结直肠癌患者血浆代谢物水平研究*

The plasma metabolite levels in patients with colorectal cancer*

摘要:

目的?研究结直肠癌患者血浆代谢物水平的变化，寻找其肿瘤生物标志物。方法?选取2018年9月—2019年8月在锦州医科大学附属第一医院普通外科住院的166例患者血液样本，将其分为实验组120例和对照组46例。采用液相色谱-串联质谱法（LC-MS/MS）检测血浆23种氨基酸、26种酰基肉碱，比较结直肠癌患者与正常人群、结直肠癌不同临床分期及手术前后的变化。结果?实验组血浆中丙氨酸（Ala）、精氨酸（Arg）、瓜氨酸（Cit）、谷氨酰胺（Gln）、甲硫氨酸（Met）、鸟氨酸（Orn）、脯氨酸（Pro）、苏氨酸（Thr）、酪氨酸（Tvr）、丁二酰基肉碱（C4DC）、葵酰基肉碱（C10）及二十四酰基肉碱（C24）均较对照组升高（P?<0.05）。不同临床分期结直肠癌患者血浆中的C4DC比较，差异有统计学意义（P?<0.05）。术后Ala、Cit、Gln、Pro、C10、C24水平较术前降低（P?<0.05），而Orn、Thr水平较术前升高（P?<0.05）。结论?结直肠癌患者血浆代谢物，如Ala、Cit、Orn、Pro、C4DC及C10在结直肠癌诊断中有重要意义。

Abstract:

Objective To explore the changes in plasma metabolite levels in patients with colorectal cancer (CRC) and to screen for potential tumor biomarkers.?Methods?Blood samples of 166 patients admitted to the Department of General Surgery of the First Affiliated Hospital of Jinzhou Medical University from September 2018 to August 2019 were selected and divided into the experimental group (120 cases) and the control group (46 cases). Liquid chromatography-tandem mass spectrometry (LC-MS / MS) was used to detect 23 amino acids and 26 acylcarnitines in plasma, and the differences in changes before and after surgery were compared among CRC patients and normal controls as well as CRC patients with different tumor stages.?Results?Alanine (Ala), arginine (Arg), citrulline (Cit), glutamine (Gln), methionine (Met), ornithine (Orn), proline (Pro), threonine (Thr), tyrosine (Tvr), succinylcarnitine (C4DC), decanoylcarnitine (C10), and tetracosanoylcarnitine (C24) in the plasma of the experimental group were all higher than those in the control group (P < 0.05). There was a statistically significant difference in C4DC in plasma of patients with stage Ⅰ, Ⅱ, Ⅲ and Ⅳ of CRC (P < 0.05). The levels of Ala, Cit, Gln, Pro, C10, and C24 were lower than those before surgery (P < 0.05), while the levels of Orn and Thr were higher than those before surgery (P < 0.05).?Conclusions?Plasma metabolites such as Ala, Cit, Orn, Pro, C4DC, and C10 in colorectal cancer patients are of important significance in the diagnosis of colorectal cancer.