#AI Reads Urine# Urinary metabolic biomarkers are better than blood biomarkers even for brainstem gliomas

This study aimed to identify urinary metabolic biomarkers for diagnosing the H3K27M mutation in brainstem gliomas (BSGs). The researchers prospectively collected plasma and urine samples from BSG patients, divided them into discovery, test, and validation cohorts, and used untargeted and targeted metabolomic strategies.

They found that the metabolomic changes caused by the H3K27M mutation were more dramatic and comprehensive in urine than in plasma. Urine metabolomic analysis detected more differentially abundant metabolites and metabolic pathways affected by the mutation. It could also better separate the H3K27M - mutant and wild - type groups through PCA.

After rigorous screening and validation, three metabolites - nomilin, Lys - Leu, and hawkinsin - were identified as significantly elevated biomarkers in H3K27M - mutant BSG urine samples. A urinary biomarker panel composed of these three metabolites had a relatively high diagnostic accuracy, and it could improve the predictive performance of radiomics and clinical models.

In conclusion, compared with plasma, urine is a more sensitive and suitable sample for identifying biomarkers related to the H3K27M mutation in BSGs. The established urinary metabolite biomarker panel provides a non - invasive and valuable method for predicting the H3K27M mutation status, which is beneficial for clinical decision - making in BSG treatment. However, the study has limitations, and an international multi - center study is needed to further validate the biomarker panel.

Neuro Oncol. 2025 Feb 14:noaf038. doi: 10.1093/neuonc/noaf038.

Youhe Gao

Statement: During the preparation of this work the author(s) used Doubao / AI reading for summarizing the content. After using this tool/service, the author(s) reviewed and edited the content as needed and take(s) full responsibility for the content of the published article.