromioclavicular melanoma through immunohistochemical experiments. The tumor diagnosis and treatment marker combination has great application and popularization values for diagnosis and treatment of acromion type melanoma.

Description

Limb-end type melanoma diagnosis and treatment marker combination and application thereof
Technical Field
The invention belongs to the technical field of biological medicines, and particularly relates to a diagnosis and treatment marker combination for acromion melanoma and application thereof.
Background
Acromegaly melanoma is a primary malignant skin tumor that originates from melanocytes at the acromegaly. Acromegaly melanoma is a major lethal cutaneous malignancy in our country, and although the incidence of malignant melanoma is low, new malignant melanoma patients are about 20000 people each year, and the incidence increases at a rate of 3% to 5% each year, being the malignant tumor that increases the speed most globally. Compared with other melanoma subtypes, the discovery period of the primary focus of the acromioclavicular melanoma is later, the prognosis is worse, and the social hazard is extremely high. Surgical excision is the main treatment modality for acro-melanoma, while other treatment regimens including large-dose interferon therapy, chemotherapy, immunotherapy, etc. have low clinical efficiency, with five-year survival rate of only 65% after surgery. Therefore, there is a need for new diagnostic and therapeutic strategies for acromioclavicular melanoma, and the identification of diagnostic markers suitable for acromioclavicular melanoma is a key bottleneck that needs to be overcome at present.
The tumor immune microenvironment plays an important role in modeling tumor phenotype, influencing tumor invasion, promoting tumor metastasis and the like. However, the immune microenvironment of acromelamas has not been studied intensively due to low incidence, difficult sample collection, etc. At present, molecular diagnosis and treatment markers of acromioclavicular melanoma based on immune microenvironment are limited, more molecular markers need to be searched, reference is provided for clinical diagnosis and treatment of acromioclavicular melanoma, and hope is brought for treatment of acromioclavicular melanoma patients.
Disclosure of Invention
Aiming at the problem that the existing acral melanoma lacks an effective tumor diagnosis and treatment marker, the invention aims to provide an acral melanoma diagnosis and treatment marker combination and application thereof, wherein the diagnosis and treatment marker combination can be used for preparing products for evaluating the malignancy of tumors, predicting the prognosis of patients and carrying out targeted treatment; the tumor diagnosis and treatment marker combination comprises APOE and CD163 genes and expression products thereof.
The purpose of the invention is realized in the following way:
a first aspect of the invention provides a acromioclavicular melanoma diagnostic marker combination, which is APOE and CD163.
Further, the marker combination is RNA or its reverse transcribed cDNA, or protein.
In a second aspect the invention provides the use of a combination of said markers for the preparation of a product for assessing the malignancy of acromioclavicular melanoma, predicting patient prognosis and targeting therapy, wherein the product uses a quantitative reagent to detect changes in the expression levels of APOE and CD163 genes, thereby assessing the malignancy of acromioclavicular melanoma, predicting patient prognosis and targeting therapy. The change of the RNA expression level and the protein expression level of the APOE and the CD163 can be used singly or in combination.
Further, the application includes:
s1, carrying out malignancy degree and patient prognosis judgment on acromioclavicular melanoma by jointly utilizing the expression of APOE and CD163 genes and products thereof;
s2, combining the APOE with the CD163 gene and products thereof and combining with other potential indexes to judge the malignancy degree and the prognosis of patients of the acromioclavicular melanoma.
Further, the samples detected were: acromium melanoma tissue; the quantitative reagent ranges include: RNA expressed by the gene, cDNA obtained by reverse transcription thereof, and protein level; the detection method used involves: RT-PCR, fluorescent quantitative PCR, mRNA Sequencing, mRNAarray detection technology, immunohistochemistry, immunofluorescence, western blot, ELISA, flow cytometry detection, immunological detection and chemical detection. The RT-PCR comprises common PCR, fluorescent quantitative PCR, nested PCR, multiplex PCR, digital PCR and the like.
In a third aspect the present invention provides a kit for assessing acromioclavicular melanoma, said kit comprising a quantification reagent for detecting the expression level of the above-mentioned marker combination.
A fourth aspect of the present invention provides a device for assessing the malignancy of acromioclavicular melanoma and prognosis of a patient, the device comprising detection means, analysis means and result output means;
the detection device comprises: for detecting the expression level of the marker combination in a sample, wherein the sample is a acro-melanoma tissue;
analysis device: evaluating the malignancy of acromioclavicular melanoma and the prognosis of the patient based on the expression level of the marker combination;
result output means: for outputting results obtained by the analysis means, including analysis of malignancy of acromioclavicular melanoma and prognosis analysis of patients.
Further, the reagents used in the detection device include RNA expressed by the gene, cDNA obtained by reverse transcription of the RNA, and protein level detection reagents; the detection method used involves: RT-PCR, fluorescent quantitative PCR, mRNA Sequencing, mRNAarray detection technology, immunohistochemistry, immunofluorescence, western blot, ELISA, flow cytometry detection, immunological detection and chemical detection.
In a fifth aspect, the present invention provides the use of a medicament for inhibiting expression of a combination of said markers in the preparation of a pharmaceutical composition for the treatment of acromioclavicular melanoma, the medicament for inhibiting expression of a combination of said markers comprising:
s1, an agent or compound that jointly inhibits transcription, or expression, or function of APOE and CD163 genes;
s2, an agent or compound that inhibits transcription, or expression, or function of the APOE and CD163 genes in combination with other potential indicators.
In a sixth aspect, the invention provides a pharmaceutical composition for the treatment or prophylaxis of acromioclavicular melanoma comprising: pharmaceutically effective amounts of inhibitors of APOE and CD163 or antibodies/immunologically active fragments thereof that bind to the protein products thereof, and a pharmaceutically acceptable carrier.
The invention has the advantages and beneficial effects that:
1. the invention discovers that the change of the expression quantity of the APOE and the CD163 plays an important role in the diagnosis prognosis and the treatment of the acral melanoma for the first time, and can be used as a diagnosis and treatment marker of the acral melanoma;
2. at present, the invasion depth of the tumor is clinically used as an index for evaluating the malignancy degree of the acromioclavicular melanoma and the prognosis of a patient, the index is closely related to the onset time of the tumor, and generally the longer the disease course is, the deeper the invasion depth of the tumor is. Therefore, the index of the invasion depth of a tumor lacks the ability to distinguish malignant tumors at an early stage. Compared with the invasion depth of the tumor, the invention reflects the internal characteristics of the tumor and the microenvironment where the tumor is positioned by changing the expression quantity of the APOE and the CD163, can simply, conveniently and accurately judge the malignancy degree of the acromiotic melanoma and the prognosis of the patient, further can distinguish the acromiotic melanoma with early high malignancy degree and poor prognosis, and provides possibility of early intervention on the acromiotic melanoma;
3. compared with the target, the target therapy of taking the APOE and the CD163 gene as diagnosis markers provides a new direction for treating the acromioclavicular melanoma, and has great application and popularization value for diagnosis and treatment of the acromioclavicular melanoma.
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The invention is further described below with reference to the drawings and examples.
FIG. 1 shows the results of high throughput transcriptome sequencing: expression of APOE in patients with different acromegaly melanoma and relation between expression amount and prognosis of patients after operation. Wherein, (a) the amount of APOE expressed in groups of patients with different acromegaly melanoma; (B) The level of APOE expression can effectively distinguish between patients with different prognosis.
FIG. 2 shows the results of high throughput transcriptome sequencing: relation between the expression and the expression amount of CD163 in different patients with acromioclavicular melanoma and the prognosis of the patients after operation. Wherein, (a) the amount of expression of CD163 in the grouping of patients with different acromegaly melanoma; (B) The level of CD163 expression can be effective in distinguishing patients with different prognosis.
FIG. 3 shows the results of high throughput transcriptome sequencing: the ability to predict prognosis outcome in acromioclavicular melanoma patients in combination with the expression levels of APOE and CD163. Wherein (A) the amount of expression of binding APOE and CD163 is effective to distinguish between patients with different prognosis; (B) The expression level of the combined APOE and CD163 has better prediction effect than any single gene.
Fig. 4 shows immunohistochemical results: staining results of APOE in different acronymous melanoma patients and relationship between acronymous melanoma patients post-operative prognosis. Wherein, (a) APOE staining in a patient with acromioclavicular melanoma; (B) APOE staining results can effectively differentiate patients with different prognosis.
Fig. 5 shows immunohistochemical results: the staining results of CD163 in different acronymous melanoma patients and the relationship between the postoperative prognosis of acronymous melanoma patients. Wherein, (a) staining of CD163 in patients with acromegaly melanoma; (B) CD163 staining results can effectively distinguish patients with different prognosis.
Fig. 6 shows immunohistochemical results: staining results of APOE and CD163 in different acronymous melanoma patients and relationship between the acronymous melanoma patients post-operative prognosis. Staining results that bind APOE and CD163 can effectively distinguish patients with different prognosis.
Detailed Description
Example 1 high throughput sequencing and analysis of the APOE Gene of human acromioclavicular melanoma tumor tissue
Collecting 62 cases of acromegaly melanoma primary focus case tissues, extracting RNA, measuring the concentration and purity of the extracted RNA by using a Qubit 3 fluorescence quantitative analyzer, and judging whether the quality of the extracted RNA sample is qualified by using a capillary electrophoresis apparatus so as to judge whether the extracted RNA sample can be used for further high-throughput library-building sequencing and transcriptome analysis.
The sequencing platform was the NovaSeq platform from Illumina, inc., and was used for high throughput transcriptome sequencing, in this example, fastqc software was used to evaluate the quality of the sequencing data. Sequencing results were then aligned to a reference genome using STAR software and gene expression quantified using RSEM software. Based on the TPM values of the obtained APOEs, 62 patients were divided into two groups, high-expression and low-expression, and further, survival analysis showed that patients with high-expression APOE had significantly shorter post-operative progression-free survival than patients with low-expression APOE (see FIG. 1, in particular).
Example 2 high throughput sequencing and analysis of the CD163 Gene of human acromioclavicular melanoma tumor tissue
By the same analysis method as in example 1, this example divides 62 patients with acromegaly melanoma into two groups according to the expression level of CD163 gene, and the analysis result shows that: the post-operative progression free survival time was significantly shorter for patients with high CD163 expression than for patients with low CD163 expression (see in particular fig. 2).
Example 3 high throughput sequencing and analysis of the APOE and CD163 genes in human acromioclavicular melanoma tumor tissues
By the same analysis method as in example 1, 62 patients with acromegaly melanoma were divided into two groups according to the average value of the expression amounts of APOE and CD163 gene, and the results of the study showed that: combining the high throughput transcriptome sequencing results of APOE and CD163 can effectively differentiate patients with acromegaly expected from different survival (see in particular fig. 3), and can improve sensitivity and specificity for tumour malignancy and prognostic assessment (see in particular table 1).
TABLE 1 high throughput transcriptome sequencing results of APOE and CD163 for analysis of acromioclavicular melanoma patient postoperative progression
Figure BDA0004022805000000051
Example 4
The example performs APOE immunohistochemical staining and analysis of human acromioclavicular melanoma tumor tissue, and the specific method is as follows:
1. materials and methods
1. Material
67 human acromioclavicular melanoma tissues were collected and numbered.
2. Method of
Fixing the clinical fresh tissue sample with 4% paraformaldehyde for more than 24 hours, repairing and leveling the tissue, and then placing the tissue sample into a dehydration box for dehydration in gradient alcohol. Embedding is completed in an embedding machine after water immersion and wax removal, and then the wax block is placed on a paraffin microtome to cut into tissue sections with the diameter of 4 mu m.
Dewaxing the tissue slice at room temperature, hydrating with gradient alcohol, and preparing antigen retrieval liquid to complete antigen retrieval under heating. The reaction space containing the tissues is circled by an immunohistochemical pen, 3% hydrogen peroxide is dripped into the circled reaction space, the reaction space is incubated for 10 minutes at room temperature, and then a blocking solution is added to block non-specific sites. Incubation with APOE antibody (abcam) (primary antibody) overnight at 4 ℃, PBST wash three times, secondary antibody incubation for 20 min at room temperature, PBST wash three times. 2 drops of DAB solution were added dropwise to each slide for color development, and the slide was removed and placed in water to terminate the reaction when appropriate staining was observed under a microscope. Hematoxylin is added dropwise for counterstaining for 3 minutes, tap water is used for flushing, hydrochloric acid alcohol is used for differentiation for 2 to 3 seconds, and then the mixture is immediately placed in ammonia water for blue reflection. And (3) dehydrating the film with gradient alcohol after the blue turning is finished, airing the film, dripping xylene and neutral resin to seal the film, standing and airing to obtain the observation result.
For each sample, at least two continuous sections are simultaneously dyed, wherein at least one section is a negative control, namely, buffer solution is used for replacing primary antibody, and other steps are completely the same as the steps, so that the negative control is used for the experiment, and the judgment accuracy of the experimental result is improved.
2. Experimental results
According to the dyeing condition of the samples, all the samples are divided into two groups of APOE dyeing positive and dyeing negative, and survival analysis results show that: compared with the APOE-negative acromegaly melanoma patients, the patient positive for APOE staining has poorer prognosis and shorter survival time; APOE staining can differentiate acromioclavicular melanoma patients with different post-operative survival outcomes; the APOE staining results have good efficiency in prognosis evaluation of patients, high sensitivity and good specificity (see FIG. 4 in particular).
Example 5
This example was performed with the same materials and methods as in example 4, except that each sample was stained for CD163.
According to the dyeing condition of the samples, all the samples are divided into two groups of CD163 dyeing positive and dyeing negative, and survival analysis results show that: patients positive for CD163 staining have a poorer prognosis and a shorter survival period than patients with acromegaly melanoma that are negative for CD163 staining; staining with CD163 can distinguish patients with acromion melanoma with different post-operative survival outcomes; the results of staining with CD163 gave good efficiency and high sensitivity for prognosis evaluation of patients (see in particular fig. 5).
Example 6
In this example, the human acromegaly melanoma tumor tissue was stained and analyzed for APOE and CD163 immunohistochemistry using the same materials and methods as in example 4, except that the samples of each example were stained for APOE and CD163.
All samples were divided into two groups, APOE and CD163 stained double positive and other staining conditions, the survival analysis results show that: patients in the APOE and CD163 stained biscationic groups had worse prognosis and shorter survival than the other stained condition groups (see in particular fig. 6); combining APOE staining with CD163 staining can improve specificity for tumor malignancy and post-operative prognostic assessment over any single index (see in particular table 2).
Table 2 immunohistochemical staining results for apoe and CD163 analysis of acromioclavicular melanoma patient postoperative progression
Figure BDA0004022805000000071
Example 7
The present example provides a kit for assessing acromioclavicular melanoma comprising a quantification reagent to detect the expression level of the marker combination APOE and CD163. The kit comprises upstream and downstream primers for RNA of APOE and CD163. The kit combines a common RNA extraction reagent and a common reverse transcription reagent, can specifically detect the expression amounts of APOE and CD163 in a sample, and can accurately judge the malignancy degree of the acromioclavicular melanoma and the prognosis of a patient.
Can be measured immediately after the operation or focus puncture, biopsy taking and limb end type melanoma tissue taking are carried out on the limb end type melanoma patients.
Example 8
The present embodiment provides an apparatus for evaluating the malignancy of acromioclavicular melanoma and prognosis of a patient, the apparatus comprising a detection means, an analysis means and a result output means.
The detection device comprises: the method comprises the steps of detecting the expression level of a marker combination APOE and CD163 in a sample, wherein the sample is acromioclavicular melanoma tissue; the reagents used were RT-PCR quantification reagents, including the upstream and downstream primers for APOE and CD163.
Analysis device: based on the expression levels of the marker combination APOE and CD163, the malignancy of acromioclavicular melanoma and the prognosis of the patient were evaluated.
Result output means: for outputting results obtained by the analysis means, including analysis of malignancy of acromioclavicular melanoma and prognosis analysis of patients.
Example 9
The embodiment provides an application of a drug for inhibiting the expression of the marker combination in preparing a drug composition for treating acromioclavicular melanoma, wherein the drug for inhibiting the expression of the marker combination comprises the following components:
s1, an agent or compound that jointly inhibits transcription, or expression, or function of APOE and CD163 genes;
s2, an agent or compound that inhibits transcription, or expression, or function of the APOE and CD163 genes in combination with other potential indicators.
Example 10
The present embodiment provides a pharmaceutical composition for treating or preventing acromioclavicular melanoma, comprising: pharmaceutically effective amounts of inhibitors of APOE and CD163 or antibodies/immunologically active fragments thereof that bind to the protein products thereof, and a pharmaceutically acceptable carrier.
The pharmaceutically acceptable carrier is a carrier commonly used in preparation, and the carrier includes lactose, dextrose, sucrose, sorbitol, mannitol, starch, gum acacia, calcium phosphate, alginate, gel, calcium silicate, microcrystalline cellulose, polyvinylpyrrolidone, cellulose, water, syrup, methylcellulose, methyl hydroxybenzoate, propyl hydroxybenzoate, talc, magnesium stearate, mineral oil and the like, but is not limited thereto.
The pharmaceutical composition may contain, in addition to the above ingredients, lubricants, wetting agents, sweeteners, flavoring agents, emulsifiers, suspending agents, preservatives and the like. Pharmaceutically acceptable carriers and formulations are described in detail in the pharmaceutical literature of Leidden.
The pharmaceutical composition can be administered orally or parenterally, and when administered parenterally, it can be administered by intravenous injection, intranasal injection, topical injection, intraventricular injection, spinal cavity injection, subcutaneous injection, intraperitoneal injection, transdermal administration, etc.
The appropriate dosage of the pharmaceutical composition may be formulated according to the method of preparation, the mode of administration, the age, weight, sex, condition, food, time of administration, route of administration, rate of excretion and sensitivity of reaction of the patient, and in general, the skilled practitioner can easily determine and prescribe an effective dosage for the desired treatment or prophylaxis.
The pharmaceutical compositions can be prepared in unit dosage form or in a multi-volume container by formulating with pharmaceutically acceptable carriers and/or excipients according to methods readily practiced by those of ordinary skill in the art to which the present invention pertains. In this case, the dosage form may be in the form of a solution, suspension or emulsion in an oily or aqueous medium, or may be in the form of an extract, powder, granule, tablet or capsule, and may further include a dispersing agent or stabilizer.
Finally, it should be noted that the above only illustrates the technical solution of the present invention and is not limiting, and although the present invention has been described in detail with reference to the preferred arrangement, it should be understood by those skilled in the art that modifications and equivalents may be made to the technical solution of the present invention without departing from the spirit and scope of the technical solution of the present invention.

Claims (10)

1. An acromioclavicular melanoma diagnosis and treatment marker combination, which is characterized by being APOE and CD163.
2. The acromioclavicular melanoma diagnostic marker combination according to claim 1, wherein the marker combination is RNA or its reverse transcribed cDNA, or protein.
3. Use of a marker combination according to claim 1 or 2 for the preparation of a product for assessing the malignancy of acromegaly melanoma, predicting patient prognosis and targeting therapy, characterized in that the product is used for assessing the malignancy of acromegaly melanoma, predicting patient prognosis and targeting therapy by detecting changes in the expression levels of APOE and CD163 genes with quantitative reagents.
4. The application according to claim 3, wherein the application comprises:
s1, carrying out malignancy degree and patient prognosis judgment on acromioclavicular melanoma by jointly utilizing the expression of APOE and CD163 genes and products thereof;
s2, combining the APOE with the CD163 gene and products thereof and combining with other potential indexes to judge the malignancy degree and the prognosis of patients of the acromioclavicular melanoma.
5. The use according to claim 3 or 4, wherein the sample detected is: acromium melanoma tissue; the quantitative reagent ranges include: RNA expressed by the gene, cDNA obtained by reverse transcription thereof, and protein level; the detection method used involves: RT-PCR, fluorescent quantitative PCR, mRNA Sequencing, mRNAarray detection techniques, immunohistochemistry, immunofluorescence, westernblot, ELISA, flow cytometry detection, immunological detection, and chemical detection.
6. A kit for assessing acromioclavicular melanoma, characterized in that it comprises a quantification reagent for detecting the expression level of the marker combination according to claim 1 or 2.
7. A device for assessing the malignancy of acromioclavicular melanoma and prognosis of a patient, characterized in that the device comprises a detection device, an analysis device and a result output device;
the detection device comprises: for detecting the expression level of the marker combination of claim 1 or 2 in a sample, which is acro-melanoma tissue;
analysis device: evaluating the malignancy of acromioclavicular melanoma and the prognosis of the patient based on the expression level of the marker combination;
result output means: for outputting results obtained by the analysis means, including analysis of malignancy of acromioclavicular melanoma and prognosis analysis of patients.
8. The device of claim 7, wherein the reagents used in the detection device include RNA expressed by the gene, cDNA obtained by reverse transcription thereof, and protein level detection reagents; the detection method used involves: RT-PCR, fluorescent quantitative PCR, mRNASequencing, mRNAarray detection technology, immunohistochemistry, immunofluorescence, westernblot, ELISA, flow cytometry detection, immunological detection and chemical detection.
9. Use of a medicament for inhibiting expression of a marker combination according to claim 1 or 2 in the manufacture of a pharmaceutical composition for treating acral melanoma, wherein the medicament for inhibiting expression of the marker combination comprises:
s1, an agent or compound that jointly inhibits transcription, or expression, or function of APOE and CD163 genes;
s2, an agent or compound that inhibits transcription, or expression, or function of the APOE and CD163 genes in combination with other potential indicators.
10. A pharmaceutical composition for treating or preventing acromioclavicular melanoma, said pharmaceutical composition comprising: pharmaceutically effective amounts of inhibitors of APOE and CD163 or antibodies/immunologically active fragments thereof that bind to the protein products thereof, and a pharmaceutically acceptable carrier.
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