title: Diagnosis of early stage ovarian cancer by 1H NMR metabonomics of serum explored by use of a microflow NMR probe.
abstract: We show that (1)H NMR based metabonomicsof serum allows the diagnosis of early stage I/II epithelial ovarian cancer (EOC) required for successful treatment. Because patient specimens are highly precious, we conducted an exploratory study using a microflow probe requiring only 20 μL of serum. By use of logistic regression on principal components (PCs) of the NMR profiles, we built a 4-variable model for early stage EOC prediction (training set: 69 EOC specimens, 84 healthy controls; test set: 40 EOC, 44 controls) with operating characteristics estimated for the test set at 80% specificity [95% confidence interval (CI): 65-90%], 63% sensitivity (95% CI: 46-77%), and an area under the Receiver Operator Characteristic Curve (AUC) of 0.796. Independent validation (50 EOC, 50 controls) of the model yielded 95% specificity (95% CI: 86-99.5%), 68% sensitivity (95% CI: 53-80%) and an AUC of 0.949. A test on cancer type specificity showed that women diseased with renal cell carcinoma were not incorrectly diagnosed with EOC, indicating that metabonomics bears significant potential for cancer type-specific diagnosis. Our model can potentially be applied for women at high risk for EOC, and our study promises to contribute to developing a screening protocol for the general population.
authors.affiliation: Departments of Chemistry, The State University of New York at Buffalo, New York 14260, United States.
authors.forename: Erwin
authors.initials: E
authors.lastname: Garcia
authors.forename: Chris
authors.initials: C
authors.lastname: Andrews
authors.forename: Jia
authors.initials: J
authors.lastname: Hua
authors.forename: Hyung L
authors.initials: HL
authors.lastname: Kim
authors.forename: Dinesh K
authors.initials: DK
authors.lastname: Sukumaran
authors.forename: Thomas
authors.initials: T
authors.lastname: Szyperski
authors.forename: Kunle
authors.initials: K
authors.lastname: Odunsi
mesh_terms: D019540:Area Under Curve; D014408:Biomarkers, Tumor / Q000097:blood*; D005260:Female; D006801:Humans; D055432:Metabolomics / Q000379:methods*; D009367:Neoplasm Staging; D019906:Nuclear Magnetic Resonance, Biomolecular / Q000295:instrumentation* / Q000379:methods*; D010051:Ovarian Neoplasms / Q000097:blood* / Q000175:diagnosis* / Q000473:pathology; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D014408:Biomarkers, Tumor