Background: Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy, yet diagnosis still relies primarily on invasive bone-marrow procedures and advanced laboratory assays. Non-invasive, rapid, and cost-effective tools remain an unmet need. Fourier-transform infrared (FTIR) spectroscopy has shown promise for detecting cancer-associated biochemical changes in biofluids and cells. Methods: Serum from pediatric ALL patients and controls (n= 103; ALL = 45, controls = 58: healthy = 14, hematology controls = 44 with anemia, thrombocytopenia, leukopenia, and pancytopenia) was analyzed using FTIR. Spectra (800–1800, 2800–3500 cm−1) were preprocessed with baseline correction, derivative filtering, and normalization. Group differences were assessed statistically, and logistic regression with stratified 10-fold cross-validation was applied; Receiver operating characteristic (ROC)\precision–recall (PR) analyses were based on out-of-fold predictions. Results: Distinct spectral alterations were observed between ALL and controls. Leukemia samples showed higher amide I (~1640 cm−1) and amide II (~1545 cm−1) absorbance, lower lipid-related bands (~1450, ~2920 cm−1), and increased nucleic-acid–associated signals (~1080 cm−1). Differences were significant (q< 0.05) with moderate effect sizes. Logistic regression achieved area under the curve (AUC) ≈ 0.80 with sensitivity ~0.73–0.84 across practical decision thresholds (0.50 → 0.30) and higher recall attainable at the expense of specificity. Principal component analysis (PCA)\hierarchical cluster analysis (HCA) indicated partial but consistent group separation, aligning with supervised performance. Conclusions: Serum FTIR spectroscopy shows promise for distinguishing pediatric ALL from controls by reflecting disease-related metabolic changes. The technique is rapid, label-free, and requires only small serum volumes. Our findings represent proof-of-concept, and validation in larger, multi-center studies is needed before clinical implementation can be considered.
背景：急性淋巴细胞白血病（ALL）是最常见的儿童恶性肿瘤，但其诊断仍主要依赖于侵入性骨髓穿刺和复杂的实验室检测。目前仍缺乏非侵入性、快速且经济高效的诊断工具。傅里叶变换红外（FTIR）光谱技术已显示出通过检测生物体液和细胞中癌症相关生化变化的潜力。方法：本研究采用FTIR光谱技术对儿童ALL患者与对照组的血清样本（n=103；ALL组45例，对照组58例：健康对照14例，血液学对照44例，包括贫血、血小板减少、白细胞减少及全血细胞减少患者）进行分析。光谱数据（800–1800 cm⁻¹，2800–3500 cm⁻¹）经过基线校正、导数滤波和归一化预处理。通过统计学方法评估组间差异，并采用分层10折交叉验证的逻辑回归模型进行分析；受试者工作特征（ROC）曲线与精确率-召回率（PR）分析基于交叉验证的预测结果。结果：ALL组与对照组之间存在显著的光谱差异。白血病样本显示出更高的酰胺I带（~1640 cm⁻¹）和酰胺II带（~1545 cm⁻¹）吸光度，更低的脂质相关谱带（~1450 cm⁻¹，~2920 cm⁻¹），以及增强的核酸相关信号（~1080 cm⁻¹）。这些差异具有统计学显著性（q<0.05），效应量中等。逻辑回归模型曲线下面积（AUC）约为0.80，在实际决策阈值（0.50→0.30）范围内灵敏度约0.73–0.84，可通过牺牲特异性获得更高的召回率。主成分分析（PCA）与层次聚类分析（HCA）显示组间存在部分但稳定的分离趋势，与监督学习模型的性能表现一致。结论：血清FTIR光谱技术通过反映疾病相关的代谢变化，在区分儿童ALL与对照组方面展现出应用前景。该技术具有快速、免标记、仅需微量血清样本的优势。本研究结果为概念验证阶段，在考虑临床应用前仍需通过更大规模、多中心研究进行验证。
肿瘤(癌症)患者之家