Abstract

Proton metabolic profiling of incisional biopsied cervical lymph node tissue specimens of 109 patients suffering from tubercular (CTBL) and non-specific (NSCLA) lymphadenitis were analyzed by high resolution magic angle spinning (HR-MAS) NMR spectroscopy. In the present study, 40 endogenous metabolites namely, myo-inositol (m-Ins), branched chain amino acids (BCAA), glutamate, serine, taurine (Tau) aromatic amino acids, choline (Cho) containing compounds and glucose were characterized. To the best of our knowledge, this is the first report on metabolic profiling of cervical tubercular lymph node tissues using HR-MAS NMR spectroscopy. The principal component analysis revealed a clear discrimination between CTBL and NSCLA tissues. Increase in the concentration of mobile poly unsaturated fatty acids, BCAA, Cho, Tau, glycine and a decrease in the concentration of lactate, phosphocholine and m-Ins was observed in CTBL cases. The partial least square discriminant analysis (PLS-DA) with R 2 = 0.95 and Q 2 = 0.92 provided >98 % of correct classification between the two groups. A PLS-DA training set model of 75 % (CTBL = 54, NSCLA = 27) of the subjects when subjected for prediction of 25 % cases (CTBL = 18, NSCLA = 10) as an unknown dataset provided more than 98 % of diagnostic accuracy in their respective histological categories. The receiver operator characteristic curve was generated from PLS-DA factor-1 projected an area under the curve of 0.962. The metabolic profile obtained from HR-MAS NMR spectroscopy may be used as surrogate markers in vivo MRS for differentiating between CTBL and NSCLA cases non-invasively.

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