Noninvasive serum N -glycans associated with ovarian cancer diagnosis and precancerous lesion prediction

Background Ovarian cancer (OC) is one of the most common gynecological tumors with high morbidity and mortality. Altered serum N -glycome has been observed in many diseases, while the association between serum protein N -glycosylation and OC progression remains unclear, particularly for the onset of carcinogenesis from benign neoplasms to cancer. Methods Herein, a mass spectrometry based high-throughput technique was applied to characterize serum N -glycome profile in individuals with healthy controls, benign neoplasms and different stages of OC. To elucidate the alterations of glycan features in OC progression, an orthogonal strategy with lectin-based ELISA was performed. Results It was observed that the initiation and development of OC was associated with increased high-mannosylationand agalactosylation, concurrently with decreased total sialylation of serum, each of which gained at least moderately accurate merits. The most important individual N -glycans in each glycan group was H7N2, H3N5 and H5N4S2F1, respectively. Notably, serum N -glycome could be used to accurately discriminate OC patients from benign cohorts, with a comparable or even higher diagnostic score compared to CA125 and HE4. Furthermore, bioinformatics analysis based discriminative model verified the diagnostic performance of serum N -glycome for OC in two independent sets. Conclusions These findings demonstrated the great potential of serum N -glycome for OC diagnosis and precancerous lesion prediction, paving a new way for OC screening and monitoring.