Department of Biochemistry, Inha University Hospital and Center for Advanced Medical Education by BK21 Project, College of Medicine, Inha University, Incheon, Republic of Korea.
J Hepatol. 2010 Feb;52(2):228-33. doi: 10.1016/j.jhep.2009.11.002. Epub 2009 Nov 27.
BACKGROUND & AIMS: Biliary tract cancer is highly lethal at presentation, with increasing mortality worldwide. Current diagnostic measures employing multiple criteria such as imaging, cytology, and serum tumor markers are not satisfactory, and a new diagnostic tool is needed. Because bile is a cognate metabolite-rich bio-fluid in the biliary ductal system, we tested a new metabolomic approach to develop an effective diagnostic tool.
Biles were collected prospectively from patients with cancer (n=17) or benign biliary tract diseases (n=21) with percutaneous or endoscopic methods. Nuclear magnetic resonance spectra (NMR) of these biles were analyzed using orthogonal partial least square discriminant analysis (OPLS-DA).
The metabolomic 2-D score plot showed good separation between cancer and benign groups. The contributing NMR signals were analyzed using a statistical TOCSY approach. The diagnostic performance assessed by leave-one-out analysis exhibited 88% sensitivity and 81% specificity, better than the conventional markers (CEA, CA19-9, and bile cytology).
The NMR-based metabolomics approach provides good performance in discriminating cancer and benign biliary duct diseases. The excellent predictability of the method suggests that it can, at least, augment the currently available diagnostic approaches.
胆道癌在发病时具有高度致命性，全球死亡率不断上升。目前采用多种标准（如影像学、细胞学和血清肿瘤标志物）的诊断措施并不令人满意，需要一种新的诊断工具。由于胆汁是胆管系统中同源代谢产物丰富的生物液体，我们测试了一种新的代谢组学方法来开发有效的诊断工具。
通过经皮或内镜方法前瞻性地从癌症（n=17）或良性胆道疾病（n=21）患者中收集胆汁。使用正交偏最小二乘判别分析（OPLS-DA）对这些胆汁的核磁共振光谱（NMR）进行分析。
代谢组学二维得分图显示癌症和良性组之间有良好的分离。使用统计 TOCSY 方法分析了有贡献的 NMR 信号。通过留一法分析评估的诊断性能显示出 88%的敏感性和 81%的特异性，优于传统标志物（CEA、CA19-9 和胆汁细胞学）。
基于 NMR 的代谢组学方法在区分癌症和良性胆管疾病方面具有良好的性能。该方法具有出色的预测性，表明它至少可以增强当前可用的诊断方法。
