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. 2025 Apr 22;15(1):13929.
doi: 10.1038/s41598-025-97440-2.

Cerumenogram as an assay for the metabolic diagnosis of precancer, cancer, and cancer remission

João Marcos Gonçalves Barbosa  1 , Camilla Gabriela de Oliveira  1 , Marina Ferraz Gontijo Soares  1 , Larissa Fernanda Medeiros Vieira  2 , Omar Carneiro Filho  2 , Daniela Medeiros Milhomem Cardoso  3 , Patricia Medeiros Milhomem Beato  4 , Cristina Aparecida Trigo Martins Moro  4 , Anselmo Elcana de Oliveira  5 , Nelson Roberto Antoniosi Filho  6
Affiliations

Cerumenogram as an assay for the metabolic diagnosis of precancer, cancer, and cancer remission

João Marcos Gonçalves Barbosa et al. Sci Rep. .

Abstract

Early diagnosis is crucial for successful cancer treatment. As a mitochondrial metabolic disease, cancer produces volatile organic metabolites that are present in earwax, allowing differentiation between healthy individuals and those with cancer through an assay called cerumenogram. In this case series study, we demonstrated that this assay also enables the diagnosis of precancerous stages, such as hypermetabolic inflammation and dysplasia, which can aid in treatments to prevent cancer progression. Additionally, this assay reveals that oncological metabolism differs from that observed in metaplasias, cysts, and benign tumors, helping to avoid unnecessary oncological procedures due to suspected malignancy. Cerumenogram can also be used to assess cancer remission. Thus, the cerumenogram emerges as an assay that might enable the diagnosis of cancer, monitor remission, and identify precancerous stages, covering key steps of tumorigenesis.

Keywords: Biomarkers; Carcinogenesis; Cerumenogram; Early diagnosis; Earwax; Volatile organic compounds.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests. Ethical approval: All volunteers in this work signed a written informed consent form to confirm that they agreed to participate in the “Cerumen Project” which is coordinated by Prof. Dr. Nelson Roberto Antoniosi Filho and approved by the Universidade Federal de Goiás and Hospital Amaral Carvalho ethics committees for research involving humans (Protocol: #57880516.9.0000.5083 and #57880516.9.3003.5434). All the procedures applied in this study strictly followed the principles of the Declaration of Helsinki.

Figures

Fig. 1
Fig. 1
Radiopharmaceutical uptake in the proximal third of the ascending colon, as observed in early images and persisting in delayed images (SUVmax: 8.9 and 11.0 g mL−1), with colonic biopsy revealing eosinophilic inflammatory infiltration in differentiated cells.
Fig. 2
Fig. 2
(A) Cerumenogram protocol for the volunteer. (B) The volunteer’s oncological 18F-FDG PET/CT exam indicated a hypermetabolic region in the zygomaticus minor and major muscles with an SUVmax of 6.9 g mL−1.
Fig. 3
Fig. 3
(A) Group test: metaplasia (n = 3), dysplasia (n = 3), and benign tumors (n = 11). (B) Sample prediction table showing the sample labels, predicted class by the Cerumenogram assay (N-OR = Oncological Risk-free, Y-OR = Oncological Risk), diagnostic category (MP = Metaplasia, DP = Dysplasia, BT-C = Benign Tumor), and the clinical diagnostic description of each volunteer.
Fig. 4
Fig. 4
Tumorigenesis from a volatilomic point of view.
Fig. 5
Fig. 5
(A) Cerumenogram longitudinal results for the volunteer. Three Cerumenogram analyses classified the sample as part of the oncological risk group; in the fourth analysis, the sample was classified as part of the oncological risk-free group. (B) 68Ga-PET-CT/PSMA confirmed a hypercapturing lymph node abnormality in the left external iliac lymph node, with SUVmax values of 7.6 and 17.6 g mL−1 in the early and delayed images, respectively. (C) Computed tomography (CT) images (iii) before and (iv) after treatment, showing complete remission of the lymph node.
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References

    1. David, A. R. & Zimmerman, M. R. Cancer: an old disease, a new disease or something in between?. Nat. Rev. Cancer10, 728–733 (2010). - PubMed
    1. Office for National Statistics. Cancer survival in England: adult, stage at diagnosis and childhood—Patients followed up to 2018. Off. Natl. Stat. 1–37 (2019).
    1. Crosby, D. et al. Early detection of cancer. Science (80-.)375, eaay9040 (2023). - PubMed
    1. de Martel, C., Georges, D., Bray, F., Ferlay, J. & Clifford, G. M. Global burden of cancer attributable to infections in 2018: A worldwide incidence analysis. Lancet Glob. Heal.8, e180–e190 (2020). - PubMed
    1. Organization, W. H. Assessing national capacity for the prevention and control of noncommunicable diseases: report of the 2021 global survey (2023).

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