阅读说明：本技术 检测突变基因的方法 (Method for detecting mutant gene ) 是由 海老沼宏幸 塚本百合子 于 2018-07-25 设计创作，主要内容包括：本发明的目的是提供一种高灵敏度地检测包含野生型等位基因的核酸样品中以低频包含的突变基因(突变等位基因)的方法和定量方法。在单反应系统中,将设计为在目的基因的突变位点侧翼的第一引物组与包含对应于该突变的ASP的第二引物组混合,可以从低频突变基因获得扩增产物,并且通过包含竞争性核酸以抑制该基因的野生型等位基因的扩增反应,选择特定的引物浓度条件,并使用第一和第二引物组控制PCR反应的循环数,可以确保定量。(An object of the present invention is to provide a method for detecting a mutant gene (mutant allele) contained at a low frequency in a nucleic acid sample containing a wild-type allele with high sensitivity and a quantitative method. In a single reaction system, an amplification product can be obtained from a low-frequency mutant gene by mixing a first primer set designed to flank a mutation site of a target gene with a second primer set comprising ASP corresponding to the mutation, and quantification can be secured by an amplification reaction comprising a competitive nucleic acid to inhibit a wild-type allele of the gene, selecting a specific primer concentration condition, and controlling the number of cycles of a PCR reaction using the first and second primer sets.)

1. A method for detecting a gene mutation contained in a nucleic acid sample based on the presence or absence of an amplification product in a nucleic acid amplification reaction using a DNA polymerase, the method comprising the steps of:

in a nucleic acid amplification reaction solution, wherein a first primer set designed to flank a genetic polymorphic site coexists with a second primer set comprising one or more allele-specific primers for selective amplification from a nucleic acid containing a mutation,

(a) amplifying a nucleic acid comprising a mutant allele by the nucleic acid amplification reaction of the first primer set in the presence of a competitive nucleic acid having the sequence of the wild-type allele of the gene and hybridizing with all or part of the polymorphic site, under conditions that prevent the nucleic acid amplification reaction of the second primer set, to obtain an amplification product, and

(b) performing an amplification reaction using a primer concentration of the first primer set that is lower than a primer concentration of the second primer set when obtaining the amplification product of step (a); and

(c) selectively amplifying a nucleic acid comprising a mutant allele by a nucleic acid amplification reaction under conditions that allow at least a second primer set to act on the amplification product obtained in step (a).

2. The method of claim 1, wherein the conditions that prevent the nucleic acid amplification reaction of the second primer set are temperature conditions under which the allele-specific primer does not anneal to the nucleic acid comprising the mutation.

3. The method according to claim 1 or 2, wherein the primers of the second primer set other than the allele-specific primer are designed together with one primer of the first primer set.

4. The method according to any one of claims 1 to 3, wherein in the first primer set, the concentration of primers having the same orientation as the allele-specific primers of the second primer set is 1/100 to 1/20 of the concentration of the other primers.

5. The method according to any one of claims 1 to 4, comprising the step of detecting the presence or absence of an amplification product of the second primer set based on the presence or absence of an amplification product peak separated by ion exchange chromatography.

6. A method for quantifying a mutant allele contained in a nucleic acid sample by using an amplification product from a nucleic acid amplification reaction of a DNA polymerase, the method comprising the steps of:

in a nucleic acid amplification reaction solution, wherein a first primer set designed to flank a genetic polymorphic site coexists with a second primer set comprising one or more allele-specific primers for selective amplification from a nucleic acid containing a mutation,

(a) amplifying a nucleic acid comprising a mutant allele by the nucleic acid amplification reaction of the first primer set in the presence of a competitive nucleic acid having the sequence of the wild-type allele of the gene and hybridizing with all or part of the polymorphic site, under conditions that prevent the nucleic acid amplification reaction of the second primer set, to obtain an amplification product, and

(b) selectively amplifying a nucleic acid containing a mutant allele by a nucleic acid amplification reaction under the following conditions before the nucleic acid amplification reaction by the first primer set reaches a saturation stage when obtaining the amplification product of step (a): the conditions allow at least the second primer set to act continuously on the resulting amplification product in a manner that reflects the amount of DNA of the mutant allele contained in the nucleic acid sample.

7. The method according to claim 6, wherein the number of cycles of the nucleic acid amplification reaction by the first primer set is set to 15 to 32, wherein the number of cycles of the nucleic acid amplification reaction by the second primer set is set to 30 to 60, and wherein both reactions are combined and continuously performed.

8. The method according to claim 6 or 7, wherein the amplification products of the second primer set are separated by ion exchange chromatography, and wherein the mutant allele contained in the nucleic acid sample is quantified from a peak area of the amplification products.

Technical Field

The present invention relates to a method for detecting and quantifying a mutant allele contained at a low frequency in a nucleic acid sample containing a wild-type allele with high sensitivity.

Background

Genetic mutations include genetically inherited germline mutations and somatic mutations obtained in individual cells. It is reported that Single Nucleotide Polymorphism (SNP), which is a germline mutation of a certain gene, and point mutation (single nucleotide mutation), which is a typical somatic mutation, are associated with various diseases, and in recent years, detection of such nucleotide sequences has been used to select patients for whom a certain drug is expected to be effective.

For example, Epidermal Growth Factor Receptor (EGFR) gene mutation testing is performed as a basis for determining the efficacy of Tyrosine Kinase Inhibitors (TKIs), which are therapeutic agents for lung cancer. Since this test is performed by using a trace amount of cancer tissue specimen, and wild-type alleles derived from normal tissue and cancer tissue are mixed, the test is required to have high sensitivity and high specificity.

In EGFR gene mutation, the point mutation at codon 790 of exon 20 (T790M, 2369C- > T) is specifically referred to as a resistance mutation to first and second generation TKIs (e.g., gefitinib and afatinib). Third generation TKI (osimertinib) effective against the T790M mutation has recently been used clinically and the T790M mutation needs to be tested as a condition for its application to patients known to be TKI resistant and to experience recurrence of lung cancer. Furthermore, tissue specimens need to be collected and examined by frequent re-biopsy to avoid ignoring evidence of TKI resistance due to the T790M mutation and recurrence of lung cancer; however, a highly invasive re-biopsy places a heavy burden on the patient and in some cases cannot be performed. Therefore, in recent years, even if the T790M mutation has been detected in cell-free DNA derived from cancer tissue that has been shed into plasma, oxcetinib can be prescribed. However, the amount of cell-free DNA in plasma is very small and mutation detection methods are required to have higher sensitivity than that required for detection from tissue samples. In addition, quantitative methods for capturing changes in the T790M mutant number are needed to monitor recurrence of lung cancer.

Reported methods for detecting gene mutation in EGFR include a real-time PCR method (non-patent document 1) and an MBP-QP method (non-patent document 2) by combining an ASP-PCR method using allele-specific primers (ASP) and dissociation curve analysis by a Q probe. These methods have a detection sensitivity of about 0.1% to 1% sufficient to detect from tissue samples that have been confirmed to contain cancer cells; however, this is considered insufficient to detect low frequency mutations in relapsing patients. The sensitivity of the recently-developed digital PCR method is 100 times or more higher than those of these detection methods and enables quantification, and it has been reported that a mutation that cannot be detected by the existing detection methods, for example, a mutation of a patient not treated with TKI, can be detected using this method (non-patent document 3). One widely accepted idea is that even when such a low frequency T790M mutation is detected, the relationship between the proportion of mutated genes and drug response should be evaluated based on resistance to first and second generation TKIs as well as the effectiveness of third generation TKIs. If this relationship is clear, an appropriate drug can be selected according to the ratio of the resistance mutation gene. However, digital PCR methods that achieve highly sensitive quantitation are complex to operate and require expensive specialized equipment.

The ASP-PCR method described above is a simple and relatively sensitive technique for detecting gene mutations (particularly point mutations) of EGFR, RAS, etc.; however, the improvement of ASP specificity is crucial for constructing a highly sensitive mutation detection system using this method. ASP is generally designed to have any one of 1 to 3 bases of the 3' end corresponding to a mutant nucleotide of a gene polymorphism (e.g., single nucleotide polymorphism), and further designed to ensure specificity by artificially adding a sequence (mismatch) that is not complementary to a target nucleic acid at a position other than the polymorphic site (patent document 1, patent document 2, and unpublished patent application of the applicant at the priority date of this application (PCT/JP 2017/12820)). However, ASP with artificially added mismatches has lower affinity than the perfectly matched primers, which may result in reduced amplification efficiency.

For ASP used for detecting single nucleotide mutations, shortening the primer length is effective for ensuring specificity according to the difference of single bases. On the other hand, in the case of amplification with ASP having a short primer length, it is necessary to lower the annealing temperature of PCR, which may cause a concern that non-specific amplification occurs. Such non-specific amplification is particularly prone to occur when multiple mutations are amplified simultaneously using multiple primers in one reaction system (multiplex PCR).

Nested PCR is known as a technique to reduce non-specific amplification. In this method, after a first amplification reaction is performed by a first primer set flanking a target sequence, a first reaction solution of 1/20 to 1/50 is used as a template for a second amplification reaction to amplify a desired sequence, and a second primer set designed on the inner side of the first primer set is used. This method can utilize the fact that the following facts are used to efficiently amplify a region containing a target sequence: even if a nonspecific product is amplified due to erroneous priming of the first primer set, the same nonspecific region is unlikely to be amplified by the second primer set. However, since the PCR reaction is performed twice, the operation is complicated and takes time. Further, since the reaction solution after the first PCR reaction is used as a template for the second PCR reaction, it is necessary to open the lid of the reaction solution containing a large amount of amplification products, which causes a concern that the amplification products contaminate the measurement environment (mutual contamination).

List of citations

Patent document

Patent document 1: japanese laid-open patent publication No. 2005-160430

Patent document 2: japanese patent No. 3937136

Non-patent document

Non-patent document 1: biomed Res int.2013; 2013:385087.

Non-patent document 2: j Thorac oncol.2011oct; 6(10):1639-48.

Non-patent document 3: clin Cancer Res.2015Aug 1; 21(15):3552-60.

Disclosure of Invention

Technical problem

In order to solve the above conventional problems, it is an object of the present invention to provide a method and a quantitative method for detecting a mutant allele contained at a low frequency in a nucleic acid sample containing a wild-type allele with high sensitivity.

Solution to the problem

The present inventors attempted to perform nested PCR in a homogeneous reaction system, and found that, in a single reaction system, mixing a first primer set designed to sandwich or flank a mutation site of a target gene with a second primer set comprising ASP corresponding to the mutation makes it possible to obtain an amplification product with high sensitivity from a low-frequency mutant gene, and that by containing a competitive nucleic acid to inhibit an amplification reaction of a wild-type allele of the gene, selecting a certain primer concentration condition, and optionally controlling the number of cycles of a PCR reaction using the first primer set and the second primer set, makes it possible to ensure quantitation, thereby completing the present invention.

Accordingly, the present invention provides the following [1] to [8 ].

[1] A method for detecting a gene mutation contained in a nucleic acid sample based on the presence or absence of an amplification product in a nucleic acid amplification reaction using a DNA polymerase, the method comprising the steps of:

in a nucleic acid amplification reaction solution, wherein a first primer set designed to flank a genetic polymorphic site coexists with a second primer set comprising one or more allele-specific primers for selective amplification from a nucleic acid containing a mutation,

(a) amplifying a nucleic acid comprising a mutant allele by the nucleic acid amplification reaction of the first primer set in the presence of a competitive nucleic acid having the sequence of the wild-type allele of the gene and hybridizing with all or part of the polymorphic site, under conditions that prevent the nucleic acid amplification reaction of the second primer set, to obtain an amplification product, and

(b) performing an amplification reaction using a primer concentration of the first primer set that is lower than a primer concentration of the second primer set when obtaining the amplification product of step (a); and

(c) selectively amplifying a nucleic acid comprising a mutant allele by a nucleic acid amplification reaction under conditions that allow at least a second primer set to act on the amplification product obtained in step (a).

[2] The method according to [1] above, wherein the condition for preventing the nucleic acid amplification reaction of the second primer set is a temperature condition under which the allele-specific primer does not anneal to the nucleic acid comprising the mutation.

[3] The method according to [1] or [2] above, wherein the primers of the second primer set other than the allele-specific primer are designed together with one primer of the first primer set.

[4] The method according to any one of [1] to [3] above, wherein in the first primer group, the concentration of the primer having the same direction as the allele-specific primer of the second primer group is 1/100 to 1/20 of the concentration of the other primer.

[5] The method according to any one of [1] to [4] above, comprising a step of detecting the presence or absence of an amplification product of the second primer set based on the presence or absence of an amplification product peak separated by ion exchange chromatography.

[6] A method for quantifying a mutant allele contained in a nucleic acid sample by using an amplification product from a nucleic acid amplification reaction of a DNA polymerase, the method comprising the steps of:

in a nucleic acid amplification reaction solution, wherein a first primer set designed to flank a genetic polymorphic site coexists with a second primer set comprising one or more allele-specific primers for selective amplification from a nucleic acid containing a mutation,

(a) amplifying a nucleic acid comprising a mutant allele by the nucleic acid amplification reaction of the first primer set in the presence of a competitive nucleic acid having the sequence of the wild-type allele of the gene and hybridizing with all or part of the polymorphic site, under conditions that prevent the nucleic acid amplification reaction of the second primer set, to obtain an amplification product, and

(b) selectively amplifying a nucleic acid containing a mutant allele by a nucleic acid amplification reaction under the following conditions before the nucleic acid amplification reaction by the first primer set reaches a saturation stage when obtaining the amplification product of step (a): the conditions allow at least the second primer set to act continuously on the resulting amplification product in a manner that reflects the amount of DNA of the mutant allele contained in the nucleic acid sample.

[7] The method according to [6] above, wherein the number of cycles of the nucleic acid amplification reaction by the first primer set is set to 15 to 32, wherein the number of cycles of the nucleic acid amplification reaction by the second primer set is set to 30 to 60, and wherein both reactions are combined and continuously performed.

[8] The method according to [6] or [7] above, wherein the amplification products of the second primer set are separated by ion exchange chromatography, and wherein the mutant allele contained in the nucleic acid sample is quantified from a peak area of the amplification products.

Advantageous effects of the invention

According to the present invention, a mutant gene contained at a low frequency can be specifically and rapidly detected and quantified. For example, as in the detection of mutations in the EGFR gene in lung cancer patients, even if a wild-type allele corresponding to a mutant gene (e.g., T790M) is present in a large amount in a sample, mutations can be detected and quantified with high sensitivity, which enables clinical applications by risk assessment and monitoring of resistance to first-and second-generation TKIs.

Drawings

FIG. 1 shows the amplification curve for 30 cycles of a second PCR reaction when PCR amplification is performed at different concentrations of the forward primer used in the first PCR.

FIG. 2 shows [ A ] an amplification curve in the case of PCR amplification from a 0.05ng mutant by the ASP-PCR method, [ B ] an amplification curve in the case of PCR amplification from a 0.015ng mutant by the ASP-PCR method, [ C ] an amplification curve of 55 cycles of the first PCR reaction in the case of PCR amplification from a 0.05ng mutant by using a forward primer (0.025. mu.M) of the first PCR, [ D ] an amplification curve of 30 cycles of the second PCR reaction in the case of PCR amplification from a 0.05ng mutant by using a forward primer (0.025. mu.M) of the first PCR, [ E ] an amplification curve of 55 cycles of the first PCR reaction in the case of PCR amplification from a 0.015ng mutant by using a forward primer (0.025. mu.M) of the first PCR, and [ F ] a PCR amplification curve of 0.015ng mutant by using a forward primer (0.025. mu.M) of the first PCR, amplification curve for 30 cycles of the second PCR reaction.

FIG. 3 shows elution peaks of amplification products obtained by ion exchange chromatography after 55 cycles of the first PCR reaction and 30 cycles of the second PCR reaction.

FIG. 4 shows [ A ] an amplification curve after 55 cycles of a first PCR reaction, [ B ] a 30-cycle amplification curve of a second PCR reaction after 55 cycles of the first PCR reaction of [ A ], [ C ] a correlation between an RFU value and a T790M mutant allele ratio at 30 cycles of the second PCR reaction of [ B ], [ D ] a 35-cycle amplification curve of the first PCR reaction, [ E ] a 30-cycle amplification curve of the second PCR reaction after 35 cycles of the first PCR reaction of [ D ], [ F ] a correlation between an RFU value and a T790M mutant allele ratio at 30 cycles of the second PCR reaction of [ E ], G ] a 32-cycle amplification curve of the first PCR reaction, [ H ] a 30-cycle amplification curve of the second PCR reaction after 32 cycles of the first PCR reaction of [ G ], [I] correlation between RFU value and T790M mutant allele ratio at 30 cycle of the second PCR reaction of the above-mentioned [ H ], [ J ] amplification curve of 25 cycles of the first PCR reaction, [ K ] amplification curve of 30 cycles of the second PCR reaction after 25 cycles of the first PCR reaction of the above-mentioned [ J ], [ L ] correlation between RFU value and T790M mutant allele ratio at 30 cycle of the second PCR reaction of the above-mentioned [ K ], [ M ] amplification curve of 25 cycles of the first PCR reaction, [ N ] amplification curve of 37 cycles of the second PCR reaction after 25 cycles of the first PCR reaction of the above-mentioned [ M ], [ O ] amplification curve of 15 cycles of the first PCR reaction of the above-mentioned [ P ], 790M mutant allele ratio of the RFU value and T790, [ Q ] amplification curves for 47 cycles of the second PCR reaction after 15 cycles of the first PCR reaction of [ P ] above, and [ R ] correlation between RFU value and T790M mutant allele ratio at 47 cycles of the second PCR reaction of [ Q ] above.

FIG. 5 shows [ A ] elution peaks of amplification products after 15 cycles of the first PCR reaction and 47 cycles of the second PCR reaction, [ B ] correlation between elution peak areas of amplification products of the above [ A ] and T790M mutant allele ratio, [ C ] elution peaks of amplification products after 25 cycles of the first PCR reaction and 37 cycles of the second PCR reaction, [ D ] correlation between elution peak areas of amplification products of the above [ C ] and T790M mutant allele ratio, [ E ] elution peaks of amplification products after 32 cycles of the first PCR reaction and 30 cycles of the second PCR reaction, [ F ] correlation between elution peak areas of amplification products of the above [ E ] and T790M mutant allele ratio, [ G ] elution peaks of amplification products after 35 cycles of the first PCR reaction and 27 cycles of the second PCR reaction, [H] correlation between the peak area of the elution peak of the amplification product of the above [ G ] and the ratio of mutant allele of T790M.

Detailed Description

Embodiments for implementing the present invention will now be described; however, the present invention is not limited to these embodiments in any way, and may be implemented in various forms without departing from the spirit thereof.

In the present invention, primers of a second primer set other than an allele-specific primer (ASP) may be designed together with one primer of a first primer set (hereinafter, primers having a common design will be referred to as "common primers" in some cases). Thus, the common primer functions in both the first primer set and the second primer set. In this case, it is preferable to set the concentration of the common primer to the concentration of the second primer group.

In the present invention, in order to prevent the second primer set coexisting during the first PCR reaction from operating, the lowest Tm value of the first primer set is designed to be higher than the lowest Tm value of the second primer set by 10 ℃ or more, and the difference in amplification reaction temperature is preferably 10 ℃ or more. In the present invention, in order to prevent the second primer set coexisting during the first PCR reaction from operating, it is preferable to employ conditions that prevent the nucleic acid amplification reaction from being performed by the second primer set.

In the present invention, the concentration of each primer of the first primer set is preferably 1/100 (one hundredth) to 1/20 (one twentieth) of the ASP concentration of the second primer set. In this case, one primer in the first primer set preferably has a concentration within 100 times, 20 times or 10 times that of the other primer, and one primer in the second primer set preferably has a concentration within 100 times, 20 times or 10 times that of the other primer. If the primers of the second primer set other than ASPs are designed together with one primer of the first primer set, the primers in the first primer set having the same orientation as the ASPs of the second primer set preferably have a concentration of 1/100 to 1/20 which is the concentration of the common primer.

In the present invention, the concentration of the primer in the first primer set having the same orientation as the ASP of the second primer set is preferably 0.010 to 0.100. mu.M, 0.020 to 0.050. mu.M, or 0.025 to 0.040. mu.M.

In the present invention, in order to perform quantification of a mutant gene (measurement of the ratio to the wild-type allele and/or measurement of the copy number of the mutant gene), although any conditions for selectively amplifying a detection region including a mutation site of the mutant gene may be used without particular limitation, it is preferable to perform a nucleic acid amplification reaction by changing the conditions (e.g., lowering the amplification reaction temperature) such that at least the second primer set functions before the nucleic acid amplification reaction performed by the first primer set reaches the saturation stage through the exponential stage. Suitably, the number of cycles of the nucleic acid amplification reaction by the first primer set may be set to 15 to 32 times, 16 to 31 times, 17 to 30 times, 18 to 29 times, 19 to 28 times, 20 to 27 times, 21 to 26 times, 22 to 25 times or 23 to 24 times or 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31 or 32 times; the number of cycles of the nucleic acid amplification reaction by the second primer set may be set to 30 to 60 times, 31 to 59 times, 32 to 58 times, 33 to 57 times, 34 to 56 times, 35 to 55 times, 36 to 54 times, 37 to 53 times, 38 to 52 times, 39 to 51 times, 40 to 50 times, 41 to 49 times, 42 to 48 times, 43 to 47 times, or 44 to 46 times, or 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, or 60 times; the two reactions can be combined and performed sequentially.

In the present specification, the phrase "the nucleic acid amplification reaction reaches the saturation stage" refers to a case where at least one of the following (1) and (2) falls: (1) the amount of amplification product after the Nth cycle of the nucleic acid amplification reaction is equal to or less than 1.3 times the amount of amplification product after the N-1 th cycle of the nucleic acid amplification reaction; and (2) an inflection point (when the second derivative is positive) appears on a curve obtained by taking the number of cycles of the nucleic acid amplification reaction as the x-axis and the amount of amplification product after the corresponding cycle of the nucleic acid amplification reaction as the y-axis.

In the present invention, the chain length of the first amplification product is preferably 250bp or less and 50bp or more. In the present invention, when cell-free DNA is detected in blood, the chain length of the first amplification product is preferably 120bp or less and 50bp or more.

In the present invention, examples of the competitive nucleic acid include Peptide Nucleic Acid (PNA), Locked Nucleic Acid (LNA), and oligonucleotide having a 3 'end modified such as phosphorylation so that a DNA synthesis reaction from the 3' end by a DNA polymerase does not occur. The concentration of the competitive nucleic acid is preferably a concentration that inhibits amplification of the wild-type allele, which is not the subject of detection, and does not inhibit amplification of the mutant gene to be detected in amplification by the first primer set. More specifically, the concentration of the competitive nucleic acid is 0.01 to 1.00. mu.M, 0.01 to 0.75. mu.M, 0.02 to 0.50. mu.M, 0.03 to 0.30. mu.M, 0.04 to 0.25. mu.M, 0.05 to 0.20. mu.M, 0.06 to 0.17. mu.M, 0.07 to 0.14. mu.M, 0.08 to 0.13. mu.M, and 0.09 to 0.11. mu.M.

In the present invention, the sequence of the competing nucleic acid is identical to at least 10 nucleotides, preferably 10 to 30 nucleotides, 11 to 29 nucleotides, 12 to 28 nucleotides, 13 to 27 nucleotides, 14 to 26 nucleotides, 15 to 25 nucleotides, 16 to 24 nucleotides, 17 to 23 nucleotides, 18 to 22 nucleotides or 19 to 21 nucleotides of the polymorphic site of the wild-type allele of the gene including the gene to be subjected to mutation detection, or 10 nucleotides, 11 nucleotides, 12 nucleotides, 13 nucleotides, 14 nucleotides, 15 nucleotides, 16 nucleotides, 17 nucleotides, 18 nucleotides, 19 nucleotides, 20 nucleotides, 21 nucleotides, 22 nucleotides, 23 nucleotides, 24 nucleotides, 25 nucleotides, 26 nucleotides, 27 nucleotides, 28 nucleotides, 29 nucleotides or 30 nucleotides are identical. In the present invention, the sequence of the competitive nucleic acid to be used may be either one of two DNA strands of the DNA of the gene to be subjected to mutation detection. In the present invention, the length of the competitive nucleic acid is preferably 10 to 40 nucleotides, 11 to 39 nucleotides, 12 to 38 nucleotides, 13 to 37 nucleotides, 14 to 36 nucleotides, 15 to 35 nucleotides, 16 to 34 nucleotides, 17 to 33 nucleotides, 18 to 32 nucleotides, 19 to 31 nucleotides, 20 to 30 nucleotides, 21 to 29 nucleotides, 22 to 28 nucleotides, 23 to 27 nucleotides, 24 to 26 nucleotides, 25 to 25 nucleotides, 26 to 34 nucleotides, 27 to 33 nucleotides, 28 to 32 nucleotides, or 29 to 31 nucleotides, or 10 nucleotides, 11 nucleotides, 12 nucleotides, 13 nucleotides, 14 nucleotides, 15 nucleotides, 16 nucleotides, 17 nucleotides, 18 nucleotides, 19 nucleotides, 20 nucleotides, 21 nucleotides, 22 nucleotides, 23 nucleotides, 24 nucleotides, 25 nucleotides, 26 nucleotides, 27 nucleotides, 28 nucleotides, 29 nucleotides, 30 nucleotides, 31 nucleotides, 32 nucleotides, 33 nucleotides, 34 nucleotides, 35 nucleotides, 36 nucleotides, 37 nucleotides, 38 nucleotides, 39 nucleotides, 40 nucleotides, 41 nucleotides, 42 nucleotides, 43 nucleotides, 44 nucleotides, 45 nucleotides, 46 nucleotides, 47 nucleotides, 48 nucleotides, 49 nucleotides or 50 nucleotides. In the present invention, the position of the polymorphic site in the competitive nucleic acid may be any position as long as the polymorphic site is completely or partially contained in the sequence of the competitive nucleic acid. If the polymorphic site is completely contained in the sequence of the competing nucleic acid, in embodiments, the polymorphic site preferably corresponds to the full length of nucleotides 1/10 to 9/10 from the 5' side. In this case, for example, if the competitive nucleic acid has a length of 49 nucleotides, the polymorphic site preferably corresponds to nucleotides from 4.9(═ 49 × 1/10) to 44.1, i.e., from the fifth to 44 th nucleotides. In another embodiment, the polymorphic site preferably corresponds to the full length of nucleotides 2/10 to 8/10, nucleotides 3/10 to 7/10 or nucleotides 4/10 to 6/10 from the 5' side.

In the present invention, the method for detecting or quantifying the amplification product of the second primer set is preferably a method for measuring the intensity of fluorescence generated by an intercalator such as SYBR (registered trademark) Green, and more preferably a method in which the amplification product is separated by ion exchange chromatography and detected or quantified by the presence or absence of its peak and comparison of peak areas. Although the peak of the amplification product is usually detected by performing absorbance measurement at 260nm, the amplification product can be detected by a fluorescence detector using ASP labeled with a fluorescent dye at the 5' end, and is useful when the amplification product is different from a non-specific amplification product other than ASP. Examples of the fluorescent dye used in this case include Alexa Fluor (registered trademark) series, Cy (registered trademark) series, ATTO series, DY series, DyLight (registered trademark) series, FAM, TAMRA, and the like.

In the present invention, the nucleic acid sample is preferably a sample in which the wild type allele and the mutant allele are mixed, particularly preferably a sample in which the mutant allele is mixed with or suspected of being mixed with the wild type allele at a low frequency. In the present specification, "low frequency" means that the mixing ratio (mu/wild%) of wild-type allele DNA (wild) and mutant allele DNA (mu) in a sample is 0.001 to 0.01%, 0.001 to 0.02%, 0.001 to 0.05%, 0.001 to 0.1%, 0.001 to 0.2%, 0.001 to 0.5%, 0.001 to 1%, 0.001 to 2%, 0.001 to 5%, 0.001 to 10%, 0.002 to 0.01%, 0.002 to 0.02%, 0.002 to 0.05%, 0.002 to 0.1%, 0.002 to 0.2%, 0.002 to 0.5%, 0.002 to 1%, 0.002 to 2%, 0.002 to 5%, 0.002 to 10%, 0.005 to 0.01%, 0.005 to 0.02%, 0.005 to 0.05%, 0.005 to 0.005%, 0.1%, 0.01 to 0.005%, 0.01 to 0.01%, 0.005 to 0.01%, 0.005 to 0.05%, 0.005 to 0.01%, 0.01% to 0.05%, 0.01 to 0.0.01%, 0.05%, 0.01% or 0.01 to 0.05%, 0.002%, 0.005%, 0.01%, 0.02%, 0.05%, 0.1%, 0.2%, 0.5%, 1%, 2%, 5% or 10%. The sample is preferably a biological sample of cancerous tissue derived from a cancer patient susceptible to a Tyrosine Kinase Inhibitor (TKI). In the present specification, "high sensitivity" means when the DNA concentration of the mutant allele in a sample is 0.0001 to 0.001ng/μ L, 0.0001 to 0.003ng/μ L, 0.0001 to 0.01ng/μ L, 0.0001 to 0.03ng/μ L, 0.0001 to 0.1ng/μ L, 0.0001 to 0.3ng/μ L, 0.0001 to 1ng/μ L, 0.0003 to 0.001ng/μ L, 0.0003 to 0.003ng/μ L, 0.0003 to 0.01ng/μ L, 0.0003 to 0.03ng/μ L, 0.0003 to 0.1ng/μ L, 0.0003 to 0.3ng/μ L, 0.0003 to 1ng/μ L, 0.001 to 0.003ng/μ L, 0.001 to 0.01ng/μ L, 0.001 to 0.001ng/μ L, 0.003ng/μ L to 0.003ng/μ L, 0.003 to 0.003ng/μ L, 0.003 ng/0.003 to 0.003ng/μ L, 0.003 to 0.003 ng/0.003 to 0.003L, 0.003 to 0.3 ng/. mu.L, 0.003 to 1 ng/. mu.L, 0.01 to 0.03 ng/. mu.L, 0.01 to 0.1 ng/. mu.L, 0.01 to 0.3 ng/. mu.L, 0.01 to 1 ng/. mu.L, 0.03 to 0.1 ng/. mu.L, 0.03 to 0.3 ng/. mu.L, or 0.03 to 1 ng/. mu.L, or 0.0001 ng/. mu.L, 0.0003 ng/. mu.L, 0.001 ng/. mu.L, 0.003 ng/. mu.L, 0.01 ng/. mu.L, 0.03 ng/. mu.L, 0.1 ng/. mu.L, 0.3 ng/. mu.L, or 1 ng/. mu.L, a gene mutation contained in the nucleic acid sample can be detected.

In the present invention, the gene mutation is preferably a point mutation of codon 790 of exon 20 of the EGFR gene (T790M, 2369C- > T). The sequence around codon 790 of exon 20 of the EGFR gene is shown as SEQ ID NO:1 (wild type) and SEQ ID NO:2 (mutant).

(EGFR gene T790M wild sequence [ ACG ] fragment)

[ chemical formula 1]

(EGFR gene T790M mutant sequence [ ATG ] fragment)

[ chemical formula 2]

In the present invention, the nucleic acid amplification reaction is preferably a polymerase chain reaction method.

In the present invention, the allele-specific primer is preferably a primer having a base of a second nucleotide corresponding to the base of the mutated nucleotide from the 3 'end, a base of a third nucleotide not complementary to the base of the corresponding nucleotide of the target nucleic acid from the 3' end, and a base of another nucleotide complementary to the base of the corresponding nucleotide of the target nucleic acid. In another form of the invention, the allele-specific primer is preferably a primer having a base of a third nucleotide corresponding to the base of the mutated nucleotide from the 3 'end, a base of a second nucleotide not complementary to the base of the corresponding nucleotide of the target nucleic acid from the 3' end, and a base of another nucleotide complementary to the base of the corresponding nucleotide of the target nucleic acid.

In the present invention, when we say that the first primer set and the second primer set coexist, this means that all the primers contained in the first primer set and the second primer set are present in a single continuous liquid phase (i.e., in the nucleic acid amplification reaction solution).

In the present invention, it is preferable that the condition for preventing the nucleic acid amplification reaction by the second primer set is achieved by using a temperature condition that the allele-specific primer does not anneal to the nucleic acid containing the mutation. More specifically, the conditions preventing the nucleic acid amplification reaction by the second primer set are preferably achieved by using temperature conditions that are 1 to 19 ℃ higher, 2 to 18 ℃ higher, 3 to 17 ℃ higher, 4 to 16 ℃ higher, 5 to 15 ℃ higher, 6 to 14 ℃ higher, 7 to 13 ℃ higher, 8 to 12 ℃ higher, or 9 to 11 ℃ higher, or 1 ℃ higher, 2 ℃ higher, 3 ℃ higher, 4 ℃ higher, 5 ℃ higher, 6 ℃ higher, 7 ℃ higher, 8 ℃ higher, 9 ℃ higher, 10 ℃ higher, 11 ℃ higher, 12 ℃ higher, 13 ℃ higher, 14 ℃ higher, 15 ℃ higher, 16 ℃ higher, 17 ℃ higher, 18 ℃ higher, 19 ℃ higher, 20 ℃ higher than the melting temperature (Tm) of the allele-specific primer.

In the present invention, the polymorphic site is preferably a site including a single nucleotide polymorphism. In the target polymorphic site of the target gene, an allele having a mutation is referred to as a mutant allele, and an allele having no mutation is referred to as a wild-type allele.

In the present invention, the wild-type allele means an allele having no mutation to be detected at the mutation site of the mutation of the gene to be detected. In the present invention, the wild-type allele is preferably an allele in which the amino acid at codon 790 of exon 20 of the EGFR gene is T.

In the present invention, a mutant allele means an allele having a mutation to be detected at a mutation site of a mutation of a gene to be detected. In the present invention, the mutant allele is preferably an allele in which the amino acid at codon 790 of exon 20 of the EGFR gene is M.

In the present invention, the method for quantifying a mutant allele in a nucleic acid sample is preferably a method in which the amplification products of the second primer set are separated by ion exchange chromatography so as to quantify the mutant allele contained in the nucleic acid sample from the peak area of the amplification products in a curve represented by the elution time on the x-axis and the amount of DNA eluted on the y-axis. In this case, the peak area of the amplification product can be obtained as, for example, the area of a region surrounded by a curve and a baseline, which is a straight line connecting minimum points (least points) if there are no minimum points) on both sides of the peak. By using a nucleic acid sample containing a known amount of a mutant allele as a control sample and comparing the peak area of an amplification product obtained from the control sample, the absolute amount of the mutant allele contained in the nucleic acid sample of interest can be quantified.