title: (1)H-NMR urinary metabolomic profiling for diagnosis of gastric cancer.
abstract: BACKGROUND
  Metabolomics has shown promise in gastric cancer (GC) detection. This research sought to identify whether GC has a unique urinary metabolomic profile compared with benign gastric disease (BN) and healthy (HE) patients.
  
  
  METHODS
  Urine from 43 GC, 40 BN, and 40 matched HE patients was analysed using (1)H nuclear magnetic resonance ((1)H-NMR) spectroscopy, generating 77 reproducible metabolites (QC-RSD <25%). Univariate and multivariate (MVA) statistics were employed. A parsimonious biomarker profile of GC vs HE was investigated using LASSO regularised logistic regression (LASSO-LR). Model performance was assessed using Receiver Operating Characteristic (ROC) curves.
  
  
  RESULTS
  GC displayed a clear discriminatory biomarker profile; the BN profile overlapped with GC and HE. LASSO-LR identified three discriminatory metabolites: 2-hydroxyisobutyrate, 3-indoxylsulfate, and alanine, which produced a discriminatory model with an area under the ROC of 0.95.
  
  
  CONCLUSIONS
  GC patients have a distinct urinary metabolite profile. This study shows clinical potential for metabolic profiling for early GC diagnosis.
authors.affiliation: Department of Surgery, University of Alberta Hospital, 8440-112 Street, Edmonton, AB T6G 2B7, Canada.
authors.forename: Angela W
authors.initials: AW
authors.lastname: Chan
authors.affiliation: Department of Biochemistry, NANUC, University of Alberta, Edmonton, AB T6G 2M8, Canada.
authors.forename: Pascal
authors.initials: P
authors.lastname: Mercier
authors.affiliation: Department of Surgery, Royal Alexandra Hospital, 10240 Kingsway Avenue NW, Edmonton, AB T5H 3V9, Canada.
authors.forename: Daniel
authors.initials: D
authors.lastname: Schiller
authors.affiliation: Department of Medicine, Division of Gastroenterology, HYS Medical Centre, 310-11010 101 Street NW, Edmonton, AB T5H 4B9, Canada.
authors.forename: Robert
authors.initials: R
authors.lastname: Bailey
authors.affiliation: Department of Medicine, Division of Gastroenterology, HYS Medical Centre, 310-11010 101 Street NW, Edmonton, AB T5H 4B9, Canada.
authors.forename: Sarah
authors.initials: S
authors.lastname: Robbins
authors.affiliation: School of Public Health, 2-040 Li Ka Shing Centre for Health Research Innovation, University of Alberta, Edmonton, AB T6G 2E6, Canada.
authors.forename: Dean T
authors.initials: DT
authors.lastname: Eurich
authors.affiliation: Department of Oncology, Cross Cancer Institute, 11560 University Avenue, Edmonton, AB T6G 1Z2, Canada.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Sawyer
authors.affiliation: Department of Medicine, 4126A Katz Group Centre for Pharmacy & Health, University of Alberta, Edmonton, AB T6G 2E1, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Broadhurst
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D016015:Logistic Models; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D055432:Metabolomics / Q000379:methods*; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000652:urine