1H NMR-derived serum metabolomics of leukoplakia and squamous cell carcinoma

• Metabolomics approach was applied on serum to identify oral cancer (OC).
• Four biomarkers (glutamine, propionate, acetone, and choline) are able to distinguish OC from healthy controls.
• Oral leukoplakia (OLK) OC can be differentiated from oral squamous cell carcinoma (OSCC).
• Four biomarkers (glutamine, acetone, acetate, and choline) are able to distinguish OLK and OSCC OC.
• Metabolomics results are at par with the gold standard histopathology for OC detection.

BackgroundOral cancer (OC) is the sixth commonest cancer worldwide with alarming mortality. If identified at an early stage, the survival rate would be improved.MethodsWe appraised the feasibility of using 1H nuclear magnetic resonance (1H NMR) based metabolomics in the identification of signature metabolites in serum from patients suffering with oral leukoplakia (OLK, n = 100), oral squamous cell carcinoma (OSCC, n = 100), and healthy control (HC, n = 75). 1H NMR derived data were processed by principal component analysis (PCA) and orthogonal partial least squares discriminant analysis (OPLS-DA) to reveal discriminating metabolites among these groups. Receiver operating characteristic (ROC) curve evaluation was also executed.ResultsNMR-derived serum metabolomics reveals eight differentially expressed biomarkers. Among them four biomarkers (glutamine, propionate, acetone, and choline) were able to accurately (ROC; 0.97) segregate 93.5% of OC cases equated to HC with substantial sensitivity and specificity. Similarly, four biomarkers (glutamine, acetone, acetate, and choline) were able to precisely (ROC; 0.96) discriminate, 92.4% of OLK cases from OSCC with considerable sensitivity and specificity. 1H NMR-based metabolic fingerprint obtained for oral cancer is remarkable, even for OLK stage.ConclusionThere is a systemic metabolic response to initial stage of cancer, which carries immense possibility for early appraisal.