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Serum Free Amino Acid Profiling in Differential Diagnosis of Ovarian Tumors—A Comparative Study with Review of the Literature

Agnieszka Horala, Szymon Plewa, Pawel Derezinski, Agnieszka Klupczynska, Jan Matysiak, Ewa Nowak-Markwitz and Zenon J. Kokot
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Agnieszka Horala: Gynecologic Oncology Department, Poznan University of Medical Sciences, Polna 33 Street, 60-535 Poznan, Poland
Szymon Plewa: Department of Inorganic and Analytical Chemistry, Poznan University of Medical Sciences, 6 Grunwaldzka Street, 60-780 Poznan, Poland
Pawel Derezinski: Department of Inorganic and Analytical Chemistry, Poznan University of Medical Sciences, 6 Grunwaldzka Street, 60-780 Poznan, Poland
Agnieszka Klupczynska: Department of Inorganic and Analytical Chemistry, Poznan University of Medical Sciences, 6 Grunwaldzka Street, 60-780 Poznan, Poland
Jan Matysiak: Department of Inorganic and Analytical Chemistry, Poznan University of Medical Sciences, 6 Grunwaldzka Street, 60-780 Poznan, Poland
Ewa Nowak-Markwitz: Gynecologic Oncology Department, Poznan University of Medical Sciences, Polna 33 Street, 60-535 Poznan, Poland
Zenon J. Kokot: Faculty of Health Sciences, Calisia University, 13 Kaszubska Street, 62-800 Kalisz, Poland

IJERPH, 2021, vol. 18, issue 4, 1-12

Abstract: Proper preoperative ovarian cancer (OC) diagnosis remains challenging. Serum free amino acid (SFAA) profiles were investigated to identify potential novel biomarkers of OC and assess their performance in ovarian tumor differential diagnosis. Serum samples were divided based on the histopathological result: epithelial OC ( n = 38), borderline ovarian tumors ( n = 6), and benign ovarian tumors (BOTs) ( n = 62). SFAA profiles were evaluated using aTRAQ methodology based on high-performance liquid chromatography electrospray ionization tandem mass spectrometry (HPLC-ESI-MS/MS). Levels of eleven amino acids significantly differed between OC+borderline and BOTs. The highest area under the receiver operating characteristic curve (AUC of ROC) (0.787) was obtained for histidine. Cystine and histidine were identified as best single markers for early stage OC/BOT and type I OC. For advanced stage OC, seven amino acids differed significantly between the groups and citrulline obtained the best AUC of 0.807. Between type II OC and BOTs, eight amino acids differed significantly and the highest AUC of 0.798 was achieved by histidine and citrulline (AUC of 0.778). Histidine was identified as a potential new biomarker in differential diagnosis of ovarian tumors. Adding histidine to a multimarker panel together with CA125 and HE4 improved the differential diagnosis between OC and BOTs.

Keywords: ovarian cancer; ovarian neoplasm; ovarian tumour; biomarker; amino acids; metabolomics; metabolic profiling (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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