Altered serum metabolome as an indicator of paraneoplasia or concomitant cancer in patients with rheumatic disease
Authors' conclusion
This new set of metabolic markers reliably predicts the presence of cancer in arthritis or PN patients with high sensitivity and specificity and has the potential to facilitate a rapid and correct diagnosis of malignancy.
Study context
- Population
- Patients with rheumatoid arthritis (RA) (model cohort); independent RA and spondyloarthritis (SpA) cohorts for blinded validation
- Participants
- 56 vs 52
- Comparison
- Serum metabolic signature for presence of cancer in RA patients with vs without a history of invasive cancer
- Cancer historyn = 56
- No cancer historyn = 52reference
- Outcome
- Diagnostic performance of a metabolic model (acetate, creatine, glycine, formate, lipid ratio L1/L6) for cancer
Methodological detailsnuclear magnetic resonance metabolomics, multivariable regression, blinded validation in two independent cohorts
- Nuclear magnetic resonance metabolomics
- Multivariable regression
- Blinded validation in two independent cohorts
Performance
As reported in the abstract
Diagnostic model for cancer (acetate, creatine, glycine, formate, lipid ratio L1/L6)
AUC, model cohort
0.995
AUC, blinded RA validation cohort
0.940
AUC, mixed RA/SpA cohort
0.928
Further findings
Cancer identification in patients with paraneoplasia (PN)
- Equally capable of identifying cancer in patients with PN
Confounders and non-invasive malignancy
- Insensitive to common demographic or clinical confounders or non-invasive (NI) malignancy like non-melanoma skin cancer
Original publication
Altered serum metabolome as an indicator of paraneoplasia or concomitant cancer in patients with rheumatic disease. Ann Rheum Dis. Published 15 July 2024. doi:10.
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