A pilot investigation of a urinary metabolic biomarker discovery in renal cell carcinoma.

Abstract

Renal cell carcinoma (RCC) is the most common and lethal malignancy of the kidney. Distinguishing RCC from benign renal tumors and healthy controls is still a clinical challenge. Urine metabolomics has been used to identify biomarkers of clinical diseases. In the present study, we explored the urine metabolomes of a cohort of 61 patients with renal tumors (39 RCC and 22 benign renal tumors) and 68 healthy controls using liquid chromatography coupled with high-resolution mass spectrometry (LC-MS). Metabolic profiling of urine could significantly differentiate RCC from healthy controls and benign renal tumors. Metabolic pathways, including lysine metabolism and phenylalanine metabolism, were found to be disturbed in the RCC group. Steroid hormone biosynthesis was significantly different between the benign tumor group and the RCC group. RCC biomarkers were further explored. A metabolite panel consisting of cortolone, testosterone and L-2-aminoadipate adenylate was discovered to have good ability of distinguishing RCC from benign tumors, with an AUC of 0.868 for tenfold cross-validation and 0.873 for the validation group. In addition, the panel of aminoadipic acid, 2-(formamido)-N1-(5-phospho-D-ribosyl) acetamidine and alpha-N-phenylacetyl-L-glutamine could distinguish the RCC group from the healthy control group, with an AUC of 0.841 for tenfold cross-validation and 0.894 for the validation group. This pilot study suggests that urine metabolomics may be useful in differentiating RCC from healthy controls and benign renal tumors.