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TMAO levels were measured in breast tissue from benign nodules, DCIS, and invasive ductal carcinoma, then analyzed in 97 treatment-naive IDC patients for clinicopathological associations using logistic regression and ROC analysis.",{"@graph":14,"@context":71},[15,34,54],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/trimethylamine-n-oxide-as-a-potential-biomarker-for-predicting-axillary-lymph-node-metastasis-in-breast-cancer-a-retrospective-study/356564/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":48,"encodingFormat":47,"isAccessibleForFree":49,"interactionStatistic":50},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/trimethylamine-n-oxide-as-a-potential-biomarker-for-predicting-axillary-lymph-node-metastasis-in-breast-cancer-a-retrospective-study/356564.png","ImageObject",300,407,{"name":42,"@type":43},"Jacob","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-09-23",true,{"@type":51,"interactionType":52,"userInteractionCount":22},"InteractionCounter",{"@type":53},"ViewAction",{"@type":55,"mainEntity":56},"FAQPage",[57,63,67],{"name":58,"@type":59,"acceptedAnswer":60},"What clinical problem does the study address?","Question",{"text":61,"@type":62},"It targets the need to more accurately predict axillary lymph node (ALN) metastasis in breast cancer, since current assessment methods have limitations.","Answer",{"name":64,"@type":59,"acceptedAnswer":65},"How were TMAO levels measured and what comparisons were made?",{"text":66,"@type":62},"TMAO concentrations were quantified via ELISA in breast tissue from benign breast nodules, DCIS, and invasive ductal carcinoma, and then evaluated further in a cohort of treatment-naive IDC patients.",{"name":68,"@type":59,"acceptedAnswer":69},"What did the study find about TMAO and ALN metastasis?",{"text":70,"@type":62},"TMAO levels were higher in invasive ductal carcinoma than in DCIS or benign nodules, and were elevated in ALN-positive compared with ALN-negative patients. Multivariable analysis indicated TMAO as an independent predictor, and a combined model improved predictive accuracy.","https://schema.org",{"og:url":32,"og:type":73,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":75,"canonical":32},"index,follow",{"doc_id":77,"site_id":7},356564,1790147366,{"code":4,"msg":80,"data":81},"success",[82,86,90,94,99,104,108,113,118,121,125],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":83,"show_sort_weight":84,"slug":85},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":87,"show_sort_weight":88,"slug":89},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":91,"show_sort_weight":92,"slug":93},"Exam",70,"exam",{"id":95,"doc_module":4,"doc_module_name":25,"category_name":96,"show_sort_weight":97,"slug":98},5,"Comic",60,"comic",{"id":100,"doc_module":4,"doc_module_name":25,"category_name":101,"show_sort_weight":102,"slug":103},6,"Technology",50,"technology",{"id":105,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":106,"slug":107},7,40,"healthcare",{"id":109,"doc_module":4,"doc_module_name":25,"category_name":110,"show_sort_weight":111,"slug":112},8,"Research & Report",30,"research-report",{"id":114,"doc_module":4,"doc_module_name":25,"category_name":115,"show_sort_weight":116,"slug":117},9,"Religion & Spirituality",20,"religion-spirituality",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":119,"show_sort_weight":116,"slug":120},"World Cup","world-cup",{"id":122,"doc_module":4,"doc_module_name":25,"category_name":123,"show_sort_weight":122,"slug":124},10,"Lifestyle","lifestyle",{"id":126,"doc_module":4,"doc_module_name":25,"category_name":127,"show_sort_weight":95,"slug":128},19,"General","general",{"code":4,"msg":80,"data":130},{"doc_id":77,"user_id":131,"nickname":42,"user_avatar":132,"doc_module":4,"category_id":105,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":133,"file_id":134,"file_url":135,"file_type":136,"file_size":137,"view_count":22,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":114,"language":138,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":139,"faqs":140,"seo_title":141,"seo_description":12,"update_tm":142,"read_time":143},962084931830,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","Wu et al. World Journal of Surgical Oncology (2026) 24:149  \n[https://doi.org/10.1186/s12957-026-04251-4](https://doi.org/10.1186/s12957-026-04251-4)  \nWorld Journal of Surgical Oncology  \nRESEARCH Open Access  \nTrimethylamine N-oxide as a potential biomarker for predicting axillary lymph node metastasis in breast cancer: a retrospective study  \nZhijie Wu1,3†, Yi Cheng2†, Siyuan Lin4†, Qiongyu Hu5, Xiaoyan Fu1,3, Zongyan Li1,3, Ge Qin2* and Haiyan Li 1,3*  \nAbstract  \nBackground Axillary lymph node (ALN) metastasis is a critical prognostic factor in breast cancer, but current assessment methods have limitations. Trimethylamine N-oxide (TMAO), a gut microbiota-derived metabolite, has been implicated in tumor progression, though its role in breast cancer remains unclear.  \nMethods This retrospective study analyzed TMAO levels in breast tissue from benign breast nodules (BBN, n = 10), ductal carcinoma in situ (DCIS, n = 10), and invasive ductal carcinoma (IDC, n = 10) . A cohort of 97 treatment-naive IDC patients (26 ALN + , 71 ALN −) was further evaluated. TMAO concentrations were quantified via ELISA, and associations with clinicopathological features were assessed using logistic regression and ROC analysis.  \nResults TMAO levels were significantly higher in IDC (113 . 9 ± 16.36 ng/g) than in DCIS (82 . 29 ± 13.84 ng/g, p \u003C 0. 01) or BBN (76 . 09 ± 10.32 ng/g, p \u003C 0. 001) . ALN + patients exhibited elevated TMAO (210 . 92 ± 82.09 ng/g) versus  \nALN − (122 . 99 ± 48.23 ng/g, p \u003C 0. 001) . Multivariable analysis identified TMAO (OR = 1 . 022, 95% CI: 1.009–1. 031),  \nT-stage (T1 vsT2, OR = 1 . 201, 95% CI: 1.019–2. 169), and axillary ultrasound positivity (OR = 6 . 993, 95% CI: 1.099–45.455) as independent predictors. A combined model (TMAO + T-stage + ultrasound) improved predictive accuracy  \n(AUC = 0 . 915; 95% CI: 0 .838–0. 992) .  \nConclusion TMAO levels correlate with breast cancer progression and ALN metastasis, demonstrating potential as abiomarker. Further studies are needed to validate its clinical utility and mechanistic role.  \nKeywords Breast cancer, Trimethylamine N-oxide (TMAO), Axillary lymph node metastasis, Biomarker  \n†Zhijie Wu, Yi Cheng and Siyuan Lin contributed equally to this study.  \n*Correspondence: Ge Qin [qing6@mail.sysu.edu.cn](qing6@mail.sysu.edu.cn)[ ](qing6@mail.sysu.edu.cn)Haiyan Li[lihy27@mail.sysu.edu.cn](lihy27@mail.sysu.edu.cn)  \n1Department of Breast Surgery, Department of General Surgery, The Sixth Affiliated Hospital, Sun Yat-Sen University, 26 Yuancun Erheng Road, Guangzhou 510655, Guangdong, China  \n2Department of Oncology, The Sixth Affiliated Hospital, SunYat-Sen University, Guangzhou, China  \n3Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China  \n4The Affiliated Dongguan Songshan Lake Central Hospital, Guangdong Medical University, Guangzhou, China  \n5Department of Anesthesiology, The Sixth Affiliated Hospital, SunYat-Sen University, Guangzhou, China  \n© The Author(s) 2026. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://c","cbCaijRzzYgy0NYt","https://ap.wps.com/l/cbCaijRzzYgy0NYt","pdf",1660280,"English","# Abstract\n## Background\n## Methods\n## Results\n## Conclusion\n# Introduction\n## Sentinel lymph node biopsy and limitations\n## Rationale for TMAO in cancer","[{\"question\":\"What clinical problem does the study address?\",\"answer\":\"It targets the need to more accurately predict axillary lymph node (ALN) metastasis in breast cancer, since current assessment methods have limitations.\"},{\"question\":\"How were TMAO levels measured and what comparisons were made?\",\"answer\":\"TMAO concentrations were quantified via ELISA in breast tissue from benign breast nodules, DCIS, and invasive ductal carcinoma, and then evaluated further in a cohort of treatment-naive IDC patients.\"},{\"question\":\"What did the study find about TMAO and ALN metastasis?\",\"answer\":\"TMAO levels were higher in invasive ductal carcinoma than in DCIS or benign nodules, and were elevated in ALN-positive compared with ALN-negative patients. Multivariable analysis indicated TMAO as an independent predictor, and a combined model improved predictive accuracy.\"}]","Trimethylamine N-oxide as a potential biomarker for predicting axillary lymph node metastasis in breast cancer - a retrospective study | PDF",1790125974,23]