Serum Lipidome Profiling Reveals a Distinct Signature of Ovarian Cancer in Korean Women

Distinguishing ovarian cancer (OC) from other gynecological malignancies remains a critical unmet medical need with significant implications for patient survival. However, non-specific symptoms along with our lack of understanding of OC pathogenesis hinder its diagnosis, preventing many women from receiving appropriate medical assistance. Accumulating evidence suggests a link between OC and deregulated lipid metabolism. Most studies, however, are limited by small sample size, particularly for early-stage cases. Furthermore, racial/ethnic differences in OC survival and incidence have been reported, yet most of the studies consist largely of non-Hispanic white women or women with European ancestry. Studies of more diverse racial/ethnic populations are needed to make OC diagnosis and prevention more inclusive. Here, we profiled the serum lipidome of 208 OC, including 93 patients with early-stage OC, and 117 non-OC (other gynecological malignancies) patients of Korean descent. Serum samples were analyzed with a high-coverage liquid chromatography high-resolution mass spectrometry platform, and lipidome alterations were investigated via statistical and machine learning approaches. Results show that lipidome alterations unique to OC were present in Korean women as early as when the cancer is localized, and those changes increase in magnitude as the diseases progresses. Analysis of relative lipid abundances revealed specific patterns for various lipid classes, with most classes showing decreased abundance in OC in comparison to other gynecological diseases. Machine learning methods selected a panel of 17 lipids that discriminated OC from non-OC cases with an AUC of 0.85 for an independent test set. This study provides a systemic analysis of lipidome alterations in human OC, specifically in Korean women, emphasizing the potential of circulating lipids in distinguishing OC from non-OC conditions. ### Competing Interest Statement The authors have declared no competing interest.