Zhang Yong, Ding Nan, Cao Yunfeng, Zhu Zhitu, Gao Peng
Translational Medicine Center, Affiliated Dalian Sixth People's Hospital of Dalian Medical University Dalian, People's Republic of China.
Clinical Laboratory, Affiliated Dalian Sixth People's Hospital of Dalian Medical University Dalian, People's Republic of China.
Int J Clin Exp Pathol. 2018 Mar 1;11(3):1763-1769. eCollection 2018.
The routine biochemical parameters for hepatocellular carcinoma (HCC) diagnosis are all protein markers. Serum concentrations of these markers can be affected by some benign diseases. Most of the occurrence of HCC has a background of cirrhosis, posing a great challenge to differential diagnosis of HCC from cirrhosis using traditional biochemical parameters. Values of serum small molecular metabolites for HCC diagnosis are not fully evaluated. In this study, a traditionalmass spectrometry-based screening strategy was employed to profile amino acids and acylcarnitines in blood samples collected from HCC and cirrhosis patients. Each whole blood specimen was sampled on filter paper and dried at room temperature. Metabolites in the dried blood spots were extracted using organic solvent and then concentrated for mass spectrometry analysis. It was found that 11 parameters, including amino acids, acylcarnitines and some of their relevant ratios, could be used to construct a satisfied differential diagnosis model. In this model, most of the relevant amino acids were essential amino acids. It was noticed that short-chain acylcarnitines tended to be risk factors for HCC. Long-chain acylcarnitines seemed to be risk factors for cirrhosis. This study demonstrates the value of mass spectrometry-based analysis for differential diagnosis of HCC and cirrhosis. Improved differential diagnosis ability may be achieved by combined use of traditional protein markers along with metabolite markers.
用于肝细胞癌（HCC）诊断的常规生化参数均为蛋白质标志物。这些标志物的血清浓度会受到一些良性疾病的影响。大多数HCC的发生都有肝硬化背景，这给使用传统生化参数鉴别诊断HCC与肝硬化带来了巨大挑战。血清小分子代谢物在HCC诊断中的价值尚未得到充分评估。在本研究中，采用了一种基于传统质谱的筛查策略，对从HCC和肝硬化患者采集的血液样本中的氨基酸和酰基肉碱进行分析。每个全血标本都在滤纸上取样，并在室温下干燥。干燥血斑中的代谢物用有机溶剂提取，然后浓缩用于质谱分析。研究发现，包括氨基酸、酰基肉碱及其一些相关比率在内的11个参数可用于构建一个满意的鉴别诊断模型。在该模型中，大多数相关氨基酸为必需氨基酸。值得注意的是，短链酰基肉碱往往是HCC的危险因素。长链酰基肉碱似乎是肝硬化的危险因素。本研究证明了基于质谱分析在HCC与肝硬化鉴别诊断中的价值。联合使用传统蛋白质标志物和代谢物标志物可能会提高鉴别诊断能力。
