title: Metabolic Signatures of Lung Cancer in Sputum and Exhaled Breath Condensate Detected by1H Magnetic Resonance Spectroscopy: A Feasibility Study.
abstract: OBJECTIVE
  Lung cancer is one of the most lethal cancers. Currently, there are no biomarkers for early detection, monitoring treatment response, and detecting recurrent lung cancer. We undertook this study to determine if1H magnetic resonance spectroscopy (MRS) of sputum and exhaled breath condensate (EBC), as a noninvasive tool, can identify metabolic biomarkers of lung cancer.
  
  
  METHODS
  Sputum and EBC samples were collected from 20 patients, comprising patients with pathologically confirmed non-small cell lung cancer (n= 10) and patients with benign respiratory conditions (n= 10). Both sputum and EBC samples were collected from 18 patients; 2 patients provided EBC samples only.1H MR spectra were obtained on a Bruker Avance 400 MHz nuclear magnetic resonance (NMR) spectrometer. Sputum samples were further confirmed cytologically to distinguish between true sputum and saliva.
  
  
  RESULTS
  In the EBC samples, median concentrations of propionate, ethanol, acetate, and acetone were higher in lung cancer patients compared to the patients with benign conditions. Median concentration of methanol was lower in lung cancer patients (0.028 mM) than in patients with benign conditions (0.067 mM;P= 0.028). In the combined sputum and saliva and the cytologically confirmed sputum samples, median concentrations ofN-acetyl sugars, glycoprotein, propionate, lysine, acetate, and formate were lower in the lung cancer patients than in patients with benign conditions. Glucose was found to be consistently absent in the combined sputum and saliva samples (88%) as well as in the cytologically confirmed sputum samples (86%) of lung cancer patients.
  
  
  CONCLUSIONS
  Absence of glucose in sputum and lower concentrations of methanol in EBC of lung cancer patients discerned by1H MRS may serve as metabolic biomarkers of lung cancer for early detection, monitoring treatment response, and detecting recurrence.
authors.affiliation: CancerCare Manitoba, Winnipeg, Manitoba, Canada.; University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Naseer
authors.initials: N
authors.lastname: Ahmed
authors.affiliation: Department of Chemistry, University of Winnipeg, Winnipeg, Manitoba, Canada.; Current address: College of Natural and Applied Sciences, University of Guam, Guam, USA.
authors.forename: Tedros
authors.initials: T
authors.lastname: Bezabeh
authors.affiliation: Department of Chemistry, University of Winnipeg, Winnipeg, Manitoba, Canada.
authors.forename: Omkar B
authors.initials: OB
authors.lastname: Ijare
authors.affiliation: Department of Respirology, Health Sciences Centre, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Renelle
authors.initials: R
authors.lastname: Myers
authors.affiliation: CancerCare Manitoba, Winnipeg, Manitoba, Canada.; University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Reem
authors.initials: R
authors.lastname: Alomran
authors.affiliation: Department of Human Nutritional Sciences, University of Manitoba, Winnipeg, Canada.; St. Boniface Hospital Albrechtsen Research Centre, Winnipeg, Canada.
authors.forename: Michel
authors.initials: M
authors.lastname: Aliani
authors.affiliation: CancerCare Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Zoann
authors.initials: Z
authors.lastname: Nugent
authors.affiliation: CancerCare Manitoba, Winnipeg, Manitoba, Canada.; University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Shantanu
authors.initials: S
authors.lastname: Banerji
authors.affiliation: CancerCare Manitoba, Winnipeg, Manitoba, Canada.; University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Julian
authors.initials: J
authors.lastname: Kim
authors.affiliation: Department of Pathology, Health Sciences Centre, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Gefei
authors.initials: G
authors.lastname: Qing
authors.affiliation: Department of Respirology, Health Sciences Centre, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Zoheir
authors.initials: Z
authors.lastname: Bshouty
keywords: breath condensate; lung cancer; magnetic resonance spectroscopy; sputum