Cancer remains a global health crisis, significantly impacting individuals and societies
worldwide. In 2020, approximately 19.3 million new cancer cases and 10 million
cancer-related deaths were reported globally. Screening and triaging are crucial in the
early detection, diagnosis, and management of cancer, targeting different stages to
improve patient outcomes. Despite being one of the leading causes of mortality, many
cancers lack effective screening methods. While conventional screening techniques are
available for some cancers, they have varying accuracy and limitations. Identifying
cancer or precancerous conditions early can significantly reduce mortality and enhance
treatment outcomes. The analysis of biofluids to detect cancer-related signals—liquid
biopsy, has garnered considerable attention over the past decade. Although promising,
many current liquid biopsies lack the sensitivity needed for early-stage cancer detection.
Raman spectroscopy (RS) is a non-destructive, real-time technique for molecular
analysis. Our study investigated the impact of optimising selected parameters and
assessed various spectral processing methods on the reliability and accuracy of spectral
analyses, and demonstrated that manual extension of the sampled volume significantly
enhanced the detection of low-concentration cancer biomolecules, improving spectral
resolution in half the measurement time compared to conventional settings.
Additionally, we examined chemical changes associated with acquired radioresistance
in HR+ and HR− breast cancer cell lines. Combining RS with machine learning, we
achieved high accuracy in distinguishing between parental cell lines and their
radioresistant phenotypes, regardless of hormonal status. The radioresistant phenotypes
exhibited similar difference spectra and formed a single cluster, suggesting common
biochemical changes during the acquisition of radioresistance. We also integrated RS
with advanced machine learning techniques for accurate cancer detection in blood
plasma, using both liquid and dried samples. Our results showed high sensitivity and
specificity in classifying stage Ia breast cancer, with an Area Under the Curve (AUC)
of 1.00. Hierarchical clustering validated the reproducibility of our results. This
research highlights the potential of combining vibrational spectroscopy with AI for
cost-effective, non-invasive, and personalised early cancer detection, emphasising the
need for standardised protocols and robust data processing techniques to facilitate
clinical translation in liquid biopsy applications
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