Serum and Urine Metabolic Fingerprints Characterize Renal Cell Carcinoma for Classification, Early Diagnosis, and Prognosis

Adv Sci (Weinh). 2024 Sep;11(34):e2401919. doi: 10.1002/advs.202401919. Epub 2024 Jul 8.

Abstract

Renal cell carcinoma (RCC) is a substantial pathology of the urinary system with a growing prevalence rate. However, current clinical methods have limitations for managing RCC due to the heterogeneity manifestations of the disease. Metabolic analyses are regarded as a preferred noninvasive approach in clinics, which can substantially benefit the characterization of RCC. This study constructs a nanoparticle-enhanced laser desorption ionization mass spectrometry (NELDI MS) to analyze metabolic fingerprints of renal tumors (n = 456) and healthy controls (n = 200). The classification models yielded the areas under curves (AUC) of 0.938 (95% confidence interval (CI), 0.884-0.967) for distinguishing renal tumors from healthy controls, 0.850 for differentiating malignant from benign tumors (95% CI, 0.821-0.915), and 0.925-0.932 for classifying subtypes of RCC (95% CI, 0.821-0.915). For the early stage of RCC subtypes, the averaged diagnostic sensitivity of 90.5% and specificity of 91.3% in the test set is achieved. Metabolic biomarkers are identified as the potential indicator for subtype diagnosis (p < 0.05). To validate the prognostic performance, a predictive model for RCC participants and achieve the prediction of disease (p = 0.003) is constructed. The study provides a promising prospect for applying metabolic analytical tools for RCC characterization.

Keywords: mass spectrometry; metabolic fingerprinting; prognosis; renal diagnosis; subtype classification.

MeSH terms

  • Adult
  • Aged
  • Biomarkers, Tumor* / urine
  • Carcinoma, Renal Cell* / diagnosis
  • Carcinoma, Renal Cell* / metabolism
  • Carcinoma, Renal Cell* / urine
  • Early Detection of Cancer / methods
  • Female
  • Humans
  • Kidney Neoplasms* / diagnosis
  • Kidney Neoplasms* / metabolism
  • Kidney Neoplasms* / urine
  • Male
  • Middle Aged
  • Prognosis
  • Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization / methods

Substances

  • Biomarkers, Tumor