Abstract
Saliva biomarkers using reagent-free biophotonic technology have not been investigated as a strategy for early detection of breast cancer (BC). The attenuated total reflection-Fourier transform infrared (ATR-FTIR) spectroscopy has been proposed as a promising tool for disease diagnosis. However, its utilization in cancer is still incipient, and currently saliva has not been used for BC screening. We have applied ATR-FTIR onto saliva from patients with breast cancer, benign breast disease, and healthy matched controls to investigate its potential use in BC diagnosis. Several salivary vibrational modes have been identified in original and second-derivative spectra. The absorbance levels at wavenumber 1041 cm−1 were significantly higher (p < 0.05) in saliva of breast cancer patients compared with those of benign patients, and the ROC curve analysis of this peak showed a reasonable accuracy to discriminate breast cancer from benign and control patients. The 1433–1302.9 cm−1 band area was significantly higher (p < 0.05) in saliva of breast cancer patients than in control and benign patients. This salivary ATR-FTIR spectral area was prevalidated as a potential diagnostic biomarker of BC. This spectral biomarker was able to discriminate human BC from controls with sensitivity and specificity of 90% and 80%, respectively. Besides, it was able to differentiate BC from benign disease with sensitivity and specificity of 90% and 70%, respectively. Briefly, for the first time, saliva analysis by ATR-FTIR spectroscopy has demonstrated the potential use of salivary spectral biomarkers (1041 cm−1 and 1433–1302.9 cm−1) as a novel alternative for noninvasive BC diagnosis, which could be used for screening purposes.
Highlights
Breast cancer is a complex and heterogeneous disease caused by several factors, and its dissemination involves a succession of clinical and pathological stages beginning with carcinoma in situ, progressing to invasive lesion and culminating in metastatic disease [1, 2]
In this study was used the tumor-node-metastasis (TNM) cancer classification, which is according to the American Joint Committee on Cancer (AJCC) and the International Union for Cancer Control (UICC). is classification evaluates the extent of the primary tumor (T), regional lymph nodes (N), and distant metastases (M) and provides staging based on T, N, and M [42]
Demography characteristics of the subjects are demonstrated in Table 1. e breast cancer, benign breast disease, and control patients consisted of 10 women, each one with a mean age ± standard deviation (SD) of 53.3 ± 11.2, 41.5 ± 4.2, and 43.2 ± 16.0 years, respectively. e smoking and alcoholism patterns were similar (P > 0.05) in breast cancer, benign breast disease, and control patients
Summary
Breast cancer is a complex and heterogeneous disease caused by several factors, and its dissemination involves a succession of clinical and pathological stages beginning with carcinoma in situ, progressing to invasive lesion and culminating in metastatic disease [1, 2]. Breast cancer diagnostic comprises four conventional techniques: histopathology, mammography, ultrasonography, and magnetic resonance imaging (MRI). In general these techniques have critical limitations related to efficacy and production of false positive or false negative results [4, 5]. Journal of Oncology erefore, the increasing worldwide incidence of breast cancer and the absence of sufficient reliable, cost-effective, and high-throughput methods for detection requires a search for other diagnostic tools. ATR, the experimental configuration for FTIR spectra acquisition utilized in this study, presents high signal-to-noise ratio (SNR), does not present unwanted spectral contributions, and enables a sample to be analyzed without further preparation by placing it in direct contact with a crystal with a refractive index higher than the sample [8,9,10,11]
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