Abstract
BACKGROUND: In early work ambient ionization mass spectrometry (MS) revealed lipid patterns distinguishing muscle invasive bladder cancer (invasive urothelial carcinoma, InvUC) from normal urothelium. A new ambient ionization MS approach, touch spray MS (TS-MS) can rapidly generate mass spectra in real time, potentially in a point-of-care setting. A tissue sample removed from a patient is touched by a probe, and mass spectra generated within seconds. OBJECTIVE: To validate TS-MS methods using specimens from naturally-occurring InvUC in dogs where the cancer closely mimics the human condition, and to demonstrate proof-of-concept that TS-MS can elucidate lipid patterns distinguishing InvUC from normal urothelium. METHODS: Samples of normal urothelium and InvUC from dogs of several breeds were analyzed by TS-MS with correlative histopathology across each sample. Results were compared to those obtained with desorption electrospray ionization mass spectrometry (DESI-MS), a more traditional method. Data were analyzed by Principal Component Analysis and Linear Discriminant Analysis. RESULTS: Lipid patterns identified by TS-MS, as well as by DESI-MS, differed between InvUC and normal urothelium with m/z 281.5 (oleic acid) and m/z 563.5 (oleic acid dimer) substantially contributing to the differences. Using histologic diagnosis as the gold standard, TS-MS had a global prediction rate of 93%. CONCLUSIONS: TS-MS can be used to identify lipid patterns that differentiate canine InvUC from normal urothelium. Optimization of TS-MS could lead to a point-of-care approach to distinguish cancer from normal in ex vivo tissues in real time, and to define biochemical processes leading to cancer development and progression.