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Metabolomics differentiate cancer from non-cancer pleural effusions based on steroid lipids and acyl carnitines

da Costa, R.; Love, K.; Beckmann, M.; Morley, A.; Bhatnagar, R.; Maskel, N.; Mur, L. A.; Lewis, K.

2020-07-29 respiratory medicine
10.1101/2020.07.27.20162958 medRxiv
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ObjectiveTo identify and detect metabolomic markers to differentiate cancer related from other pleural effusions. Material and methodsUn-targeted flow infusion electrospray mass spectrometry was used on a cohort of 100 samples from benign and malignant pleural effusions (12 primary lung cancers, 14 mesotheliomas, 24 other cancers, 25 congestive cardiac failure, 22 parapneumonic effusion, 3 empyema). Standard metabolomic statistical models for analysis were performed. ResultsFive novel markers were identified using univariate and multivariate receiving operator curve analyses using five discriminant features yielding a diagnostic accuracy of above 0.91 (95% CI: 0.839-0.976) with a sensitivity of 0.97 (95% CI 0.952-0.979) and specificity 0.87 (95% CI 0.852-0.894). ConclusionIndividual biomarkers with the highest accuracy (>0.84) were all raised in cancer and are involved in metabolism of sterol-lipids and acyl carnitines linked to {beta}-oxidation. Our markers performed better than those previously published. Further, these published markers failed to achieve their stated accuracies in our data.

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