Patent Publication Number: US-2023162813-A1

Title: Apparatus and method for diagnosing cancer using liquid biopsy data

Description:
CROSS-REFERENCE TO RELATED APPLICATION 
     A claim for priority under 35 U.S.C. § 119 is made to Korean Patent Application No. 10-2021-0162245 filed on Nov. 23, 2021 in the Korean Intellectual Property Office, the entire contents of which are hereby incorporated by reference. 
     TECHNICAL FIELD 
     The present disclosure relates to an apparatus and method for diagnosing cancer using liquid biopsy data. 
     BACKGROUND 
     With advances in science and technology, people may be in a comfort zone, but they do not have access to personalized cancer treatment strategies based on their individual characteristics. Microarrays and next-generation sequencing are key tools (carter) in cancer research to quantify gene expression, DNA copy number, and microRNA activity. 
     Since cancer is an inherited disease, initiating an integrated test of gene mutation data and expression data is one of the best means for understanding the mechanism of carcinogenesis, predicting and preventing cancer occurrence, and finding possible treatments. In the early 90s, scientists began studying the application of artificial intelligence for information processing, data analysis, knowledge expression, and management of gene expression data. Classification using artificial intelligence is a type of data analysis that aims to provide a better understanding of cancer to enable doctors to make clinical decisions by extracting knowledge from gene expression data. 
     Experts may track their knowledge, but for high-dimensional gene expression data, this may be difficult and time consuming Algorithms are available for extracting knowledge without experts, but are not suitable for good system performance. Rule-based approaches gain momentum in cancer diagnosis because making certain rules, i.e., in artificial intelligence, is a good way to express knowledge. 
     Decision trees are widely used to produce rules containing biologically meaningful terms, although they are sensitive enough to cause small biases in the training samples to lead to serious errors in the tree structure. Ensemble models of classification trees are as sensitive as decision trees. The rules generated by data-driven algorithms are simpler, but they fail to account for the redundant behavior of gene expressions in uncertain situations. 
     Although the rule-based system proposed by Komori et al. may be applied to predict cancer through intuitive knowledge generation from gene expression data, this approach is very vulnerable to self-learning. The hybrid fuzzy method fails to perfectly model the fuzzy system because it expresses only the rule set within the gene population by fixing the points of the membership function. 
     The genetic Swarm algorithm has better classification accuracy, but the if-then rules produced therefrom have more input genes and linguistic variables, making it difficult for doctors to understand. The AntBee algorithm may address the interpretability-accuracy tradeoff by producing a more readable set of rules, but the use of more complex operations with more tunable control parameters made this approach consume a lot of CPU time. 
     Fuzzy ontology may extract knowledge quickly, but is degraded by the scarce data distribution found in ultra-high-dimensional gene expression data. The framework within the fuzzy expert system construction transforms the crisp rules into fuzzy rules using a probabilistic global optimization procedure, but generation of the crisp rules using experts of various cancers is also difficult. In order to maintain a convincing focus on gene expression data analysis, it is better to deal with multicategory diagnostics. 
     In this regard, previous studies have attempted to combine classifiers from which a final decision is derived using decision by majority or fuzzy aggregation. Most ensemble classification methods are based on a black box approach whose focus is only on classification performance and provide no action for understanding the fundamental questions of medicine. 
     Recently, in order to utilize the significant advantage of interpretability provided by fuzzy systems, fuzzy rule-based multiclassification systems (FRBMS) using a combination method have been proposed. However, the presence of a large number of genomic variables compared to a relatively small number of patients makes the data difficult to understand. Attempts have been made to use a genetic algorithm in FRBMS to perform classifier fusion and selection together, but they did not satisfy the skewness of gene expression data. 
     Furthermore, underfitting should be avoided in multiple classifications where insufficient experiments result in an non-optimized robust system. In order to construct a fruitful cancer diagnosis system that pretenses multiple encounters, such as inaccurate and non-linear multicategory values, it is essential to think about ideal and suitable techniques that use the principles of rigorous data analysis. These various algorithms may achieve the most optimized results only when applied to an appropriate data set. 
     Whole genome sequencing data of ctDNA contains information about many molecules. 
     In most analyzes, only the difference in DNA mutation information or copy number variations is interpreted, and the rest of the information is mostly discarded. In most cases, attention is not paid to a change in the copy number variations of mitochondria or P/Q-arm, a comparison of total copy number, and fragment length information. 
     DISCLOSURE 
     Technical Task 
     An aspect of the present disclosure is directed to providing an apparatus and method for diagnosing cancer, capable of determining the presence of cancer from liquid biopsy data and determining an origin and stage of cancer with an optimized method. 
     The aspects of the present disclosure are not limited to those mentioned above, and other aspects not mentioned herein will be clearly understood by those skilled in the art from the following description. 
     Technical Solution 
     A method for diagnosing cancer using liquid biopsy data performed by an apparatus according to an embodiment of the present disclosure includes: a) acquiring ctDNA sequence information from plasma extracted from blood, and extracting a fragment length and a copy number variations of a chromosome based on the acquired sequence information; b) extracting fragment reads of P-arm and Q-arm using the acquired sequence information; c) extracting a copy number variations of mitochondria using the acquired sequence information; d) inputting at least one of the fragment length and the copy number variations of the chromosome, the fragment length of the P-arm, the fragment length of the Q-arm, and the copy number variations of the mitochondria as an input value of a pre-learned algorithm, and outputting occurrence of cancer as an output value; and e) inputting at least one of the fragment length and the copy number variations of the chromosome, the fragment length of the P-arm, the fragment length of the Q-arm, and the copy number variations of the mitochondria as an input value of an artificial intelligence algorithm, and outputting a stage and origin of cancer as an output value. 
     In an embodiment, operation a) includes: acquiring ctDNA sequence information from the plasma, an aligning sequence using a human reference genome data; aligning the sequence by removing sequence quality information, mapping information, and duplication information from the sequence information; and extracting fragment lengths of an autosome and a sex chromosome from a first length to a second length using the aligned sequence information. 
     In an embodiment, operation b) is configured to extract fragment reads of P-arm and Q-arm based on a centromere of the chromosome. 
     In an embodiment, operation a) includes: extracting sequence information having a GC content and a mapping rate equal to or greater than a reference value (cut-off) using the aligned sequence information; dividing each chromosomal region into bin regions having a size equal to or greater than a specific size and normalizing an amount of each section; calculating a Z-score using a mean and standard deviation for each bin region; and extracting a copy number variations by quantifying the Z-score. 
     In an embodiment, operation c) includes: calculating copy number variations of mitochondria; calculating an average copy number variations of an autosome; and extracting the copy number variations of mitochondria by dividing the copy number variations of mitochondria into the average copy number variations of the autosome. 
     In an embodiment, in operation d), the pre-learned algorithm includes at least one algorithm of Random Forest (RF), Support Vector Machine (SVM), eXtra Gradient Boost (XGB), Decision Tree Classifier (DTC), K-nearest Neighbors (KNN), Gaussian Naive Bayes (GNB), Stochastic Gradient Descent (SGD), Linear Discriminant Analysis (LDA), Ridge Regression, Lasso, and Elastic net. 
     In an embodiment, the method further includes integrating a fragment length of the chromosome and ratio data of the P-arm and Q-arm; and integrating a copy number variations of the autosome and ratio data of the mitochondria, wherein operations d) and e) are characterized in that the integrated ratio data are input as input values. 
     In addition, an apparatus for diagnosing cancer using liquid biopsy data according to an embodiment of the present disclosure includes: a DNA analysis unit for acquiring ctDNA sequence information from plasma extracted from blood, extracting a fragment length and a copy number variations of a chromosome based on the acquired sequence information, extracting fragment reads of P-arm and Q-arm using the acquired sequence information, and extracting a copy number variations of mitochondria using the acquired sequence information; and a control unit for inputting at least one of the fragment length and the copy number variations of the chromosome, the fragment length of the P-arm, the fragment length of the Q-arm, and the copy number variations of the mitochondria as an input value of a pre-learned algorithm, and outputting occurrence of cancer as an output value, wherein the control unit is configured to input at least one of the fragment length and the copy number variations of the chromosome, the fragment length of the P-arm, the fragment length of the Q-arm, and the copy number variations of the mitochondria as an input value of an artificial intelligence algorithm, and output a stage and origin of cancer as an output value. 
     In an embodiment, the DNA analysis unit is configured to: acquire ctDNA sequence information from the plasma, and align sequence using a human reference genome database; align the sequence by removing sequence quality information, mapping information, and duplication information from the sequence information; and extract a fragment length of an autosome and a sex chromosome from a first length to a second length using the aligned sequence information. 
     In an embodiment, the DNA analysis unit is configured to extract fragment reads of P-arm and Q-arm based on a centromere of the chromosome. 
     In an embodiment, the DNA analysis unit is configured to: extract sequence information having a GC content and a mapping rate equal to or greater than a reference value using the aligned sequence information; divide each region into bin regions having a size equal to or greater than a specific size and normalize an amount of each section; calculate a Z-score using a mean and standard deviation for each bin region; and extract a copy number variations by quantifying the Z-score. 
     In an embodiment, the DNA analysis unit is configured to: calculate copy number variations of mitochondria, and calculate average copy number variations of an autosome; and extract the copy number variations of mitochondria by dividing the copy number variations of mitochondria into the average copy number variations of the autosome. 
     In an embodiment, the pre-learned algorithm includes at least one algorithm of Random Forest (RF), Support Vector Machine (SVM), eXtra Gradient Boost (XGB), Decision Tree Classifier (DTC), K-nearest Neighbors (KNN), Gaussian Naive Bayes (GNB), Stochastic Gradient Descent (SGD), Linear Discriminant Analysis (LDA), Ridge Regression, Lasso, and Elastic net. 
     In an embodiment, the control unit is configured to integrate a fragment length of the chromosome and ratio data of the P-arm and Q-arm, and integrate a copy number variations of the autosome and ratio data of the mitochondria, wherein the integrated ratio data are input as input values. 
     A program for diagnosing cancer according to another embodiment of the present disclosure is stored in a medium for performing any one of the methods described above in combination with a computer, which is hardware. 
     In addition, another method for implementing the present disclosure, another system, and a computer readable recording medium for recording a computer program for executing the method may be further provided. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG.  1    is a conceptual diagram illustrating an apparatus for diagnosing cancer according to an embodiment of the present disclosure. 
         FIG.  2    is a flowchart illustrating a method for diagnosing cancer according to an embodiment of the present disclosure. 
         FIGS.  3  to  13    are conceptual diagrams illustrating the method for diagnosing cancer illustrated in  FIG.  2   . 
     
    
    
     DETAILED DESCRIPTION 
     The advantages and features of the present disclosure and methods of achieving them will be apparent from the embodiments that will be described in detail with reference to the accompanying drawings. It should be noted, however, that the present disclosure is not limited to the following embodiments, and may be implemented in various different forms. Rather the embodiments are provided so that this disclosure will be thorough and complete and will fully convey the scope of the present disclosure to those skilled in the technical field to which the present disclosure pertains. It is to be noted that the scope of the present disclosure is defined only by the claims. 
     Terms used in the specification are used to describe embodiments of the present disclosure and are not intended to limit the scope of the present disclosure. In the specification, the terms in singular form may include plural forms unless otherwise specified. The expressions “comprise” and/or “comprising” used herein indicate the existence of one or more other elements other than stated elements but do not exclude presence of additional elements. Like reference denotations refer to like elements throughout the specification. As used herein, the term “and/or” includes each and all combinations of one or more of the mentioned components. It will be understood that, although the terms “first”, “second”, etc., may be used herein to describe various components, these components should not be limited by these terms. These terms are only used to distinguish one component from another component. Accordingly, a first component mentioned below could be termed a second component without departing from the technical ideas of the present disclosure. 
     Unless otherwise defined, all terms (including technical and scientific terms) used herein have the same meaning as commonly understood by those skilled in the technical field to which the present disclosure pertains. It will be further understood that terms, such as those defined in commonly used dictionaries, should not be interpreted in an idealized or overly formal sense unless expressly so defined herein. 
     Hereinafter, the embodiments of the present disclosure will be described in detail with reference to the accompanying drawings. 
     Prior to the description, the meanings of the terms used in the present specification will be described briefly. However, it should be noted that the description of terms is used to help the understanding of the present specification, but is not to be used to limit the technical spirit of the present disclosure in the case where the limitative details of the present disclosure are not explicitly described. 
     As used herein, the term “apparatus for diagnosing cancer” includes various devices capable of providing a result to a user by performing an arithmetic process. 
     For example, the apparatus for diagnosing cancer may include a computer, a terminal, a desktop PC, and a notebook computer as well as a smart phone, a tablet PC, a cellular phone, a Personal Communication Service (PCS) phone, a mobile terminal of a synchronous/asynchronous International Mobile Telecommunication-2000 (IMT-2000), a Palm Personal Computer (Palm PC), a personal digital assistant (PDA), etc. 
     In addition, the apparatus for diagnosing cancer may communicate with a server that receives a request from a client and processes information. 
     The apparatus for diagnosing cancer according to an embodiment of the present disclosure may be implemented to include at least one of the components described with reference to  FIG.  1   . 
       FIG.  1    is a conceptual diagram illustrating an apparatus for diagnosing cancer according to an embodiment of the present disclosure. 
     The apparatus  100  for diagnosing cancer according to an embodiment of the present disclosure may include a DNA analysis unit  110  and a control unit  130 . 
     The DNA analysis unit  110  may acquire ctDNA sequence information from plasma extracted from blood. 
     The DNA analysis unit  110  may extract a fragment length and a copy number variations of a chromosome based on the acquired sequence information. 
     The DNA analysis unit  110  may extract the fragment reads of P-arm and Q-arm using the acquired sequence information. 
     The DNA analysis unit  110  may extract the copy number variations of mitochondria using the acquired sequence information. 
     The control unit  130  may perform cancer diagnosis using the data extracted from the DNA analysis unit  110 . 
     Specifically, the control unit  130  may input at least one of the fragment length and the copy number variations of the chromosome, the fragment length of the P-arm, the fragment length of the Q-arm, and the copy number variations of the mitochondria as an input value of the pre-learned algorithm, and output occurrence of cancer as an output value. 
     In addition, the control unit  130  may input at least one of the fragment length and the copy number variations of the chromosome, the fragment length of the P-arm, the fragment length of the Q-arm, and the copy number variations of the mitochondria as an input value of an artificial intelligence algorithm, and output a stage and origin of cancer as an output value. 
     In addition, the control unit  130  may perform monitoring to determine the recurrence and metastasis of a patient using the output value of the cancer occurrence, the stage and origin of cancer. 
       FIG.  2    is a flowchart illustrating a method for diagnosing cancer according to an embodiment of the present disclosure.  FIGS.  3  to  13    are conceptual diagrams illustrating the method for diagnosing cancer illustrated in  FIG.  2   . 
     The present disclosure provides an apparatus and method for diagnosing cancer capable of discriminating the origin and stage as well as the classification of cancer or normal condition (cancer occurrence) by inputting fragment data of cell-free circulating tumor nucleic acid (ctDNA) into an artificial intelligence algorithm. 
     According to the present disclosure, data generated by Next Generation Sequencing (NGS) may be discriminated even at low-depth from 3× to 0.5×. 
     The present disclosure can significantly improve the accuracy by simultaneously inputting various data such as the difference in the copy number variations of chromosomes, the fragment length (fragment size) of the chromosomes, and the ratios of mitochondria, P-arm, and Q-arm to the pre-learned algorithm. 
     Accordingly, the apparatus and method for diagnosing cancer of the present disclosure can significantly reduce medical expenses by detecting cancer at an early stage, reduce cancer mortality, and can be usefully used for cancer treatment and prognosis prediction. 
     Referring to  FIG.  2   , in the apparatus for diagnosing cancer of the present disclosure, the DNA analysis unit  110  acquires ctDNA sequence information from plasma extracted from blood, and extracts the fragment length and copy number variations of chromosomes based on the acquired sequence information (S 210 ). 
     The control unit  130  may control a centrifuge. 
     The control unit  130  may control a rpm speed of the centrifuge to maximize the amount of ctDNA (or cfDNA). 
     Specifically, the control unit  130  may control a centrifuge in such a way that a) in a separation method using only a one-phase one, plasma is extracted in 10 minutes at 400 g (gravity acceleration) to 1000 g, and b) in a separation method using a two-phase one, plasma is extracted at a rotational speed of 6000 g or more after applying the method a). 
     The plasma separated in the centrifuge may be moved to the DNA analysis unit  110  and used for analysis. 
     The DNA analysis unit  110  may analyze a pattern of a ctDNA fragment length in a sequenced file of whole genome sequences (WGS). 
     In addition, the DNA analysis unit  110  may calculate the copy number variations of ctDNA from a sequenced file of whole genome sequences (WGS). 
     The control unit  130  may diagnose cancer using the pattern and copy number variations of the DNA fragment length of data produced by the mass sequencing method. 
     The DNA analysis unit  110  may acquire sequence information (fastq format file or reads) of ctDNA from plasma, and align sequence using a human reference genome data (Human reference genome). 
     The DNA analysis unit  110  may align the sequence by removing sequence quality information, mapping information, and duplicate information from the sequence information. 
     In addition, the DNA analysis unit  110  may extract fragment lengths of an autosome, a sex chromosome and mitochondria from a first length (for example, 75) to a second length (for example, 440) using the aligned sequence information. 
     As illustrated in  FIG.  3   , the control unit  130  may secure a pattern for fragment lengths of a chromosome, and the number in a specific fragment length (for example, 155 or 166) is shown to be different from a normal case and a cancer case. 
     In addition, the DNA analysis unit  110  may extract a fragment read of P-arm and a fragment read of Q-arm using the acquired sequence information (S 220 ). 
     The DNA analysis unit  110  may extract the fragment lengths of the P-arm and the Q-arm based on a centromere of a chromosome (all chromosomes). 
     In addition, the DNA analysis unit  110  may extract sequence information having a GC content and a mapping rate equal to or greater than a reference value (cut-off) using the aligned sequence information. 
     The DNA analysis unit  110  may divide each region into bin regions having a size equal to or greater than a specific size and normalize an amount of each section. 
     The DNA analysis unit  110  may calculate a Z-score using a mean and standard deviation for each bin region, and extract the copy number variations by quantifying the Z-score. 
     Specifically, the DNA analysis unit  110  of the present disclosure may extract a read (sequence information) having a GC content and a mapping rate (mappability) equal to or greater than a reference value using the aligned sequence information (data). 
     In addition, the DNA analysis unit  110  may divide each chromosomal region into bins of 5 kb or more (5 KB to 10 MB) to check and normalize an amount of each section. 
     The DNA analysis unit  110  may calculate the Z-score using the mean and standard deviation obtained based on the bin. 
     The DNA analysis unit  110  may quantify the value of the Z-score to digitize data on a difference in the copy number. 
     Specifically, the DNA analysis unit  110  may calculate a difference between copy number variations (CNV) of autosomes, sex chromosomes, and mitochondria using sequence alignment data. 
     The DNA analysis unit  110  may remove ambiguous reads (sequence information) from the sequence alignment data, align only perfectly matched reads, and extract a read having a GC content and a mapping rate (Mappability) equal to or greater than a reference value from the aligned sequences. 
     The DNA analysis unit  110  may divide each region into bins of 5 kb or more (5 KB to 10 MB) to calculate a Z-score. 
       FIG.  4    illustrates the results at various read depths from 0.1× to 5×. 
       FIG.  4    is a graph showing the results of the copy number variations according to the read depth, and graphs of 5×, 3×, 1×, 0.5×, and 0.1× are shown in plan view. 
     Referring to  FIG.  4   , as the final result graph, a depth of up to 0.5× is appropriate, but from a depth of 0.1×, the score rapidly changes and falls, and it is determined that there is a change in the copy number variations due to the low depth of the result of a normal person without a copy number variations change. 
     As in the random forest result of  FIG.  5   , the results of 0.5× to 5× are almost constant, but the value of 0.1× has a great influence on the overall result. 
     The DNA analysis unit  110  may extract the copy number variations of mitochondria using the acquired sequence information (S 230 ). 
     Specifically, the DNA analysis unit  110  may calculate a sequence information depth of mitochondria, and calculate an average sequence information depth of an autosome. 
     The DNA analysis unit  110  may extract a copy number variations of mitochondria by dividing the sequence information depth of mitochondria into the average sequence information depth of the autosome. 
     The DNA analysis unit  110  may calculate the copy number variations of mitochondria as follows. 
     Calculation of the copy number variations of mitochondria=mitochondrial read depth/average read depth of autosomes. 
     Thereafter, the control unit  130  may input at least one of the fragment length and the copy number variations of the chromosome, the fragment length of the P-arm, the fragment length of the Q-arm, and the copy number variations of the mitochondria as an input value of the pre-learned algorithm, and output occurrence of cancer as an output value (S 240 ). 
     The pre-learned algorithm may include at least one algorithm of Random Forest (RF), Support Vector Machine (SVM), eXtra Gradient Boost (XGB), Decision Tree Classifier (DTC), K-nearest Neighbors (KNN), Gaussian Naive Bayes (GNB), Stochastic Gradient Descent (SGD), Linear Discriminant Analysis (LDA), Ridge Regression, Lasso, and Elastic net. 
     In addition, the control unit  130  may input at least one of the fragment length and the copy number variations of the chromosome, the fragment length of the P-arm, the fragment length of the Q-arm, and the copy number variations of the mitochondria as well as occurrence of cancer as an input value of an artificial intelligence algorithm, and output a stage and origin of cancer as an output value (S 250 ). 
     The control unit  130  may integrate a fragment length of the chromosome and ratio data of the P-arm and Q-arm, and integrate the copy number variations of the autosome and ratio data of the mitochondria. 
     Thereafter, the control unit  130  may input the integrated ratio data as input values. 
     The artificial intelligence algorithm may include Random Forest (RF), Support Vector Machine (SVM), eXtra Gradient Boost (XGB), Decision Tree Classifier (DTC), K-nearest Neighbors (KNN), Gaussian Naive Bayes (GNB), Stochastic Gradient Descent (SGD), Linear Discriminant Analysis (LDA), and algorithms such as Ridge Regression, Lasso, and Elastic net classifiers. 
     The artificial intelligence algorithm may mean algorithm designed and learned to extract a stage and origin of cancer as well as occurrence of cancer, and may be pre-stored by the control unit  130  and periodically updated. 
     In addition, the control unit  130  may use the integrated data to inflate a sample by tens to hundreds of times using various sample expansion methods such as a Generative Adversarial Network (GAN), SMOTE, and Denoising Autoencoder, and discriminate the presence of cancer with a classifier of artificial intelligence and deep learning. 
     In addition, the control unit  130  may use the generated integrated data to inflate a sample by tens to hundreds of times using various sample expansion methods such as a Generative Adversarial Network (GAN), SMOTE, and Denoising Autoencoder, and discriminate the stage and origin of cancer with a classifier of artificial intelligence and deep learning. 
     Through this configuration, the present disclosure can introduce an artificial intelligence learning approach to a biological analyte that may affect cancer, and interpret cancer and predict the origin and stage of cancer to detect cancer at an early stage and reduce the mortality rate. Moreover, the present invention can also provide a useful method for significantly reducing medical expenses by performing cancer treatment and prognosis prediction. 
     In addition, the present disclosure can contribute to the happiness and welfare of mankind by providing a possible service for the entire nation at a low price with a method and apparatus for predicting cancer even at a depth as low as 0.5×. 
     Hereinafter, the experimental results according to the present disclosure will be described with reference to the accompanying drawings. 
     The accuracy of cancer diagnosis is as follows. 
     As for the fragment length, unlike those previously reported, the results using the total length that may be inferred from the fragment length in comparison between 155 bp or less and the whole showed slightly better results at the median value. 
     Referring to  FIG.  6   ,  FIG.  6    is a comparison diagram of a graph using Basic using the entire region and using only up to 155 bp. 
     In this experiment, the results of each algorithm were compared, in the order of Stochastic Gradient Descent (SGD), Random Forest (RF), Support Vector Machines (SVM), Decision Tree Classifier (DTC), K-nearest Neighbors (KNN), Gaussian Naive Bayes (GNB), and eXtra Gradient Boost (XGB). 
     The left one is Basic and the right one is the result up to 155 bp. All results of Basic are the result of adding copy number variations (CNV), and it is an accuracy value. 
     The result of capturing only 155 bp in a difference in the pattern of  FIG.  3    or the result of 155 bp or less (74 bp to 155 bp)+180 bp or more (180 bp to 220 bp) was not higher than the result of using the entire 75 bp to 440 bp. 
     This experiment identified that the result having all regions (75 bp˜440 bp) was more beneficial. 
     2) CNV, Fragmentation, P/Q-Arm Regions and Analysis 
     The data of the copy number variation (CNV) was segmented into a 5 kb region and the result data of a z-score was used, and the basic analysis methods of the author&#39;s previous NIPT patents 1018177850000 and 1018171800000 were used. 
     As illustrated in  FIG.  7   , the results of 1 kb to 5 kb, 1 mb, etc. were almost similar, so they are shown only in the case of segmentation into 5 kb region, and the result of Random Forest had a median value of 0.61. 
     For the fragmentation region, numerical values using the results of 1) above and the entire region of 75 bp to 440 bp in  FIG.  3    were used. 
     In the normalization process of fragmentation data, the exact fragment length was determined using the paired-end length of 1275 samples, and the number of distributions for each size was determined. 
     All data may be expressed as a ratio of each length with respect to the total fragment or obtained using a Z-score. 
     Each region of the P/Q-arm followed the general criteria for classifying the centromere into the P-arm region on the upper side and the Q-arm region on the lower side as shown in Table 1 below, and followed the criteria for classification and distribution in general in the UCSC Genome Browser. 
     
       
         
           
               
             
               
                 TABLE 1 
               
               
                   
               
               
                 Regions of P-arm and Q-arm selected based on a centromere 
               
               
                   
               
             
            
               
                   
               
            
           
           
               
               
               
               
               
               
               
            
               
                   
                 chr1 
                 chr2 
                 chr3 
                 chr4 
                 chr5 
                 chr6 
               
               
                   
               
               
                 P-arm 
                 125000000 
                  93300000 
                  91000000 
                  50400000 
                  48400000 
                  61000000 
               
               
                 Q-arm 
                 249250621 
                 243199373 
                 198022430 
                 191154276 
                 180915260 
                 171115067 
               
               
                   
               
               
                   
                 chr7 
                 chr8 
                 chr9 
                 chr10 
                 chr11 
                 chr12 
               
               
                   
               
               
                 P-arm 
                  59900000 
                  45600000 
                  49000000 
                  40200000 
                  53700000 
                  35800000 
               
               
                 Q-arm 
                 159138663 
                 146364022 
                 141213431 
                 135534747 
                 135006516 
                 133851895 
               
               
                   
               
               
                   
                 chr13 
                 chr14 
                 chr15 
                 chr16 
                 chr17 
                 chr18 
               
               
                   
               
               
                 P-arm 
                  17900000 
                  17600000 
                  19000000 
                 36600000 
                 24000000 
                 17200000 
               
               
                 Q-arm 
                 115169878 
                 107349540 
                 102531392 
                 90354753 
                 81195210 
                 78077248 
               
               
                   
               
               
                   
                 chr19 
                 chr20 
                 chr21 
                 chr22 
                 chr23 
                 chr24 
               
               
                   
               
               
                 P-arm 
                 26500000 
                 27500000 
                 13200000 
                 14700000 
                  60600000 
                 12500000 
               
               
                 Q-arm 
                 59128983 
                 63025520 
                 48129895 
                 51304566 
                 155270560 
                 59373566 
               
               
                   
               
            
           
         
       
     
     The distribution of the length of the paired-end of the P-arm was calculated, and only a region of 100 bp to 400 bp was used, and the ratio of each region and P/Q-arm was used for analysis. 
     In  FIG.  9   , a better value than the existing Basic (CNV+Fragmentation) result ( FIG.  8   ) was obtained from the data (CNV+Fragmentation+P/Q-arm) result using the ratio of P/Q-arm, and the median value of 0.78, which was improved by about 0.2 compared to the conventional one, was obtained in the XGB result. In addition, it was identified that the median value was improved as a whole. 
     3) Analysis and Results of Adding Mitochondria to Basic 
     In addition to the data of Basic (CNV+Fragmentation), in order to reflect the copy number variations of mitochondria showing significant results in cancer, it was calculated using (average read depth of mitochondria)/(average read depth of autosomes) in order to reflect the number of mitochondria compared to the total. 
     In the result of  FIG.  10   , there was an improvement in accuracy of 3 to 5%, unlike the existing data. The result of RF showed a median value of 80%, and there were also results with a maximum accuracy of 83%. Although XGB had similar results, RF showed good results with less distribution of median values and variances as a whole. 
       FIG.  10    illustrates Stochastic Gradient Descent (SGD), Random Forest (RF), Support Vector Machines (SVM), Decision Tree Classifier (DTC), K-nearest Neighbors (KNN), Gaussian Naive Bayes (GNB), and eXtra Gradient Boost (XGB) in order, where the results of Basic and BasicPlusMito (adding mitochondria to Basic) are drawn in pairs in order, and shows a result of performing the result of 10 fold 10 times. 
     
       
         
           
               
               
               
               
               
             
               
                 TABLE 2 
               
               
                   
               
               
                 Detection 
                 Patients 
                 Patients 
                 Fraction of patients 
                   
               
               
                 approach 
                 analyzed 
                 detected 
                 detected 
                 95% CI 
               
               
                   
               
             
            
               
                   
               
            
           
           
               
               
               
               
               
            
               
                 SmartCfDNA 
                 126 
                 106 
                 84% 
                 78%-89% 
               
               
                 DELFI 
                 126 
                 103 
                 82% 
                 74%-88% 
               
               
                 Mutations 
                 126 
                 83 
                 66% 
                 57%-74% 
               
               
                   
               
            
           
         
       
     
     In 98% of specificities, DELFI cited values in its entirety, and SmartCfDNA is the result of RF. 
     4) Ability to Determine the Origin of Each Cancer 
     In the present disclosure, the most important thing after distinguishing between a normal state and cancer is to determine what kind of cancer it is. Referring to  FIGS.  11  and  12   , it is possible to determine breast cancer, colon cancer, pancreatic cancer, stomach cancer, lung cancer, ovarian cancer, and biliary tract cancer using modules learned from each dataset. 
     When using RF, the accuracy in detecting lung cancer is 85%, but there is a distinguishing power of 86%, 90%, 89%, 92%, 86%, 89%, and 93%. The origin of cancer may be determined, while most lung cancers are detected with accuracy of 90% or more. 
     Referring to  FIG.  13   , the ability to distinguish 7 cancers of the present disclosure showed 60% in RF (55-65% in 95% CI), and 63% in XGB (57-66% in 95% CI), and the ability to predict the top two cancers showed 78% both in RF and XGB. 
     The operations and functions of the apparatus for diagnosing cancer described above may be inferred and applied in the same/similar way to the method for diagnosing cancer. 
     According to the present disclosure as described above, the present disclosure may provide a method for diagnosing cancer capable of diagnosing the presence of cancer and discriminating the origin and stage of cancer with an optimized method. 
     In addition, the present disclosure can provide a method for diagnosing cancer with higher accuracy compared to the related art. 
     The method according to an embodiment of the present disclosure described above may be implemented as a program (or an application) to be executed in combination with a server, which is hardware, and stored in a medium. 
     The above-described program may include a code encoded by a computer language such as C, C++, JAVA, or a machine language, which a processor (CPU) of the computer can read through a device interface of the computer, such that the computer reads the program and performs the methods implemented with the program. The code may include functional codes associated with the function that defines functions necessary to perform the methods, and may include a control code associated with an execution procedure necessary for the processor of the computer to perform the functions in a predetermined procedure. Furthermore, the code may further include additional data necessary for the processor of the computer to perform the functions or a memory reference-related code associated with the location (address) of the internal or external memory of the computer, at which the media needs to be referred. In addition, when the processor of the computer needs to communicate with any other remote computer or any other remote server to perform the functions, the code may further include a communication-related code associated with how to communicate with any other remote computer or server using the communication module of the computer, and what data or media should be transmitted or received during communication. 
     The storing media may mean the media that does not store data for a short period of time such as a register, a cache, a memory, or the like but semi-permanently stores to be read by the device. Specifically, for example, the storing media include, but are not limited to, ROM, RAM, CD-ROM, magnetic tape, floppy disk, optical data storage device, and the like. That is, the program may be stored in various recording media on various servers that the computer can access, or various recording media on the computer of the user. In addition, the media may be distributed to a computer system connected to a network, and a computer-readable code may be stored in a distribution manner. 
     The operations of a method or algorithm described in connection with the embodiments of the present disclosure may be embodied directly in hardware, in a software module executed by hardware, or in a combination thereof. The software module may reside on a Random Access Memory (RAM), a Read Only Memory (ROM), an Erasable Programmable ROM (EPROM), an Electrically Erasable Programmable ROM (EEPROM), a Flash memory, a hard disk, a removable disk, a CD-ROM, or a computer readable recording medium in any form well known in the technical field to which the present disclosure pertains. 
     Although the embodiments of the present disclosure have been described with reference to the attached drawings, those skilled in the technical field to which the present disclosure pertains will understand that the present disclosure may be practiced in other detailed forms without departing from the technical spirit or essential features of the present disclosure. Therefore, it should be understood that the above-described embodiments are exemplary in all aspects rather than being restrictive.