C-13 NMR spectroscopy of plasma reduces interference of hypertriglyceridemia in the H-1 NMR detection of malignancy. Application in patients with breast lesions
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We have previously described the application of water-suppressed proton nuclear magnetic resonance (H-1 NMR) spectroscopy of plasma for detection of malignancy. Subsequently, hypertriglyceridemia has been identified as a source of false positive results. We now describe a confirmatory, adjunctive technique — analysis of the carbon-13 (C-13) NMR spectrum of plasma — which also identifies the presence of malignancy but is not sensitive to the plasma triglyceride level. Blinded plasma samples from 480 normal donors and 208 patients scheduled for breast biopsy were analyzed by water-suppressed H-1 and C-13 NMR spectroscopy. Triglyceride levels were also measured. Among the normal donors, there were 38 individuals with hypertriglyceridemia of whom 18 had results consistent with malignancy by H-1 NMR spectroscopy. However, the C-13 technique reduced the apparent H-1 false positive rate from 7.0% to 0.6%. Similarly, in the breast biopsy cohort, C-13 reduced the false positive rate from 2.8% to 0.9%. Furthermore, the accuracy of the combined H-1/C-13 test in this blinded study was greater than 96% in 208 patients studied.
Key wordscancer detection proton NMR spectroscopy C-13 NMR spectroscopy breast lesions
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- 4.Parl FF, Harris TM: Detection of malignant tumors by nuclear magnetic resonance spectroscopy of plasma (Letter) N Engl J Med 316: 1411, 1988Google Scholar
- 7.Chmurny GN, Hilton BD, Halverson D, McGregor GN, Klose J, Issaq HJ, Muschik GM, Urba WJ, Mellini ML, Costello R, Papadopoulos NM, Caporaso N, Smith ICP, Czuba M, Kroft T, Monck M, Saunders JK, Préfontaine M: An NMR blood test for cancer: a critical assessment. NMR Biomed 1: 136–150, 1988PubMedGoogle Scholar
- 9.Bjoro K, Jellum E, Grace D: The detection of malignant tumours by H-1 NMR of plasma. Possible interference of the results in the case of hypertriglyceridemia (Abstract) Proceeding of the Society of Magnetic Resonance in Medicine, Works in Progress, p 60, 1987Google Scholar
- 11.Gannett PM, Nagel DL, Tempero MA, Rennard SI, Armitage JO: Early detection of cancer by NMR analysis of blood plasma (Abstract 690) Proc AACR Clin Invest 29: 174, 1988Google Scholar
- 14.Okunieff P, Zietman A, Kahn J, Singer S, Neuringer LJ, Levine RA, Evans FE: Lack of efficacy of water-suppressed proton nuclear magnetic resonance spectroscopy of plasma for the detection of malignant tumors. N Engl J Med 323: 953–958, 1990Google Scholar
- 18.Lipid Metabolism Branch, Division of Heart and Vascular Diseases, National Heart, Lung, and Blood Institute: The Lipid Research Clinics Population Studies Data Book. Volume I. The Prevalence Study. NIH Publication #80-1527, 1980Google Scholar
- 19.Fossel ET: C-13 NMR spectra of plasma: a potential discriminator between hypertriglyceridemia and cancer (Abstract) Proceeding of the Society of Magnetic Resonance in Medicine, p 1092, 1988Google Scholar
- 20.Haven FL, Bloor WR, Randall C: The nature of fatty acids of rats growing Walker carcinoma 256. Cancer Res 9: 619–623, 1951Google Scholar
- 23.McFarlane AS: Behaviour of lipoids in human serum. Nature 149: 439, 1942Google Scholar
- 24.Bell JD, Brown JCC, Norman RE, Sadler PJ, Newell DR: Factors affecting H-1 NMR spectra of blood plasma: cancer, diet and freezing. NMR Biomed 2: 90–94, 1988Google Scholar
- 25.Armitage IM, Marsh JC, Price TB, Lim D, Ohara E, Gore JC: Factors influencing the lipoprotein1H NMR spectra in plasma from normal and cancer patients: An oncolipid test? (Abstract) Proceeding of the Society of Magnetic Resonance in Medicine, Works in Progress, p 61, 1987Google Scholar