Cancer diagnosis using dried serum spot and nanoparticle-enhanced mass spectrometry


Enhancing Cancer Diagnostics in Low-Resource Settings through Dried Serum Spot and Nanoparticle-Enhanced Mass Spectrometry


The disparity in healthcare resources significantly impacts cancer diagnosis and treatment outcomes worldwide. In developed countries, the availability of advanced diagnostic tools supports effective population-based screening programs. Conversely, less than 30% of low-income countries have access to essential diagnostic facilities, contributing to a higher rate of undiagnosed cases and cancer-related deaths.

Revolutionizing Diagnosis with Dried Serum Spots (DSS)

Traditional serum-based testing, although effective, is limited in low-resource settings due to its requirements for large volume samples, stringent storage conditions, and extensive cold-chain logistics. To address these challenges, dried blood spot specimens, specifically dried serum spots (DSS), have emerged as a viable alternative. DSS technology simplifies the collection, storage, and transport of samples, enabling centralized testing at regional laboratories without the need for expensive infrastructure.

Innovations in Metabolic Cancer Diagnosis

Metabolic diagnosis using DSS has shown promising results in detecting inborn metabolic disorders, with broad applications in newborn screening programs. Adapting this success to cancer diagnostics, however, poses unique challenges. Traditional cancer markers like proteins, microRNAs, and circulating tumor cells often degrade in dried conditions, whereas metabolites remain stable, making them suitable targets for DSS-based diagnostics.

The Role of Nanoparticle-Enhanced Laser Desorption/Ionization Mass Spectrometry (NPELDI MS)

Nanoparticle-enhanced laser desorption/ionization mass spectrometry (NPELDI MS) represents a pivotal advancement in the field of metabolic cancer diagnostics. This innovative technique leverages the unique properties of nanoparticles to improve the sensitivity, selectivity, and reproducibility of mass spectrometric analyses, particularly when applied to dried serum spots (DSS).

Functionality and Mechanism: NPELDI MS utilizes inorganic nanoparticles as a matrix to enhance the ionization process during mass spectrometry. Traditional laser desorption/ionization (LDI) methods often require organic matrices, which can complicate the analysis due to matrix-related background noise and limited efficiency in ionizing low-abundance metabolites. In contrast, nanoparticles provide a clean and efficient alternative, facilitating the direct desorption and ionization of analytes without interference.

The nanoparticles, such as ferric nanoparticles, act as a substrate upon which the sample is deposited. When subjected to laser energy, these nanoparticles effectively transfer the energy to the analytes (metabolites of interest), resulting in their efficient ionization. This process is critical for achieving high-quality spectral data essential for accurate diagnostic conclusions.

Advantages in Metabolic Cancer Diagnostics:

  1. Enhanced Sensitivity and Specificity: Nanoparticles can selectively bind to specific metabolites, enhancing the sensitivity of the detection. This selectivity is crucial in cancer diagnostics, where detecting low concentrations of biomarkers can be the difference between early and late diagnosis.
  2. Reduced Sample Requirements: The high efficiency of NPELDI MS allows for the analysis of microliter volumes of blood, a significant advantage when using DSS. This is particularly beneficial in settings where sample collection is challenging or where samples are scarce.
  3. Streamlined Analysis: Unlike traditional methods that require extensive sample preparation, including chromatographic separation, NPELDI MS can directly analyze the dried spots. This reduces the time and labor involved in preparing samples, enabling faster diagnostic turnaround times.
  4. Robustness: The method is less susceptible to the variability introduced by complex sample preparation techniques. This robustness ensures consistent results, which is essential for clinical applications where repeated testing may not be feasible.

Challenges and Considerations: Despite its advantages, the application of NPELDI MS in clinical settings is not without challenges. The adaptation of this technology to standard clinical workflows, including the development of standardized operating procedures, is necessary to ensure its reliability and effectiveness across different environments. Moreover, the complexity of the metabolite spectrum in clinical samples demands sophisticated data analysis tools to interpret the mass spectrometric data accurately.

Future Directions: Ongoing research and development are focused on refining the NPELDI MS technique to enhance its application in cancer diagnostics further. Efforts include improving the nanoparticles’ ability to capture and ionize a broader range of cancer-specific metabolites and integrating advanced computational tools to handle the complex data generated during the analysis. These advancements could pave the way for NPELDI MS to become a standard tool in metabolic cancer diagnosis, especially in low-resource settings where traditional diagnostic infrastructures are lacking.


The integration of DSS with NPELDI MS presents a transformative approach to cancer diagnostics, particularly in underdeveloped regions. This method promises to improve the accuracy of cancer screenings while being economically and environmentally sustainable. Further research and development will be crucial in overcoming the existing barriers and expanding the reach of this innovative diagnostic technique.


  1. Wang R, Yang S, Wang M, et al. A sustainable approach to universal metabolic cancer diagnosis. Nat Sustain 2024 (in press)

Last update: 25 April 2024, 21:39


Gastroenterologist - Hepatologist, Thessaloniki

PhD at Medical School, Aristotle University of Thessaloniki, Greece

PGDip at Universitair Medisch Centrum Utrecht, The Netherlands

Ex President, Hellenic H. pylori & Microbiota Study Group