Holmberg L, Jakobsson U, Berglund A, Adami H O
Department of Surgery, University Hospital, Uppsala, Sweden.
Br J Cancer. 1993 Aug;68(2):389-92. doi: 10.1038/bjc.1993.346.
Water suppressed proton nuclear magnetic resonance (1H NMR) spectroscopy of human plasma has been described as successful in detection of malignancy. We designed a prospective study to test the hypothesis that in vitro NMR spectroscopy has a high sensitivity for detecting early breast cancer. One hundred and thirty-five women were referred for breast biopsy due to abnormal mammograms. One hundred of these were recruited through a population-based mammography screening project. Sixty-nine of 135 women were found to have breast cancer and their average line width of the methyl and methylene resonance in the plasma were compared to those women who had a benign or normal histopathology in the biopsy and to the line width for 100 healthy subjects from the same population. The mean line width at a half-height of the methyl and methylene resonances of the serum lipoprotein lipids in the NMR spectrum did not differ appreciably between the groups. The line width correlated highly with the serum triglycerides, but correction for the level of triglycerides did not improve the diagnostic accuracy of the line width. Receiver-operating characteristic analysis revealed a sensitivity of 61% and a false positive rate of 43% at the most beneficial cut-off of line width (39.7 Hz). In vitro NMR spectroscopy in our hands was thus not a useful diagnostic tool in patients with early breast cancer.
人体血浆的水抑制质子核磁共振（1H NMR）光谱法已被描述为在检测恶性肿瘤方面取得了成功。我们设计了一项前瞻性研究，以检验体外NMR光谱法在检测早期乳腺癌方面具有高灵敏度这一假设。135名女性因乳房X光检查异常而被转诊进行乳房活检。其中100名是通过基于人群的乳房X光筛查项目招募的。135名女性中有69名被发现患有乳腺癌，她们血浆中甲基和亚甲基共振的平均线宽与活检中组织病理学为良性或正常的女性以及来自同一人群的100名健康受试者的线宽进行了比较。NMR光谱中血清脂蛋白脂质的甲基和亚甲基共振半高处的平均线宽在各组之间没有明显差异。线宽与血清甘油三酯高度相关，但对甘油三酯水平进行校正并没有提高线宽的诊断准确性。受试者操作特征分析显示，在线宽最有利的截断值（39.7 Hz）时，灵敏度为61%，假阳性率为43%。因此，在我们手中，体外NMR光谱法对早期乳腺癌患者并不是一种有用的诊断工具。
