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Metabolites 2017, 7(1), 3; doi:10.3390/metabo7010003

Distinguishing Benign from Malignant Pancreatic and Periampullary Lesions Using Combined Use of 1H-NMR Spectroscopy and Gas Chromatography–Mass Spectrometry

1
Department of Oncology, University of Calgary, Calgary, AB T2N 4N2, Canada
2
Department of Surgery, University of Calgary, Calgary, AB T2N 4N2, Canada
3
Department of Biological Sciences, University of Calgary, Calgary, AB T2N 4N2, Canada
4
Department of Pharmacology, University of Pennsylvania, Philadelphia, PA 19104, USA
5
Department of Mathematics and Statistics, University of Calgary, Calgary, AB T2N 4N2, Canada
These authors contributed equally to this work.
*
Author to whom correspondence should be addressed.
Academic Editors: Claudiu T. Supuran, Natalie Serkova and Peter Meikle
Received: 13 April 2016 / Revised: 9 December 2016 / Accepted: 8 January 2017 / Published: 13 January 2017
(This article belongs to the Special Issue Cancer Metabolomics 2016)
View Full-Text   |   Download PDF [2062 KB, uploaded 13 January 2017]   |  

Abstract

Previous work demonstrated that serum metabolomics can distinguish pancreatic cancer from benign disease. However, in the clinic, non-pancreatic periampullary cancers are difficult to distinguish from pancreatic cancer. Therefore, to test the clinical utility of this technology, we determined whether any pancreatic and periampullary adenocarcinoma could be distinguished from benign masses and biliary strictures. Sera from 157 patients with malignant and benign pancreatic and periampullary lesions were analyzed using proton nuclear magnetic resonance (1H-NMR) spectroscopy and gas chromatography–mass spectrometry (GC-MS). Multivariate projection modeling using SIMCA-P+ software in training datasets (n = 80) was used to generate the best models to differentiate disease states. Models were validated in test datasets (n = 77). The final 1H-NMR spectroscopy and GC-MS metabolomic profiles consisted of 14 and 18 compounds, with AUROC values of 0.74 (SE 0.06) and 0.62 (SE 0.08), respectively. The combination of 1H-NMR spectroscopy and GC-MS metabolites did not substantially improve this performance (AUROC 0.66, SE 0.08). In patients with adenocarcinoma, glutamate levels were consistently higher, while glutamine and alanine levels were consistently lower. Pancreatic and periampullary adenocarcinomas can be distinguished from benign lesions. To further enhance the discriminatory power of metabolomics in this setting, it will be important to identify the metabolomic changes that characterize each of the subclasses of this heterogeneous group of cancers. View Full-Text
Keywords: biomarkers; metabolomics; pancreatic cancer; periampullary adenocarcinoma biomarkers; metabolomics; pancreatic cancer; periampullary adenocarcinoma
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

McConnell, Y.J.; Farshidfar, F.; Weljie, A.M.; Kopciuk, K.A.; Dixon, E.; Ball, C.G.; Sutherland, F.R.; Vogel, H.J.; Bathe, O.F. Distinguishing Benign from Malignant Pancreatic and Periampullary Lesions Using Combined Use of 1H-NMR Spectroscopy and Gas Chromatography–Mass Spectrometry. Metabolites 2017, 7, 3.

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