Patent Publication Number: US-2023159984-A1

Title: Gene target region enrichment method and kit

Description:
TECHNICAL FIELD 
     The present invention relates to the field of biotechnology, in particular, to a gene target region enrichment method and kit. 
     BACKGROUND OF THE INVENTION 
     Gene sequencing technology has gone through nearly half a century since it appears in the 1970s. The emergence of PCR technology in 1985 has promoted the development of the entire field of molecular biology. Next-generation sequencing technology (NGS) has the advantages of accuracy, sensitivity, and high throughput. As the cost of sequencing continues to decrease, its application range continues to expand, but its application is also subject to diverse requirement and time-consuming laborious library construction. In the process of building clinical samples such as plasma samples, the existing forms of DNA are usually short fragments, damaged, single-stranded or partially double-stranded. For these existing forms, especially DNA with fragments less than 200 bp, the present PCR technology cannot achieve good capture and enrichment. 
     For the enrichment of tiny DNA fragments, the existing technology still mainly uses the traditional PCR library construction method or the method of first adding a linker and then amplifying, such as the hybrid capture method. However, for the former, due to the need for double-ended primers, the length of fragments suitable for amplification is greatly limited, and the preference in amplification results in high heterogeneity of the product, and errors accumulated by exponential amplification leads to subsequent sequencing result is inaccurate. While for the latter, although the requirement for the length of the enriched fragment is not as strict as PCR, the ligation reaction needs to be performed firstly, and the efficiency of ligation is usually only 20% to 50%, resulting in low capture efficiency, in addition, there is also the problem of being easy to lose rare molecules due to difficulty in ligation. Recently developed technologies in order to solve the problem of NGS library construction include such as molecular inversion probes, Multiple PCR and the like. Compared with hybrid capture technology, the molecular inverted probe has better specificity, but design of its pocket-shaped probe is complicated, and it is not suitable for the enrichment of tiny DNA fragments. Multiple PCR technology is suitable for large-scale samples and is the most widely used. But neither of them is suitable for enrichment of small DNA fragments at low starting concentration, since either the primer design requirements are extremely high and the homogeneity of the amplicon is poor, or the homogeneity of the amplified product is good but the requirement to the concentration of the starting sample is very high. These prior arts usually require double-ended primers to construct libraries, so, in order to remove linker dimer contamination, a purification step must be introduced, which results in the loss of information in small fragments of double-stranded DNA, damaged double-stranded DNA, and single-stranded DNA molecules. However, in some genomic regions where transcription is active, it is precisely these forms of DNA. To sum up, the prior arts cannot satisfy the demand for enrichment of fragmented, especially tiny DNA of 200 bp or less. Therefore, the main technical purpose of the present invention is to provide a method for efficient enrichment of the target regions in fragmented DNA, breaking the bottleneck of the low ligation efficiency limiting the enrichment efficiency, inhibiting the production of unintended ligation products and increasing the capture efficiency of rare molecules with the target regions while maintaining the uniformity of the product. 
     SUMMARY OF THE INVENTION 
     In view of the above-mentioned shortcomings of the prior art, the object of the present invention is to provide a gene target region enrichment method for solving the problems in the prior art. 
     To achieve the above objectives and other related objectives, the present invention provides a gene target region enrichment method, including: 
     comprising: 
     (1) amplifying fragmented DNA comprising the target region(s) via specific probes to provide captured-extension products, wherein the specific probe comprises a sequence complementary to the target region of the fragmented DNA, and the 3′ terminal nucleotide of the specific probe is modified to prevent a ligation reaction at the 3′ terminal of the specific probe; 
     (2) linking the 3′ end of the captured-extension product obtained in step (1) to linker DNA to obtain a ligation product. 
     Another aspect of the present invention provides a kit for enriching a fragmented DNA target region, which includes a specific probe and linker DNA (sometimes called “adapter DNA”) suitable for the gene target region enrichment method. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG.  1    is a schematic flowchart of an enrichment process for a target region in an embodiment of the present invention. 
         FIG.  2    is a schematic diagram of a library molecule constructed according to an embodiment of the present invention. 
         FIG.  3    is a schematic diagram of the construction of the calibrator in the embodiment of the present invention. 
         FIG.  4    is a schematic flowchart of a monospecific detection system in an embodiment of the present invention. 
     
    
    
     DETAILED DESCRIPTION OF THE EMBODIMENTS 
     The inventors of the present invention have provided a gene target region enrichment method after a lot of exploratory research. The gene target region enrichment method is simple to operate and has reliable results, especially for short-length nucleotide. Based on this, the present invention has been completed. 
     The first aspect of the present invention provides a gene target region enrichment method, including: 
     (1) amplifying fragmented DNA comprising the target region(s) via specific probes to provide captured-extension products, wherein the specific probe comprises a sequence complementary to the target region of the fragmented DNA, and the 3′ terminal nucleotide of the specific probe is modified to prevent a ligation reaction at the 3′ terminal of the specific probe; 
     (2) linking the 3′ end of the captured-extension product obtained in step (1) to linker DNA to obtain a ligation product. 
     The gene target region enrichment method provided by the present invention may include: amplifying the fragmented DNA including the target region by a specific probe to provide a captured-extension product. During the reaction, the specific probe can be extended on the basis of capturing the complementary sequence of the target region to obtain a Captured-Extension Product (CEP). 
     In the gene target region enrichment method, in the reaction of amplifying the fragmented DNA including the target region by a specific probe, the fragmented DNA including the target region may be one or more. Generally, there is a one-to-one correspondence between the specific probes and the fragmented DNA including the target region, that is, the number of specific probes in the reaction system may be one kind or multiple kinds. The extension described in this step refers to the entire pre-amplification step of the sample, including single or multiple rounds(cycles) of denaturation, annealing, and extension steps. In a preferred embodiment, in this step multiple cycles, such as 2-100, 2-10, 10-20, 20-30, 30-40, 40-60, 60-80, 80-100 cycles, are implements, in order to effectively increase the number of molecules containing the target area. 
     In the gene target region enrichment method, the fragmented DNA may be double-stranded DNA, single-stranded DNA, cDNA, etc. The cDNA may generally be obtained by reverse transcription of RNA. For double-stranded DNA, the specific probe may include a sequence complementary to the target region of one strand of the fragmented DNA. Therefore, the enrichment method of the present invention is also applicable to fragmented RNA. A person skilled in the art can perform subsequent operations through the enrichment method provided by the present invention after reverse-transcribing RNA into cDNA. The length of the fragmented DNA may be 25 to 200 bps, 25 to 40 bps, 40 to 60 bps, 60 to 80 bps, 80 to 100 bps, 100 to 120 bps, 120 to 140 bps, 140 to 160 bps, 160 to 180 bps, or 180 to 200 bps. 
     In the gene target region enrichment method, the amplification system of step (1) may include specific probes, DNA polymerase and dNTP. The reaction of amplifying the fragmented DNA including target region via a specific probe can usually be carried out in the presence of DNA polymerase. After the probe with 3′ end blocking-modified binds to the template under the action of high-fidelity polymerase, the blocking group is excised, and the probe is reactivated so that the target sequence can be extended effectively. The DNA polymerase may have 3′-5′ exonuclease activity, so that the substituent group at the 3′ end of the probe after binding to the template can be cleaved, so that the probe can extend along the template. The DNA polymerase is preferably a high-fidelity DNA polymerase so as to further improve the amplification efficiency and purity of the product. The DNA polymerase may also be a common DNA polymerase (i.e., it does not have 3′-5′ exonuclease activity). The amplification system in the step (1) further includes an active substance. The active substance can be used to excise the 3′ terminal modification group of the specific probe after binding to the target region. The active substance can also be combined with DNA polymerase (for example, common DNA polymerase) in the captured-extension system to improve the efficiency of the amplification system. The active substance is preferably a nuclease. The reaction of amplifying the fragmented DNA including the target region by a specific probe can generally be carried out in the presence of dNTP, which can usually be a dNTP coupled with a labeling molecule. The labeling molecule can include but not limited to biotin and the like. The dTNP may include but not limited to dCTP, dATP and the like. The dNTP may also be coupled with a labeling molecule, which may be biotin or the like, and the labeling molecule may generally be used for purifying the captured-extension products. 
     In the gene target region enrichment method, the specific probe includes a sequence complementary to the target region of the fragmented DNA, thereby achieving specific amplification of the target region of the fragmented DNA. A person skilled in the art can select suitable target region for fragmented DNA, and design an appropriate complementary sequence according to the target region for fragmented DNA. The specific probe may be a specific probe whose 3′ terminal nucleotide is modified, to prevent the 3′ terminal of the specific probe from connecting with other groups, so as to avoid the free probe self-ligating or connecting other non-target molecules. For example, the non-target molecules may be linker DNA and the like. A person skilled in the art can select a suitable substituent group to modify the 3′ terminal of the specific probe. For example, the modification group can replace the natural group (for example, hydroxyl group, etc.) on the 3′ terminal nucleotide of the specific probe in order to prevent the ligation reaction at the 3′ terminal of the specific probe. the modification group can usually be a blocking group. After the probe is combined with the target region on the template via the complementary sequence, the 3′ end modification group can be cleaved by the enzyme, so that the probe is activated, and the target sequence can be effectively extended. The 3′ terminal modification group of the specific probe may include, but not limited to, a hydrogen atom, a C3 Spacer group, a C6 Spacer group, a phosphate group (PO 4 ), an amino group (NH 2 ), etc. The choice of different substituent groups has obvious differences in the capture effect of the probe. In a preferred embodiment of the present invention, substituting the 3′ terminal hydroxyl group of the probe with C3 Spacer gives the best effect, which has obvious advantages compared with other substituent groups. The specific probe also includes a universal sequence, which can usually be recognized by the sequencing system, so that the ligation products provided subsequently can be sequenced by the sequencing system. For example, for the Ion Torrent sequencing system, the universal sequence can be corresponding P1 sequence. In a preferred embodiment of the present invention, the base of the tail region of the 3′ end of the specific probe may contain a mismatch, and the mismatched base may be the last base at the 3′ end of the probe, or may be near the 3′ end base. Mismatched base(s) can be a single base, or multiple bases. This mismatch instead of affecting the specificity and binding efficiency of the probe, will help to improve the cutting efficiency and fidelity of the high-fidelity DNA polymerase. 
     In the gene target region enrichment method, the step (1) may further include purification to the captured-extension product. A person skilled in the art may select a suitable method for purifying the captured-extension product. For example, the purification method for captured-extension product may include magnetic bead purification and the like. In a specific embodiment of the present invention, the captured-extension product can be purified by a labeling molecule. A solid phase purification method of magnetic beads coated with avidin or streptavidin can be used in the purification process. 
     The gene target region enrichment method provided by the present invention may further include: connecting the 3′ end of the captured-extension product provided in step (1) to a linker DNA to provide a ligation product. 
     In the gene target region enrichment method, a ligation system that connects the 3′ end of the captured-extension product to the linker DNA may include a single-stranded ligase that causes the 5′ end of the linker DNA connected to the 3′ end of the captured-extension product. The single-stranded ligase is preferably T4 RNA ligase or thermostable RNA ligase or the like. 
     In the gene target region enrichment method, the linker DNA may be modified at the 5′ terminal nucleotide and has a single-stranded structure at the reaction temperature of step (2), so that under the catalysis of the chain ligase, a covalent bond is formed between 3′ end hydroxyl group of the captured-extension product and the 5′ end modification group of the linker DNA and the ligation product is obtained. In a specific embodiment of the present invention, the 5′ terminal nucleotide of the linker DNA (for example, the 5-position hydroxyl group of the 5′ terminal nucleotide) is substituted with a phosphate group, thereby forming a phosphorylation modification. Under the catalysis of the single-stranded ligase, the 3′ hydroxyl group of the captured-extension product and the phosphorylated 5′ end of the linker DNA form a covalent bond to obtain the ligation product. In another specific embodiment of the present invention, the 5′ terminal nucleotide of the linker DNA (for example, specifically the 5-position hydroxyl group of the 5′ terminal nucleotide) is substituted with an adenosine group, thereby forming an adenylation modification. Under the catalysis of 5′ App DNA/RNA thermostable ligase, the 5′ end of the linker DNA can be ligated with the 3′ end of the captured-extension product. In another specific embodiment of the present invention, the 5′ terminal nucleotide of the linker DNA (for example, specifically the 5-position hydroxyl group of the 5′ terminal nucleotide) is replaced with a phosphate group, thereby forming a phosphorylation modification. Under the catalysis of thermostable RNA ligase, the 5′ terminal of the linker DNA can be ligated with the 3′ end of the captured-extension product. The linker DNA may also be a partially double-stranded structure with a sticky end at the 5′ end region, and the sticky end at the 5′ end region has a single-stranded property, so that the 5′ end can be modified by the method described above. Under the catalysis of a suitable single-stranded ligase, the 5′ end can be linked to the captured-extension product. The linker DNA may also include one or more of a universal sequence, a sample tag sequence, a molecular tag sequence, etc. These sequences can usually be recognized by a sequencing system, so that the obtained ligation product can be sequenced. For example, for the Ion Torrent sequencing system, the universal sequence may be sequence A, the sample tag sequence may be barcode, and the molecular tag sequence corresponding thereto. Introducing barcode is helpful to distinguish samples from different sources in subsequent bioinformatics analysis, so that multiple samples can be sequenced simultaneously in a single reaction to increase throughput. The introduction of molecular tags facilitates the identification of different molecules in the subsequent bioinformatics analysis, so as to further identify the mutations generated in the subsequent amplification. The application of these sequences that can be recognized by the sequencing system enables the library of the present invention to be sequenced through the high-throughput sequencing platform to provide the information required for various subsequent research and clinical applications. 
     In a preferred embodiment of the present invention, the 3′ end hydroxyl group of the linker DNA is also replaced by other groups to prevent the ligation reaction of the 3′ end of the linker DNA to avoid self-ligation or connecting with non-target molecule, such as the free probe from step (1). 
     In the gene target region enrichment method, the step (2) may further include purification to the ligation product. A person skilled in the art may select a suitable method to purify the ligation product. For example, the purification method to the ligation product may include but not limited to silica gel column purification, heat treatment, and the like. 
     The gene target region enrichment method provided by the present invention can be used for gene detection. Methods for further genetic detection to the amplified ligation products are known to a person skilled in the art. In a specific embodiment of the present invention, the target region enrichment method can be applied to high-throughput sequencing. In another specific embodiment of the present invention, the method of enriching the target region of the present invention can be applied to the detection of gene sequences. For example, the target region includes: a site where the sequence is changed, and more specifically, a single base mutation site area, base deletion site area, base insertion site area and fusion mutation site area, etc. In another specific embodiment of the present invention, the method of enriching the target region of the present invention can be applied to the detection of the state of genetic modification. For example, the target region includes a region where methylation sites may exist, or, the DNA fragment has been treated with bisulfite. 
     The gene target region enrichment method provided by the present invention may further include: (3) amplifying the ligation product provided in the step (2). Generally, the ligation product can be PCR amplified via DNA polymerase and PCR amplification primers. By amplifying the ligation product, the product containing the DNA of the target region can be further enriched. A person skilled in the art may select a suitable method and system to amplify the ligation product provided in step (2), for example, the PCR amplification primer has a sequence matching the universal sequence of the specific probe and/or the universal sequence of the linker DNA. Specifically, the PCR amplification primer has a sequence that is at least partially complementary to the universal sequence of the specific probe and the universal sequence of the linker DNA. 
     The gene target region enrichment method provided by the present invention may further include: (4) sequencing the amplified ligation products to provide sequencing results of the target region. After PCR amplification of the ligation product, the amplification product can be sequenced by identifying the universal sequence in the amplification product to obtain the sequencing result of the target region. A person skilled in the art may select a suitable method and system to sequence the amplified ligation product, for example, sequencing the P1 sequence and the A sequence based on the Ion Torrent platform to obtain the sequencing result of the target region. It should be noted that the enrichment method of the present invention can make the ligation product obtained in step (2) contain any universal sequence for sequencing, such as Ion Torrent sequencing platform, Illumina sequencing platform, or other sequencing platforms. 
     The gene target region enrichment method provided by the present invention may further include: (5) detecting the ligation product provided in step (2) by the detection primer 1, the detection primer 2 and the probe 3, enabling the rapid detection of the target region by means of PCR instead of next-generation sequencing. At least one of the detection primer 1, the detection primer 2 and the probe 3 contains a gene-specific sequence, that is, for different gene target regions, the combination of the three primer/probe&#39;s specific sequences can be monospecific, bispecific or trispecific. In an embodiment of the present invention, the detection primer 1 includes a gene specific sequence, the detection primer 2 and the probe 3 include universal sequence; or the detection primer 1 and the detection primer 2 include a gene specific sequence; or the detection primer 1 and the probe 3 contains a gene specific sequence; or all of detection primer 1, detection primer 2, and probe 3 contain a gene specific sequence. In some embodiments, the probe 3 may further include a labeling molecule, such as a fluorescent molecule, and the sequence of the probe 3 is not complementary to the detection primer 1 or 2. 
     The second aspect of the present invention provides a kit for enriching target regions of fragmented DNA, including specific probes and linker DNA suitable for the gene target region enrichment method provided in the first aspect of the present invention. The structure of the specific probe and the linker DNA has been described in detail in the first aspect of the present invention, and will not be repeated here. 
     The kit provided by the present invention may further include one or more of the following components: RNA ligase, dNTP coupled with a labeling molecule, DNA polymerase, nuclease, etc. Among them, the RNA ligase can be a thermostable RNA ligase, T4 RNA ligase, or 5′ App DNA/RNA thermostable ligase, and the like. dTNP can be dCTP or dATP. The DNA polymerase may be a DNA polymerase having 3′-5′ exonuclease activity, preferably, the DNA polymerase is a high-fidelity polymerase. 
     The kit provided by the present invention may also include forward primers and reverse primers used for PCR amplification, which are generally matching the universal sequence of the specific probe and the universal sequence of the linker DNA. In particular, it may have a sequence at least partially complementary to the universal sequence of the specific probe and the universal sequence of the linker DNA. 
     The kit provided by the present invention may further include a detection primer 1, a detection primer 2 and a probe 3 for PCR detection, at least one of them contains a gene-specific sequence, such as monospecific, bispecific or trispecific primer/probe combinations. Preferably, only detection primer 1 contains a gene-specific sequence, refer to  FIG.  4    for the detection process. 
     In a preferred embodiment of the present invention, after library construction by the method or kit of the present invention, as shown in  FIG.  2   , library molecules (for example, the ligation product provided in step (2), the structure may be as shown in  FIG.  2   ) includes the following sequences in order: 5′ end sequencing universal sequence, gene specific probe sequence, enriched target region sequence, adapter(linker) sequence, barcode, molecular tag sequence, 3′ end sequencing universal sequence. The enriched target region contains the sequence information of the sample DNA before enrichment. The characteristics of this part of the sequence are as follows: the position of the 5′ end on the genome is fixed and determined by the specific probe; while the position of the 3′ end is not fixed, determined by the initial DNA fragmentation status of the library. Therefore, in the data analysis after enrichment, the position of the 3′ end of the sequence on the genome can also serve as a molecular tag. Molecular tags can be used to distinguish different molecules and improve detection sensitivity and accuracy. 
     The beneficial effects of the present invention are as follows: 
     Firstly, before the ligation, the target regions of all fragmented DNA samples are pre-amplified by means of captured-extension, to avoid loss or missed detection of original target molecules (especially small fragments and rare molecules) caused by insufficient ligation efficiency of ligase during the ligation stage. The extension reaction in the pre-amplification stage is linear amplification and has no preference of PCR amplification, so, it will not accumulate errors introduced by PCR amplification. Compared with the conventional PCR library building technology, the product is more uniform and the subsequent sequencing results are more accurate. 
     Secondly, in the pre-amplification stage, only a single-stranded probe with a length of about 30 bp is necessary to be designed for each target gene, avoiding the difficulty of designing double-ended primers for short fragments such as cfDNA and shorter fragments such as ctDNA. Thus, not only the success rate of library construction but also the convenience of library construction is improved. Blocking the 3′ end of the probe can block the non-intended ligation except the probe and the template, effectively reducing the background noise caused by the free probe, supplemented by the dNTP coupled to the labeling molecule and its purification system, the purity of the target product can be further improved and the sample DNA molecules can reach the theoretical maximum conversion rate. 
     Thirdly, after the 5′ end of the linker DNA is modified, the linker DNA can be well connected to the 3′ end of the extension product under the catalysis of single-stranded ligase but will not be connected to the 3′ end of the block-modified specific probe. The 3′ end of the linker is blocked to avoid the self-ligation or mis-ligation of the linker and increase the proportion of the target ligation product in the final product. 
     Finally, in the process of enriching the target region, the universal sequence for sequencing, the sample tag sequence and the molecular tag sequence are designed to be contained in the sequences of the probe and the linker, enabling direct sequencing and data analysis after library construction; or rapid PCR detection of the target region can be achieved using single, dual or trispecific primer/probe system. 
     In summary, the enrichment method and kit of the present invention are simple in operation and produces reliable results. The use of DNA with a fragment length of less than 200 bp can minimize the loss of original molecules, especially rare molecules, and enrich the target most efficiently. In addition, the enrichment method and kit have extremely High-fidelity, and the base error generated during the sequencing process can be effectively corrected through subsequent bioinformatics analysis, and the highest sequencing accuracy rate in theory can be achieved. 
     The following describes the embodiments of the present invention through specific examples. A person skilled in the art can easily understand other advantages and effects of the present invention from the contents disclosed in this specification. The present invention can also be implemented or applied through different specific embodiments. Based on different viewpoints and applications, the details in this specification can also be modified or changed without departing from the spirit of the present invention. 
     Before further describing the specific embodiments of the present invention, it should be understood that the scope of protection of the present invention is not limited to the specific embodiments described below. It should also be understood that the terms used in the examples of the present invention are intended to describe specific embodiments of the present invention, and are not intended to limit the scope of protection of the present invention. In the description and claims of the present invention, unless the context clearly indicates otherwise, the singular forms “a”, “an”, “one” and “this” include plural forms. 
     When the numerical ranges are given in the embodiments, it should be understood that unless the invention indicates otherwise, the two endpoints of each numerical range and any one value between the two endpoints can be selected. Unless otherwise defined, all technical and scientific terms used in the present invention have the same meaning as commonly understood by a person skilled in the art. In addition to the specific methods, equipment, and materials used in the embodiments, the methods, equipment, and materials described in the embodiments of the present invention can also be used according to the master of the prior art and the description of the present invention by a person skilled in the art. Similar or equivalent methods, devices and materials in prior art can also be used to implement the present invention. 
     Unless otherwise stated, the experimental methods, detection methods, and preparation methods disclosed in the present invention use conventional technologies in molecular biology, biochemistry, chromatin structure and analysis, analytical chemistry, cell culture, and reorganization DNA technology and related fields. These technologies have been well described in the existing literature. For details, see Sambrook et al., MOLECULAR CLONING: A LABORATORY MANUAL, Second edition, Cold Spring Harbor Laboratory Press, 1989 and Third edition, 2001; Ausubel et al., CURRENT PROTOCOLS IN MOLECULAR BIOLOGY, John Wiley &amp; Sons, New York, 1987 and periodic updates; the series METHODS IN ENZYMOLOGY, Academic Press, San Diego; Wolffe, CHROMATIN STRUCTURE AND FUNCTION, Third edition, Academic Press, San Diego, 1998; METHODS IN ENZYMOLOGY, Vol. 304, Chromatin (P. M. Wassarman and A. P. Wolffe, eds.), Academic Press, San Diego, 1999; and METHODS IN MOLECULAR BIOLOGY, Vol. 119, Chromatin Protocols (P. B. Becker, ed.) Humana Press, Totowa, 1999, etc. 
     Example 1 
     The oligonucleotide sequences used in Example 1 are shown in table 1: 
     
       
         
           
               
               
               
             
               
                 TABLE 1 
               
               
                   
               
               
                   
                 SEQ 
                   
               
               
                 Name 
                 ID NO. 
                 Sequence (5′→3′) 
               
               
                   
               
             
            
               
                 Probe 1 
                  1 
                 
                   CCGCTTTCCTCTCTATGGGCAGTCGGTGAT 
                 
               
               
                   
                   
                 CCTGGCAGCCAGGAACGTACTGGTGAA-OH 
               
               
                   
               
               
                 Probe 2 
                  2 
                 
                   CCGCTTTCCTCTCTATGGGCAGTCGGTGAT 
                 
               
               
                   
                   
                 CCTGGCAGCCAGGAACGTACTGGTGAA-C3 
               
               
                   
                   
                 Spacer 
               
               
                   
               
               
                 Probe 2p 
                  3 
                 
                   CCGCTTTCCTCTCTATGGGCAGTCGGTGAT 
                 
               
               
                   
                   
                 CCTGGCAGCCAGGAACGTACTGGTGAA-PO 4   
               
               
                   
               
               
                 Probe 2c 
                  4 
                 
                   CCGCTTTCCTCTCTATGGGCAGTCGGTGAT 
                 
               
               
                   
                   
                 CCTGGCAGCCAGGAACGTACTGGTGAA-C6 
               
               
                   
                   
                 Spacer 
               
               
                   
               
               
                 Probe 2n 
                  5 
                 
                   CCGCTTTCCTCTCTATGGGCAGTCGGTGAT 
                 
               
               
                   
                   
                 CCTGGCAGCCAGGAACGTACTGGTGAA-NH 2   
               
               
                   
               
               
                 Probe 2d 
                  6 
                 
                   CCGCTTTCCTCTCTATGGGCAGTCGGTGAT 
                 
               
               
                   
                   
                 CCTGGCAGCCAGGAACGTACTGGTGAA- 
               
               
                   
                   
                 DDC 
               
               
                   
               
               
                 Probe 3 
                  7 
                 
                   CCGCTTTCCTCTCTATGGGCAGTCGGTGAT 
                 
               
               
                   
                   
                 CCTGGCAGCCAGGAACGTACTGGTGAT-C3 
               
               
                   
                   
                 Spacer 
               
               
                   
               
               
                 Probe 4 
                  8 
                 
                   CCGCTTTCCTCTCTATGGGCAGTCGGTGAT 
                 
               
               
                   
                   
                 CCTGGCAGCCAGGAACGTACTGrGTGAT- 
               
               
                   
                   
                 C3 Spacer 
               
               
                   
               
               
                 ABar-X1 
                  9 
                 PO 4 -GGATCCNNNNNN CAGCTTGGA   CTGAG   
               
               
                   
                   
                 
                   TCGGAGACACGCAGGGATGAGATGG 
                 
               
               
                   
               
               
                 ABar-X2 
                 10 
                 PO 4 -GGATCCNNNNNN GTTCTCCTTA   CTGA   
               
               
                   
                   
                   GTCGGAGACACGCAGGGATGAGATGG -C3 
               
               
                   
                   
                 Spacer 
               
               
                   
               
               
                 ABar-X3 
                 11 
                 5′App-GGATCCNNNNNN TTACCTTAG   CTG   
               
               
                   
                   
                 
                   AGTCGGAGACACGCAGGGA 
                 
               
               
                   
                   
                   TGAGATGG -C3 Spacer 
               
               
                   
               
               
                 EF-1 
                 12 
                 GATCACAGATTTTGGGC 
               
               
                   
               
               
                 ER-1 
                 13 
                 TTTGCCTCCTTCTGC 
               
               
                   
               
               
                 EM-1 
                 14 
                 AACTGCTGGGTGCGGA 
               
               
                   
               
               
                 AF 
                 15 
                 GTCTCAGCCTCTCTATGGGCAGTCGGTGAT 
               
               
                   
               
               
                 AR 
                 16 
                 CCATCTCATCCCTGCGTGTCTCCGACTCAG 
               
               
                   
               
            
           
         
       
     
     The probe in this embodiment contains a universal sequence for sequencing (the bases marked in italics) and here contains the P1 sequence in the Ion Torrent sequencing system. The specific sequences of all probes in the table are directed to the L858R mutation of exon 21 of the EGFR gene. Among them, the probe 1 (SEQ ID NO.1) has no modification at the 3′ terminal, and 3′ terminal hydroxyl groups of probe 2, 3 and 4 (SEQ ID NO. 2, SEQ ID NO. 7, SEQ ID NO. 8) are replaced with C3 Spacer, 3′ terminal hydroxyl group of probe 2p (SEQ ID NO. 3) is replaced with a phosphate group, 3′ terminal hydroxyl group of probe 2c (SEQ ID NO. 4) is replaced with C6 Spacer, 3′ terminal hydroxyl group of probe 2n (SEQ ID NO. 5) was replaced with a phosphate group, and 3′ terminal hydroxyl group of probe 2d (SEQ ID NO. 6) is replaced with dideoxycytosine (DDC). Among them, the last base of probe 3 (SEQ ID NO. 7) is a mismatched base, and the G near the 3′ end in probe 4 (SEQ ID NO. 8) is replaced with the RNA base rG. 
     The linker ABar-X1/2/3 (SEQ ID NO. 9, SEQ ID NO. 10, SEQ ID NO. 11) contains universal sequence for sequencing, which is the base marked in italics, here is Ion Torrent sequence A in the sequencing system. The underlined part of the sequence is barcode, which can be substituted with different barcodes in different samples of the present invention, and the changes in this part will not be repeated in the present invention. The “N” part is a molecular tag sequence, wherein NNNNNN is a random sequence used to label different extension product molecules in the same sample. The 5′ terminal of the ABar-X1 and ABar-X2 (SEQ ID NO. 9, SEQ ID NO. 10) is phosphorylated modification. The 5′ end of the ABar-X3 (SEQ ID NO. 11) is adenylation modification. The hydroxyl group at the 3′ end of ABar-X2 and ABar-X3 (SEQ ID NO.10, SEQ ID NO.11) is substituted with C3 Spacer. 
     EF-1 and ER-1 (SEQ ID NO. 12, SEQ ID NO. 13) are the front and rear primers used for PCR detection of EGFR target sequence, wherein EM-1 (SEQ ID NO. 14) is MGB probe. AF and AR (SEQ ID NO. 15, SEQ ID NO. 16) are the front and rear primers used to amplify the library, respectively, and to match the universal sequence in the library, namely the P1 sequence in the probe and the A sequence in the linker. 
     Main Reagents and Materials 
     Plasma free DNA extraction kit was purchased from Qiagen; Cell DNA extraction kit and purified single-stranded DNA kit were RNA Clean Kit purchased from Tiangen Biotech; Thermally stable RNA ligase was purchased from Epicentre, USA; High-fidelity DNA polymerase reaction system, Biotin-dCTP and MyOne Strptavidin C1 reagent for purification were purchased from Invitrogen. DNA polymerase, high-fidelity DNA polymerase and PCR reaction kit were purchased from TOYOBO. RNAse H 2  thermostable nuclease was purchased from IDT. Q5 high-fidelity DNA polymerase, T4 RNA ligase and 5′ App DNA/RNA thermostable ligase were purchased from NEB. Agencourt AMPure magnetic beads were purchased from Beckman. The calibrators for quantitative detection in the relevant process were constructed according to the conventional methods of molecular cloning, and the detailed composition is shown in  FIG.  3   . 
     Step 1. Sample Preparation 
     Extract cfDNA in healthy human plasma samples and DNA in NCI-H1975 cell line (this cell line is mutation of exon 21 of EGFR gene L858R) with extraction kit, and the DNA samples are quantified by Qubit Fluorometer quantifier. The DNA of the NCI-H1975 cell line was broken into fragments of about 160 bp, and mixed into the cfDNA samples of healthy people at the proportions of 10%, 1%, 0.1%, and 0.01%, and the cfDNA of healthy people was used as a blank control (QC). 
     Step 2. Captured-Extension 
     Prepare the captured-extension reaction system according to table 2, table 3, and table 4, respectively. 
     
       
         
           
               
               
               
             
               
                 TABLE 2 
               
               
                   
               
               
                   
                 Volume  
                 Final  
               
               
                 Compositions 
                 (μL) 
                 Concentration 
               
               
                   
               
             
            
               
                   
               
            
           
           
               
               
               
            
               
                 2× high-fidelity DNA polymerase PCR Master  
                 25 
                 1× 
               
               
                 Mix (with 3′-5′ exonuclease activity); 
                   
                   
               
               
                 or, 2× DNA polymerase PCR Master Mix  
                   
                   
               
               
                 (without 3′-5′ exonuclease activity) 
                   
                   
               
               
                 Specific probe (10 μM) 
                 0.5 
                 100 nM 
               
               
                 cfDNA samples of all types 
                 20 
                 20000 copies 
               
               
                 H 2 O 
                 4.5 
                 / 
               
               
                 Total 
                 50 
                 / 
               
               
                   
               
            
           
         
       
     
     
       
         
           
               
               
               
             
               
                 TABLE 3 
               
               
                   
               
               
                   
                 Volume 
                 Final  
               
               
                 Compositions 
                 (μL) 
                 Concentration 
               
               
                   
               
             
            
               
                   
               
            
           
           
               
               
               
            
               
                 2× DNA polymerase PCR Master Mix  
                 25 
                 1× 
               
               
                 (without 3′-5′ exonuclease activity) 
                   
                   
               
               
                 RNAse H 2  thermostable nuclease 
                 0.5 
                 / 
               
               
                 Specific probe (10 μM) 
                 0.5 
                 100 nM 
               
               
                 cfDNA samples of all types 
                 20 
                 20000 copies 
               
               
                 H 2 O 
                 4 
                 / 
               
               
                 Total 
                 50 
                 / 
               
               
                   
               
            
           
         
       
     
     
       
         
           
               
               
               
             
               
                 TABLE 4 
               
               
                   
               
               
                   
                 Volume  
                 Final  
               
               
                 Compositions 
                 (μL) 
                 Concentration 
               
               
                   
               
             
            
               
                   
               
            
           
           
               
               
               
            
               
                 2× high-fidelity DNA polymerase PCR  
                 25 
                 1× 
               
               
                 Master Mix (with 3′-5′ exonuclease activity) 
                   
                   
               
               
                 Specific probe (10 μM) 
                 0.5 
                 100 nM 
               
               
                 Biotin-dCTP (0.4 mM) 
                 2.5 
                  20 μM 
               
               
                 cfDNA samples of all types 
                 20 
                 20000 copies 
               
               
                 H 2 O 
                 2 
                 / 
               
               
                 Total 
                 50 
                 / 
               
               
                   
               
            
           
         
       
     
     The PCR procedure of captured-extension is shown in Table 5: 
     
       
         
           
               
               
               
             
               
                 TABLE 5 
               
               
                   
               
               
                 Cycles 
                 Temperature 
                 Time 
               
               
                   
               
             
            
               
                 1 cycle 
                 98° C. 
                 60 s 
               
               
                 1/20/40 cycles 
                 98° C. 
                 10 s 
               
               
                   
                 67° C. 
                 20 s 
               
               
                   
                 72° C. 
                 20 s 
               
               
                 1 cycle 
                 72° C. 
                    5 min 
               
               
                   
               
            
           
         
       
     
     After completion of the captured-extension process, the extension product was purified by silica gel column using RNA Clean kit and eluted with 60 μL of the elution buffer. (The silica gel column purification mentioned hereafter in the present invention is the same). The extension product was further purified with the magnetic beads coated with streptavidin after the silica gel column purification, and finally all the products are dissolved in 60 μL elution buffer. 
     Step 3. Extension Efficiency Detection 
     Prepare PCR detection system for extension products according to table 6. 
     
       
         
           
               
               
               
               
             
               
                   
                 TABLE 6 
               
               
                   
                   
               
               
                   
                   
                 Volume 
                 Final 
               
               
                   
                 Compositions 
                 (μL) 
                 Concentration 
               
               
                   
                   
               
             
            
               
                   
               
            
           
           
               
               
               
               
            
               
                   
                 2× Taqman Mix 
                 25 
                 1× 
               
               
                   
                 ER-1 (10 uM) 
                 1.5 
                 300 nM 
               
               
                   
                 AF (10 uM) 
                 1.5 
                 300 nM 
               
               
                   
                 EM-1 (10 uM) 
                 0.5 
                 100 nM 
               
               
                   
                 H 2 O 
                 17.5 
                 / 
               
               
                   
                 Extension 
                 4 
                 / 
               
               
                   
                 product/Calibrator 
                   
                   
               
               
                   
                 Total Volume 
                 50 
                 / 
               
               
                   
                   
               
            
           
         
       
     
     The PCR procedure for detecting the extension efficiency is shown in table 7. 
     
       
         
           
               
               
               
               
             
               
                   
                 TABLE 7 
               
               
                   
                   
               
               
                   
                 Cycles 
                 Temperature 
                 Time 
               
               
                   
                   
               
             
            
               
                   
                  1 cycle 
                 95° C. 
                  3 min 
               
               
                   
                 45 cycles 
                 95° C. 
                 10 s 
               
               
                   
                   
                 56° C. 
                 25 s 
               
               
                   
                   
                 72° C. 
                 20 s 
               
               
                   
                   
               
            
           
         
       
     
     Step 4. Single-Stranded Ligation 
     According to the results of step 3, select part of the extension product obtained in step 2 to prepare the ligation reaction system according to table 8, table 9, and table 10, respectively. 
     
       
         
           
               
               
               
               
             
               
                 TABLE 8 
               
               
                   
               
               
                   
                 Volume  
                 Final  
                 Ligation 
               
               
                 Compositions 
                 (μL) 
                 Concentration 
                 Conditions 
               
               
                   
               
             
            
               
                   
               
            
           
           
               
               
               
               
            
               
                 CircLigase II 10× Reaction  
                 4 
                 1× 
                 60° C. 
               
               
                 Buffer 
                   
                   
                 1 hour 
               
            
           
           
               
               
               
               
               
            
               
                 50 mM MnCl 2   
                 2 
                 2.5  
                 mM 
                   
               
               
                 5 M Betaine 
                 8 
                 1  
                 M 
                   
               
               
                 Thermostable RNA ligase  
                 2 
                 5  
                 U/uL 
                   
               
            
           
           
               
               
               
               
            
               
                 (100 U/uL) 
                   
                   
                   
               
            
           
           
               
               
               
               
               
            
               
                 ABar-X1/ABar-X2 (200 nM) 
                 2 
                 10 
                 nM 
                   
               
            
           
           
               
               
               
               
            
               
                 Extension product 
                 8 
                   
                   
               
               
                 50% PEG 
                 14 
                 17.5% 
                   
               
               
                 Total 
                 40 
                 / 
               
               
                   
               
            
           
         
       
     
     
       
         
           
               
               
               
               
             
               
                 TABLE 9 
               
               
                   
               
               
                   
                 Volume  
                 Final  
                 Ligation  
               
               
                 Compositions 
                 (μL) 
                 Concentration 
                 Conditions 
               
               
                   
               
             
            
               
                   
               
            
           
           
               
               
               
               
            
               
                 10× Buffer for ligation 
                 4 
                 1× 
                 16° C. 
               
            
           
           
               
               
               
               
               
            
               
                 T4 RNA ligase 
                 2 
                 5  
                 U/uL 
                 4 hours 
               
               
                 Linker ABar-X2(200 nM) 
                 2 
                 10  
                 nM 
                   
               
            
           
           
               
               
               
               
            
               
                 Extension Product 
                 8 
                 / 
                   
               
               
                 50% PEG 
                 14 
                 17.5% 
                   
               
               
                 Total 
                 40 
                 / 
               
               
                   
               
            
           
         
       
     
     
       
         
           
               
               
               
               
             
               
                 TABLE 10 
               
               
                   
               
               
                   
                 Volume  
                 Final 
                 Ligation 
               
               
                 Compositions 
                 (μL) 
                 Concentration 
                 Conditions 
               
               
                   
               
             
            
               
                   
               
            
           
           
               
               
               
               
            
               
                 10× NE Buffer 1 
                 4 
                 1× 
                 65° C. 
               
            
           
           
               
               
               
               
               
            
               
                 50 mM MnCl 2   
                 2 
                 2.5 
                 mM 
                 1 hour 
               
            
           
           
               
               
               
               
            
               
                 H 2 O 
                 8 
                 / 
                   
               
            
           
           
               
               
               
               
               
            
               
                 5′App DNA/RNA thermostable  
                 2 
                 5 
                 U/uL 
                   
               
            
           
           
               
               
               
               
            
               
                 ligase (100 U/uL) 
                   
                   
                   
               
            
           
           
               
               
               
               
               
            
               
                 Linker ABar-X3 (200 nM) 
                 2 
                 10 
                 nM 
                   
               
            
           
           
               
               
               
               
            
               
                 Captured-Extension Product 
                 8 
                   
                   
               
               
                 50% PEG 
                 14 
                 17.5% 
                   
               
               
                 Total 
                 40 
                 / 
               
               
                   
               
            
           
         
       
     
     Processing after obtaining the ligation product is shown in table 11. 
     
       
         
           
               
               
               
             
               
                 TABLE 11 
               
               
                   
               
               
                 Process 1 
                 Process 2 
                 Process 3 
               
               
                   
               
             
            
               
                 None (as control) 
                 Incubating for 10 min  
                 Purification using silica  
               
               
                   
                 at 95° C. 
                 gel column 
               
               
                   
               
            
           
         
       
     
     Step 5. Test of the Ligation Efficiency 
     Prepare the PCR system for testing the ligation efficiency of step 4 according to table 12. 
     
       
         
           
               
               
               
             
               
                 TABLE 12 
               
               
                   
               
               
                 Reagent 
                 Dosage (  ) 
                 Final Concentration 
               
               
                   
               
             
            
               
                   
               
            
           
           
               
               
               
            
               
                 2× Taqman Mix 
                 12.5 
                 1× 
               
               
                 AF (10 μM) 
                 0.75 
                 300 nM 
               
               
                 AR (10 μM) 
                 0.75 
                 300 nM 
               
               
                 EM-1 (10 μM) 
                 0.25 
                 100 nM 
               
               
                 H 2 O 
                 8.75 
                 / 
               
               
                 Calibrator/Ligation Product 
                 2 
                 / 
               
               
                 Total 
                 25 
                 / 
               
               
                   
               
               
                     indicates data missing or illegible when filed 
               
            
           
         
       
     
     PCR reaction conditions for testing the ligation efficiency is shown in table 13. 
     
       
         
           
               
               
               
               
             
               
                   
                 TABLE 13 
               
               
                   
                   
               
               
                   
                 Cycles 
                 Temperature 
                 Time 
               
               
                   
                   
               
             
            
               
                   
                  1 cycle 
                 95° C. 
                  4 min 
               
               
                   
                 45 cycles 
                 95° C. 
                 10 s 
               
               
                   
                   
                 60° C. 
                 30 s 
               
               
                   
                   
                 72° C. 
                 20 s 
               
               
                   
                   
               
            
           
         
       
     
     Step 6. Amplification of the Library 
     Amplify the ligation product obtained in step 4 with PCR according to the reaction conditions and procedure as shown in table 14. 
     
       
         
           
               
               
             
               
                 TABLE 14 
               
               
                   
               
             
            
               
                 Compositions 
                 Volume (μL) 
               
               
                   
               
               
                 Ligation product 
                 30 
               
               
                 5× Q5 Buffer 
                 10 
               
               
                 dNTP(10 mM each) 
                 1 
               
               
                 Q5 high-fidelity DNA polymerase (2 U/uL) 
                 1 
               
               
                 AF (10 μM) 
                 1.5 
               
               
                 AR (10 μM) 
                 1.5 
               
               
                 ddH 2 O 
                 5 
               
               
                 Total Volume 
                 50 
               
               
                   
               
            
           
           
               
               
               
            
               
                 Temperature(° C.) 
                 Time(s) 
                 Cycles 
               
               
                   
               
               
                 98 
                 30 
                 1 
               
               
                 98 
                 10 
                 15 
               
               
                 72 
                 30 
                   
               
               
                 72 
                 300 
                 1 
               
               
                   
               
            
           
         
       
     
     Purify the amplified library with 80 μL of Agencourt AMPure magnetic beads, and dissolve the purified amplified product in 30 μL of elution buffer. At this point, the library construction is completed, and the library is ready for sequencing. 
     Step 7. Sequencing and Data Analysis 
     Sequencing the prepared library on the Ion Proton sequencer. Related operations include water-in-oil PCR, library enrichment, chip loading, and on-board sequencing. For detailed operation procedures, see Ion PITM Hi-Q™ OT2 200 Kit manual and Ion PITM Hi-Q™ Sequencing 200 Kit manual. 
     Experimental Results and Analysis 
     The calculation method of captured-extension multiple(magnification), capture efficiency and ligation efficiency in the results is as follows: 
       Captured-extension magnification=EGFR gene output copies after capture/EGFR gene input copies before capture 
       Capture efficiency=(Captured-extension multiple-1)/Captured-extension cycles×100%
 
       Ligation efficiency=(output copies of ligation product/input copies of extension product)×100%
 
     The analysis of all process data (such as capture efficiency, ligation efficiency) in this embodiment comes from QC samples. 
     Results 1. The Effect of Different Types of Polymerases on the Captured-Extension Results of Different Probes. 
     
       
         
           
               
             
               
                 TABLE 15 
               
             
            
               
                   
               
               
                 Testing results of different types of polymerases for 
               
               
                 captured-extension (QC sample) 
               
            
           
           
               
               
               
               
               
               
               
               
            
               
                   
                   
                   
                   
                 Copies 
                 Copies of 
                   
                   
               
               
                   
                   
                   
                   
                 of EGFR 
                 EGFR 
                   
                   
               
               
                   
                   
                   
                   
                 output 
                 input 
                   
                   
               
               
                   
                   
                   
                   
                 after 
                 before 
                 Captured- 
                 Capture 
               
               
                   
                 Types of DNA 
                   
                   
                 captured- 
                 captured- 
                 extension 
                 Efficiency 
               
               
                 Probe 
                 polymerases 
                 Nuclease 
                 Cycles 
                 extension 
                 extension 
                 Multiple 
                 % 
               
               
                   
               
            
           
           
               
               
               
               
               
               
               
               
            
               
                 Probe 1 
                 High-fidelity 
                 N 
                 40 
                 482000 
                 20000 
                 24.1 
                 57.75% 
               
               
                   
                 polymerase 
                   
                   
                   
                   
                   
                   
               
               
                 Probe 2 
                 High-fidelity 
                 N 
                 40 
                 566000 
                 20000 
                 28.3 
                 68.25% 
               
               
                   
                 polymerase 
                   
                   
                   
                   
                   
                   
               
               
                 Probe 2p 
                 High-fidelity 
                 N 
                 40 
                 98400 
                 20000 
                 4.92 
                  9.80% 
               
               
                   
                 polymerase 
                   
                   
                   
                   
                   
                   
               
               
                 Probe 2c 
                 High-fidelity 
                 N 
                 40 
                 428000 
                 20000 
                 21.4 
                    51% 
               
               
                   
                 polymerase 
                   
                   
                   
                   
                   
                   
               
               
                 Probe 2n 
                 High-fidelity 
                 N 
                 40 
                 64800 
                 20000 
                 3.24 
                   5.6% 
               
               
                   
                 polymerase 
                   
                   
                   
                   
                   
                   
               
               
                 Probe 2d 
                 High-fidelity 
                 N 
                 40 
                 71200 
                 20000 
                 3.56 
                   6.4% 
               
               
                   
                 polymerase 
                   
                   
                   
                   
                   
                   
               
               
                 Probe 3 
                 High-fidelity 
                 N 
                 40 
                 524000 
                 20000 
                 26.2 
                 63.00% 
               
               
                   
                 polymerase 
                   
                   
                   
                   
                   
                   
               
               
                 Probe 4 
                 High-fidelity 
                 N 
                 40 
                 482000 
                 20000 
                 24.1 
                 57.75% 
               
               
                   
                 polymerase 
                   
                   
                   
                   
                   
                   
               
               
                 Probe 1 
                 Common 
                 N 
                 40 
                 512000 
                 20000 
                 25.6 
                 61.50% 
               
               
                   
                 polymerase 
                   
                   
                   
                   
                   
                   
               
               
                 Probe 2 
                 Common 
                 N 
                 40 
                 24000 
                 20000 
                 1.2 
                  0.50% 
               
               
                   
                 polymerase 
                   
                   
                   
                   
                   
                   
               
               
                 Probe 2p 
                 Common 
                 N 
                 40 
                 21000 
                 20000 
                 1.05 
                  0.12% 
               
               
                   
                 polymerase 
                   
                   
                   
                   
                   
                   
               
               
                 Probe 2c 
                 High-fidelity 
                 N 
                 40 
                 21000 
                 20000 
                 1.1 
                  0.25% 
               
               
                   
                 polymerase 
                   
                   
                   
                   
                   
                   
               
               
                 Probe 2n 
                 High-fidelity 
                 N 
                 40 
                 23000 
                 20000 
                 1.15 
                  0.38% 
               
               
                   
                 polymerase 
                   
                   
                   
                   
                   
                   
               
               
                 Probe 2d 
                 High-fidelity 
                 N 
                 40 
                 24000 
                 20000 
                 1.20 
                   0.5% 
               
               
                   
                 polymerase 
                   
                   
                   
                   
                   
                   
               
               
                 Probe 3 
                 Common 
                 N 
                 40 
                 22000 
                 20000 
                 1.1 
                  0.25% 
               
               
                   
                 polymerase 
                   
                   
                   
                   
                   
                   
               
               
                 Probe 4 
                 Common 
                 N 
                 40 
                 26000 
                 20000 
                 1.3 
                  0.75% 
               
               
                   
                 polymerase 
                   
                   
                   
                   
                   
                   
               
               
                 Probe 1 
                 Common 
                 Y 
                 40 
                 496000 
                 20000 
                 24.8 
                 59.50% 
               
               
                   
                 polymerase 
                   
                   
                   
                   
                   
                   
               
               
                 Probe 2 
                 Common 
                 Y 
                 40 
                 26000 
                 20000 
                 1.3 
                  0.75% 
               
               
                   
                 polymerase 
                   
                   
                   
                   
                   
                   
               
               
                 Probe 3 
                 Common 
                 Y 
                 40 
                 22000 
                 20000 
                 1.1 
                  0.25% 
               
               
                   
                 polymerase 
                   
                   
                   
                   
                   
                   
               
               
                 Probe 4 
                 Common 
                 Y 
                 40 
                 506000 
                 20000 
                 25.3 
                 60.75% 
               
               
                   
                 polymerase 
               
               
                   
               
            
           
         
       
     
     The captured-extension reaction system involved in table 15 is shown in table 2 and table 3, wherein, the high-fidelity polymerase is 2×high-fidelity DNA polymerase PCR Master Mix (DNA polymerase has 3′-5′ exonuclease activity), the common polymerase is 2×DNA polymerase PCR Master Mix (DNA polymerase does not have 3′-5′ exonuclease activity), the cfDNA sample used is QC sample, please refer to step 3 for the method of extension efficiency detection. 
     It can be seen from the test results: 1) After the 3′ end-blocking modified probe binds to the template under the action of high-fidelity polymerase, the blocking group is excised and the probe is activated, so that the target sequence can be extended effectively; 2) Combination of thermostable nuclease and common polymerase play an activation effect to the probe with modified RNA, enhancing the applicability of the enrichment method of the present invention; 3) Selection of different substitution groups has obvious differences in the capture effect of the probe. Substituting the 3′ terminal hydroxyl group of the probe with C3 Spacer gives the best effect, which has obvious advantages compared with other substituent groups. Therefore, the data from result 2 in this example mainly refers to the result data obtained for the probe in which the 3′ terminal hydroxyl group is replaced by C3 Spacer. 
     Result 2. The Effect of Different Extension Cycles on Probe Extension Results. 
     
       
         
           
               
             
               
                 TABLE 16 
               
             
            
               
                   
               
               
                 Test results of different extended cycles (QC sample) 
               
            
           
           
               
               
               
               
               
               
               
               
            
               
                   
                   
                   
                   
                 Copies 
                 Copies of 
                   
                   
               
               
                   
                   
                   
                   
                 of EGFR 
                 EGFR 
                   
                   
               
               
                   
                   
                   
                   
                 output 
                 input 
                   
                   
               
               
                   
                   
                   
                   
                 after 
                 before 
                 Captured- 
                 Capture 
               
               
                   
                 Types of DNA 
                   
                   
                 captured- 
                 captured- 
                 extension 
                 Efficiency 
               
               
                 Probe 
                 polymerases 
                 Nuclease 
                 Cycles 
                 extension 
                 extension 
                 Magnification 
                 % 
               
               
                   
               
            
           
           
               
               
               
               
               
               
               
               
            
               
                 Probe 1 
                 High-fidelity 
                 N 
                 40 
                 482000 
                 20000 
                 24.1 
                 57.75% 
               
               
                   
                 polymerase 
                   
                   
                   
                   
                   
                   
               
               
                 Probe 2 
                 High-fidelity 
                 N 
                 40 
                 566000 
                 20000 
                 28.3 
                 68.25% 
               
               
                   
                 polymerase 
                   
                   
                   
                   
                   
                   
               
               
                 Probe 3 
                 High-fidelity 
                 N 
                 40 
                 524000 
                 20000 
                 26.2 
                 63.00% 
               
               
                   
                 polymerase 
                   
                   
                   
                   
                   
                   
               
               
                 Probe 4 
                 High-fidelity 
                 N 
                 40 
                 482000 
                 20000 
                 24.1 
                 57.75% 
               
               
                   
                 polymerase 
                   
                   
                   
                   
                   
                   
               
               
                 Probe 1 
                 High-fidelity 
                 N 
                 20 
                 276000 
                 20000 
                 13.8 
                 64.00% 
               
               
                   
                 polymerase 
                   
                   
                   
                   
                   
                   
               
               
                 Probe 2 
                 High-fidelity 
                 N 
                 20 
                 244000 
                 20000 
                 12.2 
                 56.00% 
               
               
                   
                 polymerase 
                   
                   
                   
                   
                   
                   
               
               
                 Probe 3 
                 High-fidelity 
                 N 
                 20 
                 234000 
                 20000 
                 11.7 
                 53.50% 
               
               
                   
                 polymerase 
                   
                   
                   
                   
                   
                   
               
               
                 Probe 4 
                 High-fidelity 
                 N 
                 20 
                 248000 
                 20000 
                 12.4 
                 57.00% 
               
               
                   
                 polymerase 
                   
                   
                   
                   
                   
                   
               
               
                 Probe 1 
                 High-fidelity 
                 N 
                 1 
                 34800 
                 20000 
                 1.74 
                 74.00% 
               
               
                   
                 polymerase 
                   
                   
                   
                   
                   
                   
               
               
                 Probe 2 
                 High-fidelity 
                 N 
                 1 
                 34400 
                 20000 
                 1.72 
                 72.00% 
               
               
                   
                 polymerase 
                   
                   
                   
                   
                   
                   
               
               
                 Probe 3 
                 High-fidelity 
                 N 
                 1 
                 36400 
                 20000 
                 1.82 
                 82.00% 
               
               
                   
                 polymerase 
                   
                   
                   
                   
                   
                   
               
               
                 Probe 4 
                 High-fidelity 
                 N 
                 1 
                 31400 
                 20000 
                 1.57 
                 57.00% 
               
               
                   
                 polymerase 
               
               
                   
               
            
           
         
       
     
     The captured-extension system referred to in Table 16 is disclosed in Table 2. The cfDNA sample used in the result is the QC sample. The method for testing the extension efficiency is shown in step 3. 
     The results showed that the Captured-extension magnification can be effectively increased by increasing the extension cycles. 
     Result 3. Effect of dNTP Coupling with Labeling Molecule on the Captured-Extension Performance 
     
       
         
           
               
             
               
                 TABLE 17 
               
             
            
               
                   
               
               
                 Test results of captured-extension system with Biotin-dCTP mixed (QC sample) 
               
            
           
           
               
               
               
               
               
               
               
               
            
               
                   
                   
                   
                   
                 Copies of 
                 Copies of 
                   
                   
               
               
                   
                   
                 Purification 
                   
                 EGFR 
                 EGFR 
                   
                   
               
               
                   
                   
                 system with 
                   
                 output with 
                 input 
                 Captured- 
                 Capture 
               
               
                   
                 Types of DNA 
                 Biotin-dCTP 
                   
                 biotin 
                 before 
                 extension 
                 Efficiency 
               
               
                 Probe 
                 polymerases 
                 mixed 
                 Cycles 
                 labelled 
                 capture 
                 Magnification 
                 % 
               
               
                   
               
            
           
           
               
               
               
               
               
               
               
               
            
               
                 Probe 1 
                 High-fidelity 
                 N 
                 40 
                 0 
                 20000 
                 0 
                 / 
               
               
                   
                 polymerase 
                   
                   
                   
                   
                   
                   
               
               
                 Probe 2 
                 High-fidelity 
                 N 
                 40 
                 0 
                 20000 
                 0 
                 / 
               
               
                   
                 polymerase 
                   
                   
                   
                   
                   
                   
               
               
                 Probe 3 
                 High-fidelity 
                 N 
                 40 
                 0 
                 20000 
                 0 
                 / 
               
               
                   
                 polymerase 
                   
                   
                   
                   
                   
                   
               
               
                 Probe 4 
                 High-fidelity 
                 N 
                 40 
                 0 
                 20000 
                 0 
                 / 
               
               
                   
                 polymerase 
                   
                   
                   
                   
                   
                   
               
               
                 Probe 1 
                 High-fidelity 
                 Y 
                 40 
                 212000 
                 20000 
                 10.6 
                 24.00% 
               
               
                   
                 polymerase 
                   
                   
                   
                   
                   
                   
               
               
                 Probe 2 
                 High-fidelity 
                 Y 
                 40 
                 183000 
                 20000 
                 9.15 
                 20.38% 
               
               
                   
                 polymerase 
                   
                   
                   
                   
                   
                   
               
               
                 Probe 3 
                 High-fidelity 
                 Y 
                 40 
                 198000 
                 20000 
                 9.9 
                 22.25% 
               
               
                   
                 polymerase 
                   
                   
                   
                   
                   
                   
               
               
                 Probe 4 
                 High-fidelity 
                 Y 
                 40 
                 187000 
                 20000 
                 9.35 
                 20.88% 
               
               
                   
                 polymerase 
               
               
                   
               
            
           
         
       
     
     The captured-extension system referred to in Table 17 is disclosed in Table 2 and 4. The cfDNA sample used in the result is the QC sample. The method for testing the extension efficiency is shown in step 3. 
     The results showed that the extension products can be labelled effectively and the Capture Efficiency can be effectively increased by mixing dCTP coupling with biotin. 
     Result 4. Effect of dNTP Coupling with Labeling Molecule on the Ligation Efficiency 
     
       
         
           
               
             
               
                 TABLE 18 
               
             
            
               
                   
               
               
                 Test result of the ligation reaction after mixing Biotin-dCTP into the 
               
               
                 captured-extension system (QC) 
               
            
           
           
               
               
               
               
               
               
               
               
            
               
                   
                 Purification 
                   
                   
                 Purification 
                   
                   
                   
               
               
                   
                 system with 
                   
                   
                 method 
                 Copies of 
                 Copies of 
                   
               
               
                   
                 Biotin-dCTP 
                   
                   
                 after 
                 extension 
                 ligation 
                 Ligation 
               
               
                 Probe 
                 mixed 
                 linker 
                 ligase 
                 ligation 
                 input 
                 output 
                 Efficiency 
               
               
                   
               
            
           
           
               
               
               
               
               
               
               
               
            
               
                 Probe 
                 N 
                 ABar-X2 
                 Thermostable 
                 Silica gel 
                 77120 
                 84 
                 0.11% 
               
               
                 1 
                   
                   
                 RNA ligase 
                 column 
                   
                   
                   
               
               
                 Probe 
                 N 
                 ABar-X2 
                 Thermostable 
                 Silica gel 
                 90560 
                 1452 
                 1.60% 
               
               
                 2 
                   
                   
                 RNA ligase 
                 column 
                   
                   
                   
               
               
                 Probe 
                 N 
                 ABar-X2 
                 Thermostable 
                 Silica gel 
                 83840 
                 1878 
                 2.24% 
               
               
                 3 
                   
                   
                 RNA ligase 
                 column 
                   
                   
                   
               
               
                 Probe 
                 Y 
                 ABar-X2 
                 Thermostable 
                 Silica gel 
                 28267 
                 328 
                 1.16% 
               
               
                 1 
                   
                   
                 RNA ligase 
                 column 
                   
                   
                   
               
               
                 Probe 
                 Y 
                 ABar-X2 
                 Thermostable 
                 Silica gel 
                 24400 
                 13257 
                 54.33% 
               
               
                 2 
                   
                   
                 RNA ligase 
                 column 
                   
                   
                   
               
               
                 Probe 
                 Y 
                 ABar-X2 
                 Thermostable 
                 Silica gel 
                 26400 
                 17328 
                 65.64% 
               
               
                 3 
                   
                   
                 RNA ligase 
                 column 
               
               
                   
               
            
           
         
       
     
     The ligation system referred to in Table 18 is shown in Table 8, wherein the extension product is prepared according to the system of Table 2 or 4, wherein high-fidelity polymerase is used in each system and the high-fidelity polymerase is 2×high-fidelity DNA polymerase PCR Master Mix (with a 3′-5′ exonuclease activity). The cfDNA sample used is QC sample. The method for testing the ligation efficiency is shown in step 5. 
     The results showed that probes with 3′ terminal hydroxyl group substituted by C3 Spacer in combination with using the dCTP coupled with biotin and a purification system targeting the biotin gives the best results; while in systems comprising probes without substituent group or dNTP without biotin, almost unable to ligate(connect). 
     Result 5. Effect of Probes with Different 5′ Terminal Substitution and the Use of Different Ligases on the Ligation Efficiency. 
     
       
         
           
               
             
               
                 TABLE 19 
               
             
            
               
                   
               
               
                 Test results of probes with different 5′ terminal substitution and different 
               
               
                 ligases in the ligation system (QC sample) 
               
            
           
           
               
               
               
               
               
               
               
               
            
               
                   
                 Purification 
                   
                   
                 Purification 
                 Copies 
                   
                   
               
               
                   
                 system with 
                   
                   
                 method 
                 of 
                 Copies of 
                   
               
               
                   
                 Biotin-dCTP 
                   
                   
                 after 
                 extension 
                 ligation 
                 Ligation 
               
               
                 Probe 
                 mixed 
                 Linker 
                 Ligase 
                 ligation 
                 input 
                 output 
                 Efficiency 
               
               
                   
               
            
           
           
               
               
               
               
               
               
               
               
            
               
                 Probe 2 
                 Y 
                 ABar-X2 
                 Thermostable 
                 Silica gel 
                 24400 
                 13257 
                 54.33% 
               
               
                   
                   
                   
                 RNA ligase 
                 column 
                   
                   
                   
               
               
                 Probe 3 
                 Y 
                 ABar-X2 
                 Thermostable 
                 Silica gel 
                 26400 
                 17328 
                 65.64% 
               
               
                   
                   
                   
                 RNA ligase 
                 column 
                   
                   
                   
               
               
                 Probe 2 
                 Y 
                 ABar-X2 
                 T4 RNA 
                 Silica gel 
                 24400 
                 2264 
                 9.28% 
               
               
                   
                   
                   
                   
                 column 
                   
                   
                   
               
               
                 Probe 3 
                 Y 
                 ABar-X2 
                 T4 RNA 
                 Silica gel 
                 26400 
                 2828 
                 10.71% 
               
               
                   
                   
                   
                   
                 column 
                   
                   
                   
               
               
                 Probe 2 
                 Y 
                 ABar-X3 
                 5′AppDNA/ 
                 Silica gel 
                 24400 
                 2073 
                 8.50% 
               
               
                   
                   
                   
                 RNA ligase 
                 column 
                   
                   
                   
               
               
                 Probe 3 
                 Y 
                 ABar-X3 
                 5′AppDNA/ 
                 Silica gel 
                 26400 
                 2154 
                 8.16% 
               
               
                   
                   
                   
                 RNA ligase 
                 column 
               
               
                   
               
            
           
         
       
     
     The ligation system referred to in Table 19 is shown in Table 8, 9 and 10, wherein the extension product is prepared according to the system of Table 4. The cfDNA sample used is the QC sample. The method for testing the ligation efficiency is shown in step 5. 
     The results showed that probes with phosphorylated 5′ terminal in combination with a thermostable RNA ligase can significantly improve the ligation efficiency. 
     Result 6. Effect of Linker DNAs with Different 3′ Terminal Substitution on the Ligation Efficiency. 
     
       
         
           
               
             
               
                 TABLE 20 
               
             
            
               
                   
               
               
                 Test results of linker DNAs with different 3′ terminal substitution 
               
               
                 in the system (QC sample) 
               
            
           
           
               
               
               
               
               
               
               
               
            
               
                   
                 Purification 
                   
                   
                 Purification 
                   
                   
                   
               
               
                   
                 system with 
                   
                   
                 method 
                 Copies of 
                 Copies of 
                   
               
               
                   
                 Biotin-dCTP 
                   
                   
                 after 
                 extension 
                 ligation 
                 Ligation 
               
               
                 Probe 
                 mixed 
                 Linker 
                 Ligase 
                 ligation 
                 input 
                 output 
                 Efficiency 
               
               
                   
               
            
           
           
               
               
               
               
               
               
               
               
            
               
                 Probe 2 
                 Y 
                 ABar-X2 
                 Thermostable 
                 Silica gel 
                 24400 
                 13257 
                 54.33% 
               
               
                   
                   
                   
                 RNA ligase 
                 column 
                   
                   
                   
               
               
                 Probe 3 
                 Y 
                 ABar-X2 
                 Thermostable 
                 Silica gel 
                 26400 
                 17328 
                 65.64% 
               
               
                   
                   
                   
                 RNA ligase 
                 column 
                   
                   
                   
               
               
                 Probe 2 
                 Y 
                 ABar-X1 
                 Thermostable 
                 Silica gel 
                 24400 
                 4321 
                 17.71% 
               
               
                   
                   
                   
                 RNA ligase 
                 column 
                   
                   
                   
               
               
                 Probe 3 
                 Y 
                 ABar-X1 
                 Thermostable 
                 Silica gel 
                 26400 
                 3875 
                 14.68% 
               
               
                   
                   
                   
                 RNA ligase 
                 column 
               
               
                   
               
            
           
         
       
     
     The ligation system referred to in Table 20 is shown in Table 8, wherein the extension product is prepared according to Table 4. The cfDNA sample used is the QC sample. The method for testing the ligation efficiency is shown in step 5. 
     The results showed that linkers with blocked 3′ terminal significantly improves the ligation efficiency by reducing self-ligation and mis-ligation. 
     Result 7. Effect of Different Purification Methods after Ligation on the Proportion of the Target Product. 
     
       
         
           
               
             
               
                 TABLE 21 
               
             
            
               
                   
               
               
                 Results of the proportion of the target product by using different purification 
               
               
                 methods after ligation (QC sample) 
               
            
           
           
               
               
               
               
               
               
               
               
            
               
                   
                 Purification 
                   
                   
                 Purification 
                   
                   
                 proportion 
               
               
                   
                 system with 
                   
                   
                 method 
                 Copies of 
                 Copies of 
                 of the 
               
               
                   
                 Biotin-dCTP 
                   
                   
                 after 
                 extension 
                 ligation 
                 target 
               
               
                 Probe 
                 mixed 
                 Linker 
                 Ligase 
                 ligation 
                 input 
                 output 
                 product 
               
               
                   
               
            
           
           
               
               
               
               
               
               
               
               
            
               
                 Probe 2 
                 Y 
                 ABar-X2 
                 Thermostable 
                 Silica 
                 24400 
                 13257 
                 54.33% 
               
               
                   
                   
                   
                 RNA ligase 
                 gel 
                   
                   
                   
               
               
                   
                   
                   
                   
                 column 
                   
                   
                   
               
               
                 Probe 3 
                 Y 
                 ABar-X2 
                 Thermostable 
                 Silica 
                 26400 
                 17328 
                 65.64% 
               
               
                   
                   
                   
                 RNA ligase 
                 gel 
                   
                   
                   
               
               
                   
                   
                   
                   
                 column 
                   
                   
                   
               
               
                 Probe 2 
                 Y 
                 ABar-X2 
                 Thermostable 
                 Heating 
                 24400 
                 10567 
                 43.31% 
               
               
                   
                   
                   
                 RNA ligase 
                   
                   
                   
                   
               
               
                 Probe 3 
                 Y 
                 ABar-X2 
                 Thermostable 
                 Heating 
                 26400 
                 12385 
                 46.91% 
               
               
                   
                   
                   
                 RNA ligase 
                   
                   
                   
                   
               
               
                 Probe 2 
                 Y 
                 ABar-X2 
                 Thermostable 
                 None 
                 24400 
                 2324 
                 9.52% 
               
               
                   
                   
                   
                 RNA ligase 
                   
                   
                   
                   
               
               
                 Probe 3 
                 Y 
                 ABar-X2 
                 Thermostable 
                 None 
                 26400 
                 2875 
                 10.89% 
               
               
                   
                   
                   
                 RNA ligase 
               
               
                   
               
            
           
         
       
     
     The ligation system referred to in Table 21 is shown in Table 8, wherein the extension product is prepared according to Table 4. The cfDNA sample used is the QC sample. The specific parameters of purification method used after ligation is shown in Table 11. The method for testing the ligation efficiency is shown in step 5. 
     The results showed that after the ligation reaction, either the silica gel column purification or heating purification can effectively remove or reduce the amount of residual thermostable RNA ligase in the ligation products, thereby reducing the background noise in ligation products and increasing the proportion of the target product. 
     Result 8. Data of the Samples Under Different Reaction Conditions. 
     The reaction conditions for the sequencing analysis are shown in Table 22. The sequencing method is disclosed in step 7. The results of the sequencing analysis corresponding to the conditions as stated in Table 22 are shown in Table 23. The detection results in the mutant DNA mixing with cfDNA with different ratios are shown in Table 24. 
     
       
         
           
               
             
               
                 TABLE 22 
               
             
            
               
                   
               
               
                 Reaction conditions of the sequencing analysis 
               
            
           
           
               
               
               
               
               
               
               
               
               
            
               
                   
                   
                   
                   
                   
                 Purification 
                   
                   
                   
               
               
                   
                   
                 Type of 
                   
                   
                 system with 
                   
                   
                 Process 
               
               
                 Condition 
                   
                 DNA 
                   
                   
                 Biotin-dCTP 
                   
                   
                 after 
               
               
                 Number 
                 Probe 
                 polymerase 
                 Nuclease 
                 Cycles 
                 mixed 
                 Linker 
                 Ligase 
                 ligation 
               
               
                   
               
               
                  1 
                 Probe 
                 High-fidelity 
                 N 
                 40 
                 Y 
                 ABar-X2 
                 Thermostable 
                 Silica 
               
               
                   
                 1 
                 polymerase 
                   
                   
                   
                   
                 RNA ligase 
                 gel 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                 column 
               
               
                  2 
                 Probe 
                 High-fidelity 
                 N 
                 40 
                 Y 
                 ABar-X2 
                 Thermostable 
                 Silica 
               
               
                   
                 2 
                 polymerase 
                   
                   
                   
                   
                 RNA ligase 
                 gel 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                 column 
               
               
                  3 
                 Probe 
                 High-fidelity 
                 N 
                 40 
                 Y 
                 ABar-X2 
                 Thermostable 
                 Silica 
               
               
                   
                 2p 
                 polymerase 
                   
                   
                   
                   
                 RNA ligase 
                 gel 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                 column 
               
               
                  4 
                 Probe 
                 High-fidelity 
                 N 
                 40 
                 Y 
                 ABar-X2 
                 Thermostable 
                 Silica 
               
               
                   
                 3 
                 polymerase 
                   
                   
                   
                   
                 RNA ligase 
                 gel 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                 column 
               
               
                  5 
                 Probe 
                 Common 
                 Y 
                 40 
                 Y 
                 ABar-X2 
                 Thermostable 
                 Silica 
               
               
                   
                 4 
                 polymerase 
                   
                   
                   
                   
                 RNA ligase 
                 gel 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                 column 
               
               
                  6 
                 Probe 
                 High-fidelity 
                 N 
                 40 
                 N 
                 ABar-X2 
                 Thermostable 
                 Silica 
               
               
                   
                 3 
                 polymerase 
                   
                   
                   
                   
                 RNA ligase 
                 gel 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                 column 
               
               
                  7 
                 Probe 
                 High-fidelity 
                 N 
                 40 
                 Y 
                 ABar-X1 
                 Thermostable 
                 Silica 
               
               
                   
                 3 
                 polymerase 
                   
                   
                   
                   
                 RNA ligase 
                 gel 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                 column 
               
               
                  8 
                 Probe 
                 High-fidelity 
                 N 
                 40 
                 Y 
                 ABar-X2 
                 T4 RNA 
                 Silica 
               
               
                   
                 3 
                 polymerase 
                   
                   
                   
                   
                   
                 gel 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                 column 
               
               
                  9 
                 Probe 
                 High-fidelity 
                 N 
                 40 
                 Y 
                 ABar-X3 
                 5′AppDNA/ 
                 Silica 
               
               
                   
                 3 
                 polymerase 
                   
                   
                   
                   
                 RNA ligase 
                 gel 
               
               
                   
                   
                   
                   
                   
                   
                   
                   
                 column 
               
               
                 10 
                 Probe 
                 High-fidelity 
                 N 
                 40 
                 Y 
                 ABar-X2 
                 Thermostable 
                 Heating 
               
               
                   
                 3 
                 polymerase 
                   
                   
                   
                   
                 RNA ligase 
                   
               
               
                 11 
                 Probe 
                 High-fidelity 
                 N 
                 40 
                 Y 
                 ABar-X2 
                 Thermostable 
                 None 
               
               
                   
                 3 
                 polymerase 
                   
                   
                   
                   
                 RNA ligase 
               
               
                   
               
            
           
         
       
     
     The ligation products provided by the PCR amplification as described in Table 22 are the ligation products by further preparing the extension products provided according to the systems in Table 3 and 4 according to the ligation reaction system in Tables 8 to 10. The specific parameters of the purification method used after ligation is disclosed in Table 11. The cfDNA samples referred to in the sequencing results in Table 23 are the QC samples. In the test of mixing mutant DNA into cfDNA at different ratio in Table 24, for the same condition number, except that DNA of NCI-H1975 cell line are mixed into cfDNA in different amount, the experimental steps are the same as in Table 22. 
     
       
         
           
               
             
               
                 TABLE 23 
               
             
            
               
                   
               
               
                 Results of sequencing analysis 
               
            
           
           
               
               
            
               
                   
                 Condition Number 
               
            
           
           
               
               
               
               
               
               
               
               
               
               
               
               
            
               
                   
                 1 
                 2 
                 3 
                 4 
                 5 
                 6 
                 7 
                 8 
                 9 
                 10 
                 11 
               
               
                   
               
            
           
           
               
               
               
               
               
               
               
               
               
               
               
               
            
               
                 Total reads 
                 367842 
                 245740 
                 284632 
                 345320 
                 299538 
                 327782 
                 243698 
                 288673 
                 296643 
                 308712 
                 312156 
               
               
                 Reads 
                 184 
                 211600 
                 2343 
                 327080 
                 275605 
                 1052 
                 30292 
                 126641 
                 70809 
                 270555 
                 35336 
               
               
                 aligning to 
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
               
               
                 hg19 
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
               
               
                 Alignment 
                 0.05% 
                 86.11% 
                 0.82% 
                 94.72% 
                 92.01% 
                 0.32% 
                 12.43% 
                 43.87% 
                 23.87% 
                 87.64% 
                 11.32% 
               
               
                 rate 
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
               
               
                 Reads 
                 61 
                 125072 
                 1039 
                 192654 
                 144252 
                 402 
                 14004 
                 67436 
                 34965 
                 149671 
                 16247 
               
               
                 from the 
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
               
               
                 target 
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
               
               
                 region 
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
               
               
                 Ratio of 
                 33.40% 
                 59.11% 
                 44.37% 
                 58.90% 
                 52.34% 
                 38.20% 
                 46.23% 
                 53.25% 
                 49.38% 
                 55.32% 
                 45.98% 
               
               
                 reads from 
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
               
               
                 the target 
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
               
               
                 region 
               
               
                   
               
            
           
         
       
     
     
       
         
           
               
             
               
                 TABLE 24 
               
             
            
               
                   
               
               
                 Results of detection of mutant DNA in cfDNA under different mix rates 
               
            
           
           
               
               
            
               
                   
                 Condition Number 
               
            
           
           
               
               
               
               
               
               
               
               
               
               
               
               
            
               
                   
                 1 
                 2 
                 3 
                 4 
                 5 
                 6 
                 7 
                 8 
                 9 
                 10 
                 11 
               
               
                   
               
            
           
           
               
               
               
               
               
               
               
               
               
               
               
               
            
               
                 0 mixed 
                 0 
                 0 
                 0 
                 0 
                 0 
                 0 
                 0 
                 0 
                 0 
                 0 
                 0 
               
               
                 0.01% 
                 0 
                 0.012% 
                 0 
                 0.021% 
                 0.009% 
                 0 
                 0 
                 0 
                 0 
                 0.019% 
                 0 
               
               
                 mixed 
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
               
               
                 0.1% 
                 0 
                  0.13% 
                 0 
                  0.12% 
                  0.14% 
                 0 
                 0.08% 
                 0.11% 
                 0.09% 
                  0.12% 
                 0.08% 
               
               
                 mixed 
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
               
               
                 1% 
                 0 
                  1.15% 
                 0.48% 
                  1.08% 
                  0.83% 
                 0 
                 1.12% 
                 1.13% 
                 1.11% 
                  1.18% 
                 1.13% 
               
               
                 mixed 
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
               
               
                 10% 
                 2.30% 
                 10.25% 
                 9.53% 
                 10.22% 
                  9.89% 
                 5.21% 
                 10.13% 
                 10.23% 
                 9.54% 
                 10.22% 
                 10.15% 
               
               
                 mixed 
               
               
                   
               
            
           
         
       
     
     It can be seen from Table 23 and Table 24, under the reaction conditions numbered 2, 4, 5, and 10, the sequencing alignment rates and the sensitivities are high, and the mutation can be correctly detected in the cfDNA sample with a mixing ratio of as low as 0.01%. The results showed that the blocking modification of the 3′ terminal hydroxyl group of the probes is essential to prevent self-ligation or ligating to the linker, which significantly reduces the background noise. After binding to the template, the substituent group of the probe can be cleaved and the bound probe can effectively extend. The dNTP coupled with labeling molecule and a purification system thereof can significantly improve the purity of the target product in the final library. In addition, the application of thermostable RNA ligase, the blocking of the 3′ terminal of the linker, and the purification after ligation can further improve the purity of the final library product and the sensitivity of detection, respectively/together constitute the technical solution of the present invention. 
     Embodiment 2 
     The oligonucleotide sequences used in embodiment 2 are shown in table 25. 
     
       
         
           
               
               
               
             
               
                 TABLE 25 
               
               
                   
               
               
                   
                 SEQ 
                   
               
               
                 Name 
                 ID NO: 
                 Sequence (5′→3′) 
               
               
                   
               
             
            
               
                 Probe 5 
                 17 
                 
                   CCGCTTTCCTCTCTATGGGCAGTCGGTGAT 
                 
               
               
                   
                   
                 TAGTTGGATGGGATTATTT-C3 Spacer 
               
               
                   
               
               
                 Probe 6 
                 18 
                 
                   CCGCTTTCCTCTCTATGGGCAGTCGGTGAT 
                 
               
               
                   
                   
                 TTTTTTTTGGGAGTTTAAATAAAGATTA- 
               
               
                   
                   
                 C3 Spacer 
               
               
                   
               
               
                 Probe 7 
                 19 
                 
                   CCGCTTTCCTCTCTATGGGCAGTCGGTGAT 
                 
               
               
                   
                   
                 TTTAAAATAGAGTTAGTTTTAGTTTTT-C3 
               
               
                   
                   
                 Spacer 
               
               
                   
               
               
                 ABar-X2 
                 10 
                 PO4-GGATCCNNNNNN GTTCTCCTTA   CTGA   
               
               
                   
                   
                   GTCGGAGACACGCAGGGATGAGATGG -C3  
               
               
                   
                   
                 Spacer 
               
               
                   
               
               
                 AF 
                 15 
                 GTCTCAGCCTCTCTATGGGCAGTCGGTGAT 
               
               
                   
               
               
                 AR 
                 16 
                 CCATCTCATCCCTGCGTGTCTCCGACTCAG 
               
               
                   
               
            
           
         
       
     
     The probes in this example comprise a universal sequence, that is, bases shown in italic, which is the P1 sequence of the Ion Torrent system. The DNA sample used in this embodiment has been treated with bisulfite. Probe 5 (SEQ ID NO 17) targets a methylation region of the gene SEPT9, Probe 6 (SEQ ID NO: 18) targets a methylation region of the gene NDRG4, and Probe 7 (SEQ ID NO: 19) targets a methylation region of the gene BMP3. 
     The linker ABar-X2 (SEQ ID NO. 10) comprises a universal sequence, that is, bases shown in italic, which is the A sequence of the Ion Torrent system. The sequence underlined is a barcode, which can be replaced with different barcodes in different samples in the present invention. The “N” sequence is a molecular tag sequence (UMI), in which NNNNNN is a random sequence that is used to label different extension product molecules in the same sample. The 5′ terminal of the linkers ABar-X2 (SEQ ID NO. 10) is phosphorylated. 
     AF (SEQ ID NO.15) and AR (SEQ ID NO.16) are the PCR pre-primers and post-primers used to amplify the library, respectively. The sequences thereof were matching the universal sequences (that is, the P1 sequence and the A sequence) in the library molecule. 
     Reagents and Materials 
     The bisulfite conversion kit was purchased from Promega. The Agencourt AMPure magnetic beads were purchased from Beckman. The other main reagents used were the same as in embodiment 1. 
     Step 1. Preparation of the Sample 
     Five samples of healthy people&#39;s plasma samples and intestinal cancer tissue samples were extracted, and the DNA samples were quantified by Qubit Fluorometer. The DNA from intestinal cancer tissues was sheared into fragments of about 160 bp and mixed into the plasma sample of healthy individuals at ratios of 10% and 5% to provide samples of 5% mixing rate and 10% mixing rate. Plasma sample from healthy individuals was used as a blank. Convert the plasma samples of healthy individuals using the Promega bisulfite conversion system. The converted DNA was quantified and formulated into a concentration of 1000 copies/μL. 
     Step 2. Captured-Extension 
     Prepare the captured-extension system according to table 26. 
     
       
         
           
               
               
               
             
               
                 TABLE 26 
               
               
                   
               
               
                   
                   
                 Final 
               
               
                 Compositions 
                 Volume (μL) 
                 Concentration 
               
               
                   
               
             
            
               
                   
               
            
           
           
               
               
               
            
               
                 2X High-fidelity DNA polymerase  
                 25 
                 1× 
               
               
                 PCR Master Mix 
                   
                   
               
               
                 (with 3‘-5‘ exonuclease activity) 
                   
                   
               
               
                 Probe 5 (10 μM) 
                 0.5 
                 100 nM 
               
               
                 Probe 6 (10 μM) 
                 0.5 
                 100 nM 
               
               
                 Probe 7 (10 μM) 
                 0.5 
                 100 nM 
               
               
                 cfDNA samples 
                 20 
                 20000 copies 
               
               
                 H 2 O 
                 3.5 
                 / 
               
               
                 Total 
                 50 
                 / 
               
               
                   
               
            
           
         
       
     
     PCR reaction conditions of the captured-extension system is shown in table 27. 
     
       
         
           
               
               
               
               
             
               
                   
                 TABLE 27 
               
               
                   
                   
               
               
                   
                 Cycles 
                 Temperature 
                 Time 
               
               
                   
                   
               
             
            
               
                   
                  1 cycle 
                 98° C. 
                 60 s 
               
               
                   
                 40 cycles 
                 98° C. 
                 10 s 
               
               
                   
                   
                 62° C. 
                 20 s 
               
               
                   
                   
                 72° C. 
                 20 s 
               
               
                   
                  1 cycle 
                 72° C. 
                  5 min 
               
               
                   
                   
               
            
           
         
       
     
     After completion of the captured-extension, the extension product was purified by silica gel column and eluted with 60 μL of the elution buffer. The captured-extension product in table 4 was further purified with the magnetic beads coated with streptavidin after the silica gel column purification, and finally dissolved in elution buffer of 60 μL. 
     Step 3. Single-Stranded Ligation 
     Perform the ligation reaction according to the ligation reaction system and conditions prepared in table 28. 
     
       
         
           
               
               
               
               
             
               
                 TABLE 28 
               
               
                   
               
               
                   
                 Volume  
                 Final  
                 Ligation 
               
               
                 Compositions 
                 (μL) 
                 Concentration 
                 conditions 
               
               
                   
               
             
            
               
                   
               
            
           
           
               
               
               
               
            
               
                 10× Ligase Buffer 
                 4 
                 l× 
                 60° C. 
               
            
           
           
               
               
               
               
               
            
               
                 50 mM MnCl 2   
                 2 
                 2.5  
                 mM 
                 1 hour 
               
               
                 5 M Betaine 
                 8 
                 1  
                 M 
                   
               
               
                 Thermostable RNA ligase  
                 2 
                 5  
                 U/uL 
                   
               
               
                 (100 U/uL) 
                   
                   
                   
                   
               
               
                 ABar-X2(200 nM) 
                 2 
                 10  
                 nM 
                   
               
            
           
           
               
               
               
               
            
               
                 Extension product 
                 8 
                   
                   
               
               
                 50% PEG 
                 14 
                 17.5% 
                   
               
               
                 Total 
                 40 
                 / 
               
               
                   
               
            
           
         
       
     
     After ligation, the ligation product was purified by silica gel column and finally eluted with 50 μL of elution buffer. 
     Step 4. Amplification of the Ligation Product (Library Amplification) 
     According to the reaction system and conditions in table 29, PCR amplification of the ligation product was performed. 
     
       
         
           
               
               
               
             
               
                   
                 TABLE 29 
               
               
                   
                   
               
             
            
               
                   
                 Compositions 
                 Volume 
               
               
                   
                   
               
            
           
           
               
               
               
               
            
               
                   
                 Ligation product 
                 30  
                 μL 
               
               
                   
                 5× Q5 Buffer 
                 10 
                 μL 
               
               
                   
                 dNTP (lOmM each) 
                 1 
                 μL 
               
               
                   
                 Q5 high-fidelity DNA polymerase (2 U/pL) 
                 1 
                 μL 
               
               
                   
                 AF (10 uM) 
                 1.5 
                 μL 
               
               
                   
                 AR (10 uM) 
                 1.5 
                 μL 
               
               
                   
                 ddH 2 O 
                 5 
                 μL 
               
               
                   
                 Total Volume 
                 50 
                 μL 
               
               
                   
                   
               
            
           
           
               
               
               
               
            
               
                   
                 Temperature( o  C.) 
                 Time(s) 
                 Cycles 
               
               
                   
                   
               
               
                   
                 98 
                 30 
                 1 
               
               
                   
                 98 
                 10 
                 12 
               
               
                   
                 72 
                 30 
                   
               
               
                   
                 72 
                 300 
                 1 
               
               
                   
                   
               
            
           
         
       
     
     Purify the amplified product with 80 μL of Agencourt AMPure magnetic beads, and dissolve the purified product in 30 μL, of elution buffer. At this point, the library preparation for sequencing is completed. 
     Step 5. Sequencing and Data Analysis 
     Sequencing the prepared library using an Ion Proton system. The related operations included water-in-oil PCR, library enrichment, biochip loading, and sequencing. The detailed procedure is described in the instruction manuals of Ion PITM Hi-QTM OT2 200 kit and Ion PITM Hi-QTM Sequencing 200 kit. 
     The analysis of sequencing results are shown in table 30 and table 31, respectively. 
     
       
         
           
               
             
               
                 TABLE 30 
               
             
            
               
                   
               
               
                 Sequencing results 1 
               
            
           
           
               
               
               
               
               
            
               
                   
                 Total  
                 Reads from  
                 Total  
                 Total specificity of  
               
               
                   
                 reads 
                 the target  
                 alignment 
                 the reads from the  
               
               
                 Type of sample 
                 (M) 
                 region (M) 
                 rate 
                 target region 
               
               
                   
               
            
           
           
               
               
               
               
               
            
               
                 Blank (QC) 
                 1.261 
                 0.448 
                 74.35% 
                 47.84% 
               
               
                 5% mixed 
                 1.376 
                 0.491 
                 79.78% 
                 44.74% 
               
               
                 10% mixed 
                 1.508 
                 0.513 
                 75.42% 
                 45.10% 
               
               
                   
               
            
           
         
       
     
     
       
         
           
               
             
               
                 TABLE 31 
               
             
            
               
                   
               
               
                 Results of methylation levels of each gene under different mixing  
               
               
                 ratios of DNA from intestinal cancer tissues 
               
            
           
           
               
               
               
               
               
            
               
                   
                 Methylation sites  
                   
                 5%  
                 10%  
               
               
                 Name of genes 
                 on genes 
                 Blank 
                 mixed 
                 mixed 
               
               
                   
               
               
                 SEPT9 
                 chr17: 75369623 
                 1.89% 
                 4.03% 
                 5.82% 
               
               
                   
                 chr17: 75369630 
                 1.52% 
                 5.04% 
                 6.18% 
               
               
                   
                 chr17: 75369657 
                 1.35% 
                 4.97% 
                 5.55% 
               
               
                   
                 chr17: 75369663 
                 0.65% 
                 3.67% 
                 5.50% 
               
               
                 BMF3 
                 chr4: 81952061 
                 3.01% 
                 3.10% 
                 6.63% 
               
               
                   
                 chr4: 81952065 
                 3.72% 
                 4.22% 
                 6.86% 
               
               
                   
                 chr4: 81952078 
                 2.48% 
                 2.69% 
                 5.99% 
               
               
                   
                 chr4: 81952099 
                 2.72% 
                 3.57% 
                 5.67% 
               
               
                 NDRG4 
                 chr16: 58497230 
                 1.66% 
                 2.92% 
                 4.74% 
               
               
                   
                 chr16: 58497236 
                 1.41% 
                 3.69% 
                 4.19% 
               
               
                   
                 chr16: 58494239 
                 1.43% 
                 3.00% 
                 4.67% 
               
               
                   
                 chr16: 58497251 
                 3.17% 
                 5.81% 
                 5.89% 
               
               
                   
                 chr16: 58497265 
                 3.15% 
                 5.88% 
                 6.48% 
               
               
                   
               
            
           
         
       
     
     It can be seen from tables 30 and 31, the samples with 5% and 10% intestinal cancer tissue DNA mixed were significantly different from the blank samples in the degree of methylation. The degree of methylation of the samples with 10% intestinal cancer tissue DNA mixed is highest, the blank sample had the lowest methylation level, which was same with expectations. The results show that, the target region of DNA fragmented samples treated with bisulfite can also be well enriched and can be applied to the analysis of degree of gene methylation and related diseases by using the enrichment method of the present invention. 
     Example 3 
     The oligonucleotide sequences used in examples 3 and 4 are shown in table 32: 
     
       
         
           
               
               
               
               
             
               
                 TABLE 32 
               
               
                   
               
               
                   
                   
                 SEQ 
                   
               
               
                   
                   
                 ID 
                   
               
               
                   
                 Name 
                 NO. 
                 Sequence (5′→3′) 
               
               
                   
               
             
            
               
                   
                 
                   F-SRY 
                 
                 
                   20 
                 
                 
                   TTCCAGGAGGCACAGAAATTAC 
                 
               
               
                   
               
               
                   
                 R-SRY 
                 21 
                 CTTCCGACGAGGTCGATACT 
               
               
                   
               
               
                   
                 MGB-SRY 
                 22 
                 CATGCACAGAGAGAAATACCCGAAT 
               
               
                   
               
               
                   
                 F858 
                 23 
                 CAGATTTTGGGCG 
               
               
                   
               
               
                   
                 ER1 
                 13 
                 TTTGCCTCCTTCTGC 
               
               
                   
               
               
                   
                 
                   EM1 
                 
                 
                   14 
                 
                 
                   AACTGCTGGGTGCGGA 
                 
               
               
                   
               
               
                   
                 
                   F787 
                 
                 
                   24 
                 
                 
                   GCGTGATGAGT 
                 
               
               
                   
               
               
                   
                 
                   R787 
                 
                 
                   25 
                 
                 
                   GCGTGGACAACCCCCAC 
                 
               
               
                   
               
               
                   
                 
                   MGB787 
                 
                 
                   26 
                 
                 
                   CACGGTGGAGGTGAGGC 
                 
               
               
                   
               
               
                   
                 
                   Uni-R 
                 
                 
                   27 
                 
                 
                   CCATCTCATCCCTGCGT 
                 
               
               
                   
               
               
                   
                 
                   Uni-MGB 
                 
                 
                   28 
                 
                 
                   TCCGACTCAGTAAGGAGAACGA 
                 
               
               
                   
               
               
                   
                 
                   Probe 8 
                 
                 
                   29 
                 
                 
                   CCGCTTTCCTCTCTATGGGCAGTC 
                 
               
               
                   
                   
                   
                 
                   GGGATCCAATATTGTCTTTGTGTT 
                 
               
               
                   
                   
                   
                 
                   CCCGGACATAGTCCT-C3 Spacer 
                 
               
               
                   
               
               
                   
                 
                   Probe 9 
                 
                 
                   30 
                 
                 
                   CCGCTTTCCTCTCTATGGGCAGTC 
                 
               
               
                   
                   
                   
                 
                   GGTGATCTATGGCCATTCTTCCAG 
                 
               
               
                   
                   
                   
                 
                   GAGGCACAGAAATTACT-C3 Spacer 
                 
               
               
                   
               
               
                   
                 
                   ABar-X2 
                 
                 
                   10 
                 
                 
                   PO4-GGATCCNNNNNNGTTCTCCT 
                 
               
               
                   
                   
                   
                 
                   TA 
                   
                   
                 
               
               
                   
                   
                   
                 
                   
                   -C3 Spacer 
                 
               
               
                   
               
            
           
         
       
     
     Main Reagents and Materials: 
     Same as in Example 1, the calibrator used in qPCR was prepared according to the conventional method of molecular cloning. 
     Step 1. Sample Preparation 
     The non-small cell lung cancer cell line NCI-H1975 contains both the mutation of EGFR L858R site and the SNP of Q787 site. Genomic DNA of non-small cell lung cancer cell line NCI-H1975 and normal human leukocytes was extracted using XX kit. The genomic DNA is broken by ultrasound to the molecular weight range of 100-300 bp. After quantification by the Qubit fluorescence quantifier, the genomic DNA of NCI-H1975 was mixed into the genomic DNA of normal human leukocytes at a ratio of 1%, 0.1%, 0.03%, 0.01%, 0%, and captured-extension, ligation and library expansion were applied to the samples by step 2 to step 6 in example 1 of the present invention. 
     Step 2. qPCR Detection of Different Specific Primer/Probe Combinations 
     The trispecific, bispecific and monospecific detection systems for the EGFR gene L858R site are shown in tables 33-35. 
     
       
         
           
               
             
               
                 TABLE 33 
               
             
            
               
                   
               
               
                 Trispecific detection system for L858R site 
               
            
           
           
               
               
               
            
               
                 Reagents 
                 Dosage (μL) 
                 Final concentration 
               
               
                   
               
            
           
           
               
               
               
            
               
                 2× Taqman Mix 
                 10 
                 1× 
               
               
                 F858(10 μM) 
                 0.6 
                 300 nM 
               
               
                 R858(10 μM) 
                 0.6 
                 300 nM 
               
               
                 858(10) 
                 0.2 
                 100 nM 
               
               
                 H 2 O 
                 6.6 
                 / 
               
               
                 Calibrator or sample to be tested 
                 2 
                 / 
               
               
                 Total 
                 20 
                 / 
               
               
                   
               
            
           
         
       
     
     
       
         
           
               
             
               
                 TABLE 34 
               
             
            
               
                   
               
               
                 Bispecific detection system for L858R site 
               
            
           
           
               
               
               
            
               
                 Reagents 
                 Dosage (μL) 
                 Final concentration 
               
               
                   
               
            
           
           
               
               
               
            
               
                 2× Taqman Mix 
                 10 
                 1× 
               
               
                 F858(10 μM) 
                 0.6 
                 300 nM 
               
               
                 Uni-R(10 μM) 
                 0.6 
                 300 nM 
               
               
                 MGB858(10 μM) 
                 0.2 
                 100 nM 
               
               
                 H 2 O 
                 6.6 
                 / 
               
               
                 Calibrator or sample to be tested 
                 2 
                 / 
               
               
                 Total 
                 20 
                 / 
               
               
                   
               
            
           
         
       
     
     
       
         
           
               
             
               
                 TABLE 35 
               
             
            
               
                   
               
               
                 Monospecific detection system for L858R site 
               
            
           
           
               
               
               
            
               
                 Reagents 
                 Dosage (μL) 
                 Final concentration 
               
               
                   
               
            
           
           
               
               
               
            
               
                 2× Taqman Mix 
                 10 
                 1× 
               
               
                 F858(10 μM) 
                 0.6 
                 300 nM 
               
               
                 Uni-R(10 μM) 
                 0.6 
                 300 nM 
               
               
                 Uni-MGB(10 μM) 
                 0.2 
                 100 nM 
               
               
                 H 2 O 
                 6.6 
                 / 
               
               
                 Calibrator or sample to be tested 
                 2 
                 / 
               
               
                 Total 
                 20 
                 / 
               
               
                   
               
            
           
         
       
     
     The trispecific, bispecific, and monospecific detection systems for EGFR gene Q787Q site are shown in tables 36-38. 
     
       
         
           
               
             
               
                 TABLE 36 
               
             
            
               
                   
               
               
                 Trispecific detection system for Q787Q site: 
               
            
           
           
               
               
               
            
               
                 Reagents 
                 Dosage (μL) 
                 Final concentration 
               
               
                   
               
            
           
           
               
               
               
            
               
                 2× Taqman Mix 
                 10 
                 1× 
               
               
                 F787(10 μM) 
                 0.6 
                 300 nM 
               
               
                 R787(10 μM) 
                 0.6 
                 300 nM 
               
               
                 MGB787(10 μM) 
                 0.2 
                 100 nM 
               
               
                 H 2 O 
                 6.6 
                 / 
               
               
                 Calibrator or sample to be tested 
                 2 
                 / 
               
               
                 Total 
                 20 
                 / 
               
               
                   
               
            
           
         
       
     
     
       
         
           
               
             
               
                 TABLE 37 
               
             
            
               
                   
               
               
                 Bispecific detection system for Q787Q site: 
               
            
           
           
               
               
               
            
               
                 Reagents 
                 Dosage (μL) 
                 Final concentration 
               
               
                   
               
            
           
           
               
               
               
            
               
                 2× Taqman Mix 
                 10 
                 1× 
               
               
                 F787(10 μM) 
                 0.6 
                 300 nM 
               
               
                 Uni-R(10 μM) 
                 0.6 
                 300 nM 
               
               
                 MGB787(10 μM) 
                 0.2 
                 100 nM 
               
               
                 H 2 O 
                 6.6 
                 / 
               
               
                 Calibrator or sample to be tested 
                 2 
                 / 
               
               
                 Total 
                 20 
                 / 
               
               
                   
               
            
           
         
       
     
     
       
         
           
               
             
               
                 TABLE 38 
               
             
            
               
                   
               
               
                 Monospecific detection system for Q787Q site: 
               
            
           
           
               
               
               
               
            
               
                   
                   
                 Dosage 
                 Final 
               
               
                   
                 Reagents 
                 (μL) 
                 concentration 
               
               
                   
                   
               
            
           
           
               
               
               
               
            
               
                   
                 2 × Taqman Mix 
                 10 
                 1× 
               
               
                   
                 F787(10 μM) 
                 0.6 
                 300 nM 
               
               
                   
                 Uni-R(10 μM) 
                 0.6 
                 300 nM 
               
               
                   
                 Uni-MGB(10 μM) 
                 0.2 
                 100 nM 
               
               
                   
                 H 2 O 
                 6.6 
                 / 
               
               
                   
                 Calibrator or sample  
                 2 
                 / 
               
               
                   
                 to be tested 
                   
                   
               
               
                   
                 Total 
                 20 
                 / 
               
               
                   
                   
               
            
           
         
       
     
     qPCR detection procedures are shown in table 39. 
     
       
         
           
               
               
               
               
             
               
                   
                 TABLE 39 
               
               
                   
                   
               
               
                   
                 Cycle 
                 Temperature 
                 Time 
               
               
                   
                   
               
             
            
               
                   
               
            
           
           
               
               
               
               
               
            
               
                   
                  1 cycle 
                 95° C. 
                 4  
                 min 
               
               
                   
                 40 cycles 
                 95° C. 
                 10  
                 s 
               
               
                   
                   
                 61° C. 
                 30  
                 s 
               
               
                   
                   
               
            
           
         
       
     
     Experimental Results and Analysis 
     Results 1. The detection results of L858R sites with different specific primer/probe combinations are shown in tables 40-42, respectively. Among them, the trispecific, bispecific and monospecific detection systems respectively correspond to the reaction systems in tables 33-35. 
     
       
         
           
               
             
               
                 TABLE 40 
               
             
            
               
                   
               
               
                 Results of trispecific detection of L858R  
               
               
                 site (ΔCT = ABS(mean Qi-Q5)) 
               
            
           
           
               
               
               
               
               
            
               
                 Mixing rate 
                 CT1 
                 CT2 
                 CT Mean 
                 ΔCT 
               
               
                   
               
            
           
           
               
               
               
               
               
            
               
                 1% 
                 26.13 
                 26.49 
                 26.31 
                 11.715 
               
               
                 0.1% 
                 30.35 
                 30.56 
                 30.46 
                 7.570 
               
               
                 0.03% 
                 33.43 
                 33.85 
                 33.64 
                 4.385 
               
               
                 0.01% 
                 37.34 
                 36.52 
                 36.93 
                 1.095 
               
               
                 0 
                 38.52 
                 37.53 
                 38.03 
                 0 
               
               
                   
               
            
           
         
       
     
     
       
         
           
               
             
               
                 TABLE 41 
               
             
            
               
                   
               
               
                 Results of bispecific detection of L858R site 
               
            
           
           
               
               
               
               
               
            
               
                 Mixing rate 
                 CT1 
                 CT2 
                 CT Mean 
                 ΔCT 
               
               
                   
               
            
           
           
               
               
               
               
               
            
               
                 1% 
                 24.12 
                 24.14 
                 24.13 
                 13.040 
               
               
                 0.1% 
                 28.73 
                 28.24 
                 28.49 
                 8.685 
               
               
                 0.03% 
                 30.82 
                 31.32 
                 31.07 
                 6.100 
               
               
                 0.01% 
                 33.43 
                 34.18 
                 33.81 
                 3.365 
               
               
                 0 
                 37.32 
                 37.02 
                 37.17 
                 0 
               
               
                   
               
            
           
         
       
     
     
       
         
           
               
             
               
                 TABLE 42 
               
             
            
               
                   
               
               
                 Results of monospecific detection of L858R site 
               
            
           
           
               
               
               
               
               
               
            
               
                   
                 Mixing rate 
                 CT1 
                 CT2 
                 CT Mean 
                 ΔCT 
               
               
                   
                   
               
            
           
           
               
               
               
               
               
               
            
               
                   
                 1% 
                 23.64 
                 23.52 
                 23.58 
                 12.850 
               
               
                   
                 0.1% 
                 27.38 
                 27.02 
                 27.20 
                 9.230 
               
               
                   
                 0.03% 
                 29.24 
                 29.87 
                 29.56 
                 6.875 
               
               
                   
                 0.01% 
                 32.29 
                 31.58 
                 31.94 
                 4.495 
               
               
                   
                 0 
                 36.24 
                 36.62 
                 36.43 
                 0 
               
               
                   
                   
               
            
           
         
       
     
     Results 2. The detection results of Q787Q sites with different specific primer/probe combinations are shown in tables 43-45 respectively. Among them, the trispecific, bispecific and monospecific detection systems respectively correspond to the reaction systems in tables 36-38. 
     
       
         
           
               
             
               
                 TABLE 43 
               
             
            
               
                   
               
               
                 Trispecific test results of Q787Q site 
               
            
           
           
               
               
               
               
               
            
               
                 Mixing rate 
                 CT1 
                 CT2 
                 CT Mean 
                 ΔCT 
               
               
                   
               
            
           
           
               
               
               
               
               
            
               
                 1% 
                 26.09 
                 25.85 
                 25.97 
                 11.055 
               
               
                 0.1% 
                 30.52 
                 30.82 
                 30.67 
                 6.355 
               
               
                 0.03% 
                 34.07 
                 33.59 
                 33.83 
                 3.195 
               
               
                 0.01% 
                 36.82 
                 36.43 
                 36.63 
                 0.400 
               
               
                 0 
                 37.14 
                 36.91 
                 37.03 
                 0 
               
               
                   
               
            
           
         
       
     
     
       
         
           
               
             
               
                 TABLE 44 
               
             
            
               
                   
               
               
                 Bispecific detection results of Q787Q site 
               
            
           
           
               
               
               
               
               
            
               
                 Mixing rate 
                 CT1 
                 CT2 
                 CT Mean 
                 ΔCT 
               
               
                   
               
            
           
           
               
               
               
               
               
            
               
                 1% 
                 25.45 
                 25.48 
                 25.47 
                 10.820 
               
               
                 0.1% 
                 29.01 
                 29.48 
                 29.25 
                 7.040 
               
               
                 0.03% 
                 31.77 
                 32.11 
                 31.94 
                 4.345 
               
               
                 0.01% 
                 34.12 
                 34.98 
                 34.55 
                 1.735 
               
               
                 0 
                 36.05 
                 36.52 
                 36.29 
                 0 
               
               
                   
               
            
           
         
       
     
     
       
         
           
               
             
               
                 TABLE 45 
               
             
            
               
                   
               
               
                 Monospecific detection results of Q787Q site 
               
            
           
           
               
               
               
               
               
            
               
                 Mixing rate 
                 CT1 
                 CT2 
                 CT Mean 
                 ΔCT 
               
               
                   
               
            
           
           
               
               
               
               
               
            
               
                 1% 
                 24.44 
                 24.17 
                 24.31 
                 11.950 
               
               
                 0.1% 
                 27.84 
                 28.19 
                 28.02 
                 8.240 
               
               
                 0.03% 
                 30.45 
                 31.01 
                 30.73 
                 5.525 
               
               
                 0.01% 
                 32.98 
                 32.45 
                 32.72 
                 3.540 
               
               
                 0 
                 36.03 
                 36.48 
                 36.26 
                 0 
               
               
                   
               
            
           
         
       
     
     Conclusion: For reference products with different mixing rates, bispecific and monospecific primer/probe systems have a larger ΔCT value and a higher effective resolution than trispecific system. when ΔCT=3 is used as cut off, for the L858R site, the detection limits of the monospecific system, bispecific system and trispecific system are 0.01%, 0.01% and 0.03% respectively; for Q787 site, the detection limits are 0.01%, 0.03% and 0.01%, respectively. This shows that the monospecific system and the bispecific system still have a reliable detection rate even the mixing rate is as low as 0.03%. 
     Example 4 
     The oligonucleotide sequences used in this example are shown in table 32. 
     Main reagents and materials: same as example 3. 
     Step 1. Sample Preparation 
     Extract plasma free DNA of male and female respectively by plasma free nucleic acid extraction kit. After quantification with Qubit fluorescence quantifier, at the ratio of 1%, 0.1%, 0.03%, 0.01%, 0%, mix male cfDNA into the female cfDNA sample, while using the female cfDNA as a blank control. Perform steps 2-6 in example 1 of the present invention to apply captured-extension, ligation and library expansion to the sample. 
     Step 2. qPCR Detection of Different Specific Primer/Probe Combinations 
     Trispecific, bispecific, and monospecific detection systems for specific SRY gene of male are shown in tables 46-48. 
     
       
         
           
               
             
               
                 TABLE 46 
               
             
            
               
                   
               
               
                 Trispecific detection system for male specific SRY gene: 
               
            
           
           
               
               
               
            
               
                 Reagent 
                 Dosage (μL) 
                 Final concentration 
               
               
                   
               
            
           
           
               
               
               
            
               
                 2 × Taqman Mix 
                 10 
                 1× 
               
               
                 F-SRY(10 μM) 
                 0.6 
                 300 nM 
               
               
                 R-SRY(10 μM) 
                 0.6 
                 300 nM 
               
               
                 MGB-SRY(10 μM) 
                 0.2 
                 100 nM 
               
               
                 H 2 O 
                 6.6 
                 / 
               
               
                 Calibrator or sample  
                 2 
                 / 
               
               
                 to be tested 
                   
                   
               
               
                 Total 
                 20 
                 / 
               
               
                   
               
            
           
         
       
     
     
       
         
           
               
             
               
                 TABLE 47 
               
             
            
               
                   
               
               
                 Bispecific detection system for male specific SRY gene: 
               
            
           
           
               
               
               
            
               
                 Reagent 
                 Dosage (μL) 
                 Final concentration 
               
               
                   
               
            
           
           
               
               
               
            
               
                 2 × Taqman Mix 
                 10 
                 1× 
               
               
                 F-SRY(10 μM) 
                 0.6 
                 300 nM 
               
               
                 Uni-R(10 μM) 
                 0.6 
                 300 nM 
               
               
                 MGB-SRY(10 μM) 
                 0.2 
                 100 nM 
               
               
                 H 2 O 
                 6.6 
                 / 
               
               
                 Calibrator or sample  
                 2 
                 / 
               
               
                 to be tested 
                   
                   
               
               
                 Total 
                 20 
                 / 
               
               
                   
               
            
           
         
       
     
     
       
         
           
               
             
               
                 TABLE 48 
               
             
            
               
                   
               
               
                 Monospecific detection system for male specific SRY gene: 
               
            
           
           
               
               
               
               
            
               
                   
                 Reagent 
                 Dosage (μL) 
                 Final concentration 
               
               
                   
                   
               
            
           
           
               
               
               
               
            
               
                   
                 2 × Taqman Mix 
                 10 
                 1× 
               
               
                   
                 F-SRY(10 μM) 
                 0.6 
                 300 nM 
               
               
                   
                 Uni-R(10 μM) 
                 0.6 
                 300 nM 
               
               
                   
                 Uni-MGB (10 μM) 
                 0.2 
                 100 nM 
               
               
                   
                 H 2 O 
                 6.6 
                 / 
               
               
                   
                 Calibrator or sample  
                 2 
                 / 
               
               
                   
                 to be tested 
                   
                   
               
               
                   
                 Total 
                 20 
                 / 
               
               
                   
                   
               
            
           
         
       
     
     qPCR detection procedure is shown in table 49. 
     
       
         
           
               
               
               
               
             
               
                   
                 TABLE 49 
               
               
                   
                   
               
               
                   
                 Cycles 
                 Temperature 
                 Time 
               
               
                   
                   
               
             
            
               
                   
               
            
           
           
               
               
               
               
               
            
               
                   
                  1 cycle 
                 95° C.  
                 4  
                 min 
               
               
                   
                 40 cycles 
                 95° C. 
                 10  
                 s 
               
               
                   
                   
                 61° C. 
                 30  
                 s 
               
               
                   
                   
               
            
           
         
       
     
     Test Results and Analysis 
     Results: The test results of male specific SRY genes with different specific primer/probe combinations are shown in tables 50-52 respectively. The trispecific, bispecific and monospecific detection systems correspond to the reaction systems in tables 46-48, respectively. 
     
       
         
           
               
             
               
                 TABLE 50 
               
             
            
               
                   
               
               
                 Trispecific test results of male specific SRY  
               
               
                 gene (ΔCT = ABS(mean Qi-Q5)) 
               
            
           
           
               
               
               
               
               
            
               
                 Mixing rate 
                 CT1 
                 CT2 
                 CT mean 
                 ΔCT 
               
               
                   
               
            
           
           
               
               
               
               
               
            
               
                 1% 
                 31.23 
                 32.08 
                 31.66 
                 13.345 
               
               
                 0.1% 
                 35.71 
                 35.94 
                 35.83 
                 9.175 
               
               
                 0.03% 
                 37.85 
                 38.02 
                 37.94 
                 7.065 
               
               
                 0.01% 
                 39.25 
                 39.52 
                 39.39 
                 5.615 
               
               
                 0 
                 ND 
                 ND 
                 45.00 
                 0 
               
               
                   
               
            
           
         
       
     
     
       
         
           
               
             
               
                 TABLE 51 
               
             
            
               
                   
               
               
                 Bispecific test results of male specific SRY gene 
               
            
           
           
               
               
               
               
               
               
            
               
                   
                 Mixing rate 
                 CTI 
                 CT2 
                 CT mean 
                 ΔCT 
               
               
                   
                   
               
            
           
           
               
               
               
               
               
               
            
               
                   
                 1% 
                 30.55 
                 30.99 
                 30.77 
                 14.230 
               
               
                   
                 0.1% 
                 34.23 
                 34.98 
                 34.61 
                 10.395 
               
               
                   
                 0.03% 
                 36.32 
                 37.94 
                 37.13 
                 7.870 
               
               
                   
                 0.01% 
                 39.48 
                 39.12 
                 39.30 
                 5.700 
               
               
                   
                 0 
                 ND 
                 ND 
                 45.00 
                 0 
               
               
                   
                   
               
            
           
         
       
     
     
       
         
           
               
             
               
                 TABLE 52 
               
             
            
               
                   
               
               
                 Monospecific test results of male specific SRY gene 
               
            
           
           
               
               
               
               
               
               
            
               
                   
                 Mixing rate 
                 CTI 
                 CT2 
                 CT mean 
                 ΔCT 
               
               
                   
                   
               
            
           
           
               
               
               
               
               
               
            
               
                   
                 1% 
                 29.38 
                 29.68 
                 29.53 
                 15.470 
               
               
                   
                 0.1% 
                 33.28 
                 33.89 
                 33.59 
                 11.415 
               
               
                   
                 0.03% 
                 35.45 
                 35.82 
                 35.64 
                 9.365 
               
               
                   
                 0.01% 
                 38.21 
                 37.89 
                 38.05 
                 6.950 
               
               
                   
                 0 
                 ND 
                 ND 
                 45.00 
                 0 
               
               
                   
                   
               
            
           
         
       
     
     Conclusion: As a gene only on the Y chromosome, SRY has high detection sensitivity by the three methods. If ΔCT=3 is used as the cut off, the monospecific, bispecific, and trispecific systems each can achieve a detection sensitivity of 0.01%. However, judging from the specific CT value, the detection rate of the monospecific system is higher. 
     In summary, the present invention effectively overcomes various shortcomings in the prior art and has high industrial utilization value. 
     The above embodiments are only illustrative of the principles and effects of the present invention, not intended to limit the present invention. Anyone familiar with this technology can modify or change the above embodiments without departing from the spirit and scope of the present invention. Therefore, all equivalent modifications or changes made by those with common knowledge in the technical field without departing from the spirit and technical idea disclosed by the present invention should still be covered by the claims of the present invention.