Introduction

Urine contains diagnostically important metabolites that can act as natural fluorophores. However, whether these fluorescent metabolites can be used in lung cancer diagnosis is unknown.

Objectives

This study was conducted to determine whether fluorescent urinary metabolites could be useful biomarkers for lung cancer detection.

Methods

A total of 46 lung cancer patients and 185 volunteers without cancer were evaluated between November 2013 and November 2014. Samples of the first urine of the day were collected from lung cancer patients and diagnosed at the Hamamatsu University School of Medicine and the Hamamatsu Medical Center prior to cancer treatment, and from volunteers without cancer at the Hamamatsu Medical Imaging Center. Fluorescent urinary metabolites were screened by high-performance liquid chromatography and select effective fluorescent substances for distinguishing cancer from non-cancer status.

Results

The fraction of patients at each stage of cancer severity were: 41.3% stage I, 8.7% stage II, 19.6% stage III, and 30.4% stage IV. A robust predictive biomarker for lung cancer was selected by the multivariate logistic analysis of fluorescent metabolites and identified to be O-aminohippuric acid (OAH). The area under the curve (AUC) data for OAH was 0.837 (95% CI 0.769–0.898, P < 0.001).

Conclusion

We identified a fluorescent urinary metabolite that can predict lung cancer. OAH exceeds the AUC (0.817) of lung cancer detection by AminoIndex® cancer screening, can be analyzed non-invasively without additional sample processing, and may be a valuable addition to existing lung cancer prediction models.

中文翻译：

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尿液荧光代谢物 O-氨基马尿酸是肺癌检测的有用生物标志物。

介绍

尿液中含有重要的诊断代谢物，可作为天然荧光团。然而，这些荧光代谢物是否可用于肺癌诊断尚不清楚。

目标

进行这项研究是为了确定荧光尿代谢物是否可以作为肺癌检测的有用生物标志物。

方法

在 2013 年 11 月至 2014 年 11 月期间，共评估了 46 名肺癌患者和 185 名无癌症志愿者。 当天的第一次尿液样本是从肺癌患者身上收集的，并在之前在滨松大学医学院和滨松医疗中心确诊癌症治疗，以及滨松医学影像中心没有癌症的志愿者。通过高效液相色谱法筛选尿液中的荧光代谢物，并选择有效的荧光物质来区分癌症和非癌症状态。

结果

处于癌症严重程度的每个阶段的患者比例为：41.3% 的 I 期、8.7% 的 II 期、19.6% 的 III 期和 30.4% 的 IV 期。通过荧光代谢物的多变量逻辑分析选择了一种稳健的肺癌预测生物标志物，并鉴定为O-氨基马尿酸 (OAH)。OAH 的曲线下面积 (AUC) 数据为 0.837（95% CI 0.769–0.898，P < 0.001）。

结论

我们确定了一种可以预测肺癌的荧光尿代谢物。OAH 超过了 AminoIndex® 癌症筛查肺癌检测的 AUC (0.817)，无需额外的样本处理即可进行非侵入性分析，可能是现有肺癌预测模型的宝贵补充。