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

Background: Oral cancer (OC) is the sixth commonest cancer worldwide with alarming mortality. If identified at an early stage, the survival rate would be improved. Methods: We 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. Results: NMR-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. Conclusion: There is a systemic metabolic response to initial stage of cancer, which carries immense possibility for early appraisal.