title: Metabonomics by proton nuclear magnetic resonance in human pleural effusions: A route to discriminate between benign and malignant pleural effusions and to target small molecules as potential cancer biomarkers.
abstract: BACKGROUND
  Cytopathology is a noninvasive and cost-effective method for detecting cancer cells in pleural effusions (PEs), although in many cases, the diagnostic performance is hindered by the paucity of significant cells or the lack of clear morphological criteria. This study presents the results of an omics approach to improving the diagnostic performance of PE cytology.
  
  
  METHODS
  Metabolic profiling with proton nuclear magnetic resonance (1H-NMR) was performed for 92 PEs (44 malignant cases of 8 different cancers and 48 benign cases of 7 nonneoplastic conditions). Light's criteria were used to further classify PEs as transudates or exudates, and1H-NMR spectroscopy was used to differentiate malignant pleural effusions (mPEs) from benign pleural effusions (bPEs).
  
  
  RESULTS
  1H-NMR metabolic analysis showed clearly different spectra for mPEs and bPEs in the regions of the signals due to lipids, branched amino acids, and lactate, which were increased in mPEs. Transudates and exudates in bPEs were differentiated as well on the basis of the1H-NMR signals from lipids and lipoproteins, which were increased in exudates.
  
  
  CONCLUSIONS
  Subject to validation in further larger studies,1H-NMR metabonomics could be an effective and reliable ancillary tool for PE investigations and diagnoses. Cancer Cytopathol 2017;125:341-348. © 2017 American Cancer Society.
authors.affiliation: Department of Molecular Medicine, University of Padua, Padua, Italy.|Section of Padua, National Institute of Biostructures and Biosystems, Rome, Italy.
authors.forename: Lucio
authors.initials: L
authors.lastname: Zennaro
authors.affiliation: Department of Molecular Medicine, University of Padua, Padua, Italy.|Section of Padua, National Institute of Biostructures and Biosystems, Rome, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Vanzani
authors.affiliation: Surgical Pathology and Cytopathology Unit, Department of Medicine, University of Padua, Padua, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Nicolè
authors.affiliation: Surgical Pathology and Cytopathology Unit, Department of Medicine, University of Padua, Padua, Italy.
authors.forename: Rocco
authors.initials: R
authors.lastname: Cappellesso
authors.affiliation: Surgical Pathology and Cytopathology Unit, Department of Medicine, University of Padua, Padua, Italy.
authors.forename: Ambrogio
authors.initials: A
authors.lastname: Fassina
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism*; D005122:Exudates and Transudates / Q000378:metabolism*; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000150:complications / Q000378:metabolism; D006333:Heart Failure / Q000150:complications / Q000378:metabolism*; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000378:metabolism; D008297:Male; D055432:Metabolomics / Q000379:methods*; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000378:metabolism*; D010051:Ovarian Neoplasms / Q000150:complications / Q000378:metabolism; D010996:Pleural Effusion / Q000175:diagnosis / Q000209:etiology / Q000378:metabolism; D016066:Pleural Effusion, Malignant / Q000175:diagnosis / Q000209:etiology / Q000378:metabolism*; D011014:Pneumonia / Q000150:complications / Q000378:metabolism*; D066244:Proton Magnetic Resonance Spectroscopy / Q000379:methods
chemical_list: D014408:Biomarkers, Tumor
keywords: cancer markers; metabonomics; pleural effusion