Cancer is disease that among the leading causes of death, and the early accurate diagnosis are key to improve and the survival rate. However, developing the reliable, sensitive, cost-effective diagnostic tool remains a challenge. Although the quantum dots (QDs)-based fluorescence-linked immunosorbent assays (QD-FLISA) has the advantages of shorter detection time and high-through detection, the reliability with high sensitivity and cost-effectiveness need to be fully considered before their clinical application. In this study, the biotin-streptavidin (Bio-SA) system with high affinity were introduced into the QD-based fluorescence immunosensor to enhance the performance of cancer diagnosis. The Bio-SA FLISA was firstly constructed to detect alpha-fetoprotein (AFP) and carcinoembryonic antigen (CEA). Due to the high affinity of Bio-SA and the lower steric hindrance of long PEG length, the Bio-SA FLISA not only obtained excellent linear relationship between the fluorescence signal and Ag concentration, but also achieved low detection limits of 0.18 ng/mL for AFP and 0.08 ng/mL for CEA. Ever better, the cost of expensive primary antibodies in Bio-SA FLISA has been greatly reduced by 80–90 %, lowering the cost of this immunosensor. Clinical samples test also validated the accuracy of Bio-SA FLISA for AFP and CEA detection. Furthermore, the Bio-SA-QDs probes showed brighter fluorescent cellar imaging at the less usage of antibodies. In conclusion, this Bio-SA QDs-based immunosensor owned the advantages of low cost, sensitivity, stability and accuracy for cancer biomarkers detection, and exhibited excellent cellular imaging capacity, which was a powerful tool for enhancing cancer diagnosis.
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