CPC C12Q 1/6886 (2013.01) [C12Q 1/6883 (2013.01); C12Q 1/6809 (2013.01); C12Q 2600/154 (2013.01); C12Q 2600/156 (2013.01)] | 23 Claims |
1. A method of determining a cancer classification in a biological sample from a subject, wherein the biological sample includes a mixture of cell-free DNA molecules including tumor DNA molecules and non-tumor DNA molecules, wherein the biological sample comprises plasma or serum, the method comprising:
performing a physical size separation of the biological sample for a range of sizes of the cell-free DNA molecules to form an enriched biological sample;
performing methylation-aware sequencing to identify methylated cell-free DNA molecules in the enriched biological sample;
for each size range of a plurality of size ranges:
measuring a first amount of the methylated cell-free DNA molecules from the enriched biological sample corresponding to the size range, and
determining, by a computer system, a methylation level using the first amount of the methylated cell-free DNA molecules corresponding to the size range and a second amount of DNA molecules in a second size range that includes sizes not in the size range;
obtaining, by the computer system, a reference size pattern including a reference methylation level for each size range of the plurality of size ranges, wherein the reference size pattern is determined from a plurality of reference samples from subjects with cancer or from subjects without cancer;
comparing, by the computer system, a plurality of the methylation levels to the reference size pattern; and
determining a level of cancer based on the comparison.
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