Serum metabolic profiling enables diagnosis, prognosis, and monitoring for brainstem gliomas

Q: Why are new diagnostic and monitoring methods needed for brainstem gliomas?

Brainstem gliomas have poor prognosis and current radiologic imaging has limited accuracy due to resolution constraints. Clinically approved circulating biomarkers are lacking, and biopsy sampling is invasive and difficult for dynamic monitoring.

Q: How does the study measure metabolic changes during radiotherapy?

It uses nanoparticle enhanced laser desorption/ionization mass spectrometry to characterize static and dynamic snapshots of circulating metabolites across the radiotherapy course.

Q: What performance does the proposed serological diagnostic tool achieve?

The diagnostic assay reaches an area under the curve (AUC) of 0.933 for brainstem glioma diagnosis in an independent blind test.

Sep 23, 2026

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Serum metabolic profiling offers a noninvasive approach to improve management of brainstem gliomas, a childhood tumor with <10% 5-year survival. Using circulating metabolites from a cross-sectional and longitudinal cohort totaling 106 patients, the study applies nanoparticle enhanced laser desorption/ionization mass spectrometry to capture both static and dynamic metabolic snapshots during radiotherapy. The resulting serological assays achieve AUC 0.933 in an independent blind test, predict prognostic risk differences, and reveal eight temporal metabolite regulation patterns linked to radiotherapy responses.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages15

Reading Time38 min

AccessFree to download

Introduction

Clinical need and limitations of existing diagnostics

Rationale for liquid biopsy and serum metabolites

Study approach

Patient cohort and metabolite assays

Mass spectrometry for static and dynamic snapshots

Results and implications

Diagnostic performance and prognostic prediction

Temporal metabolite patterns during radiotherapy

Potential extension to other cancers

Article [https://doi.org/10.1038/s41467-025-61163-9](https://doi.org/10.1038/s41467-025-61163-9) Serum metabolic proﬁling enables diagnosis, prognosis, and monitoring for brainstem gliomas Received: 19 August 2023 | Accepted: 11 June 2025 | | --- | | | | Check for updates | Keke Li1,9, Ruimin Wang2,3,4,9, Zhengying Gu 5,6,9, Wenyun Weng7,9, Wanshan Liu2,3,4, Yida Huang 2,3,4, Jiao Wu2,3,4, Ziyue Zhang2,3,4, Shouzhi Yang2,3,4, Jun Su1, Yujie Tang 7, Kun Qian 2,3,4 , Mawei Jiang 1 , Lin Huang 5,6 & Jingjing Wan 8 Brainstem gliomas (BSG) is a highly malignant central nervous system childhood tumors with 5-year survival rate <10%. Metabolism during radiotherapy is a dynamic and precisely programmed process, improving clinical outcomesand guiding therapy decisions of BSG. Here we construct diagnostic and prognostic assays of BSG via circulating metabolites based on both crosssectional study and longitudinal cohort study with 106 BSG patients. We employ nanoparticle enhanced laser desorption/ionization mass spectrometry to characterize static and dynamic snapshots of metabolites during BSG radiotherapy. We show that this serological tool reaches the area under the curve of 0.933 for BSG diagnosis in an independent blind test and predicts risk of patients with signiﬁcant differences (p < 0.05) in prognostic outcomes. We further identify eight distinct temporal patterns of metabolite regulation associated with radiotherapy responses and tracked the metabolic trajectory via dynamic metabolic snapshots throughout radiotherapy process. If further validated, this framework could be extended to derive comprehensive metabolic pictures for cancers including but not limited to BSG. Brainstem gliomas (BSG), accounting for 10–15% of all childhood brain tumors, exhibit a peak incidence of 0.6 cases per million population annually within the age range of 6–9 years1–3. Patients diagnosed with BSG display a poor prognosis, with a median survival time of 10–12 months and a 5-year survival rate of less than 10%4,5. Radiotherapy is a standard BSG treatment in clinical settings, capable of alleviating symptom progression and prolonging progression-free survival by a few months6–9. Patients who undergo early and timely surgery exhibit prolonged overall survival (OS) time compared to those in late surgery group (median: 28 .4 vs. 18.7 months)10–12. Accurate diagnosis, precise prognosis, and timely monitoring during radiotherapy are crucial in managing BSG patients. However, there are certain risks associated 1Department of Oncology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, PR China. 2State Key Laboratory of Systems Medicine for Cancer, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, PR China. 3Institute of Medical Robotics and Shanghai Academy of Experimental Medicine, Shanghai Jiao Tong University, Shanghai, PR China. 4Shanghai Key Laboratory of Gynecologic Oncology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, PR China. 5Department of Clinical Laboratory Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China. 6Shanghai Institute of Thoracic Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China. 7Key Laboratory of Cell Differentiation and Apoptosis of National Ministry of Education, Shanghai Key Laboratory of Reproductive Medicine, Department of Histoembryology, Genetics and Developmental Biology, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China. 8School of Chemistry and Molecular Engineering, East China Normal University, Shanghai, PR China. 9These authors contributed equally: Keke Li, Ruimin Wang, Zhengying Gu, Wenyun Weng. e-mail: [k.qian@sjtu.edu.cn](k.qian@sjtu.edu.cn); [jiangmawei@xinhuamed.com.cn](jiangmawei@xinhuamed.com.cn); [linhuang@shsmu.edu.cn](linhuang@shsmu.edu.cn); [jjwan@chem.ecnu.edu.cn](jjwan@chem.ec

FAQs

Why are new diagnostic and monitoring methods needed for brainstem gliomas?

Brainstem gliomas have poor prognosis and current radiologic imaging has limited accuracy due to resolution constraints. Clinically approved circulating biomarkers are lacking, and biopsy sampling is invasive and difficult for dynamic monitoring.

How does the study measure metabolic changes during radiotherapy?

It uses nanoparticle enhanced laser desorption/ionization mass spectrometry to characterize static and dynamic snapshots of circulating metabolites across the radiotherapy course.

What performance does the proposed serological diagnostic tool achieve?

The diagnostic assay reaches an area under the curve (AUC) of 0.933 for brainstem glioma diagnosis in an independent blind test.

Sep 23, 2026

Uploaded by Đào