ArticleWorld journal of surgical oncology2026
Trimethylamine N-oxide as a potential biomarker for predicting axillary lymph node metastasis in breast cancer: a retrospective study.
Article in World journal of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAxillary lymph node (ALN) metastasis is a critical prognostic factor in breast cancer, but current assessment methods have limitations. Trimethylamine N-oxide (TMAO), a gut microbiota-derived metabolite, has been implicated in tumor progression, though its role in breast cancer remains unclear.
methodsThis retrospective study analyzed TMAO levels in breast tissue from benign breast nodules (BBN, n = 10), ductal carcinoma in situ (DCIS, n = 10), and invasive ductal carcinoma (IDC, n = 10). A cohort of 97 treatment-naive IDC patients (26 ALN + , 71 ALN −) was further evaluated. TMAO concentrations were quantified via ELISA, and associations with clinicopathological features were assessed using logistic regression and ROC analysis.
resultsTMAO levels were significantly higher in IDC (113.9 ± 16.36 ng/g) than in DCIS (82.29 ± 13.84 ng/g, p < 0.01) or BBN (76.09 ± 10.32 ng/g, p < 0.001). ALN + patients exhibited elevated TMAO (210.92 ± 82.09 ng/g) versus ALN − (122.99 ± 48.23 ng/g, p < 0.001). Multivariable analysis identified TMAO (OR = 1.022, 95% CI: 1.009–1.031), T-stage (T1 vs T2, OR = 1.201, 95% CI: 1.019–2.169), and axillary ultrasound positivity (OR = 6.993, 95% CI: 1.099–45.455) as independent predictors. A combined model (TMAO + T-stage + ultrasound) improved predictive accuracy (AUC = 0.915; 95% CI: 0.838–0.992).
conclusionTMAO levels correlate with breast cancer progression and ALN metastasis, demonstrating potential as a biomarker. Further studies are needed to validate its clinical utility and mechanistic role.
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