1H-NMR spectroscopy metabonomics of reactive, ovarian carcinoma and hepatocellular carcinoma ascites

Background: Metabolomic profiling of human malignant effusion remain a field poorly investigated. Proton nuclear magnetic resonance (H-1-NMR) spectroscopy is a rapid relatively low cost technique, and effusion is an optimal biospecimen suitable for metabonomic investigations. With this study we addressed metabolomic profiling of malignant ascitic effusion (mAE) from patients with high grade serous ovarian carcinoma (HGSOC), Hepatocellular carcinoma (HCC), and benign AEs (bAEs) from patients with reactive peritonitis. Methods: Metabolic profiling with H-1-NMR was performed on 72 AEs (31 HGSOC, 16 HCC and 25 bAE) prospectively collected in our cytology service. Histological confirmation was requested for all malignant case. Multivariate analysis comprising PCA and PLS-DA was applied to discover metabolites suitable to differentiate effusions among the investigated groups. Results: H-1-NMR metabonomic analysis showed clearly different spectra for malignant and benign AEs, as well as for HGSOC vs. HCC effusion. When compared with HCC effusions, the HGSOC effusion were enriched, among all, in alanine, lipids, N-acetyl groups and phenylalanine and depleted in glutamine. Conclusions: Subject to validation in further larger studies, H-1-NMR metabonomics could be an effective and reliable ancillary tool for AE investigations and diagnosis particularly in acellular effusions.