Goh Yan Mei, Antonowicz Stefan S, Boshier Piers, Hanna George B
Department of Surgery & Cancer, Imperial College London, London W2 1NY, UK.
Oxid Med Cell Longev. 2020 Feb 21;2020:2930347. doi: 10.1155/2020/2930347. eCollection 2020.
Aerodigestive squamous cell carcinomas (ASCC) constitute a major source of global cancer deaths. Patients typically present with advanced, incurable disease, so new means of detecting early disease are a research priority. Metabolite quantitation is amenable to point-of-care analysis and can be performed in ASCC surrogates such as breath and saliva. The purpose of this systematic review is to summarise progress of ASCC metabolomic studies, with an emphasis on the critical appraisal of methodological quality and reporting.
A systematic online literature search was performed to identify studies reporting metabolic biomarkers of ASCC. This review was conducted in accordance with the recommendations of the Cochrane Library and MOOSE guidelines.
Thirty studies comprising 2117 patients were included in the review. All publications represented phase-I biomarker discovery studies, and none validated their findings in an independent cohort. There was heterogeneity in study design and methodological and reporting quality. Sensitivities and specificities were higher in oesophageal and head and neck squamous cell carcinomas compared to those in lung squamous cell carcinoma. The metabolic phenotypes of these cancers were similar, as was the kinetics of metabolite groups when comparing blood, tissue, and breath/saliva concentrations. Deregulation of amino acid metabolism was the most frequently reported theme.
Metabolite analysis has shown promising diagnostic performance, especially for oesophageal and head and neck ASCC subtypes, which are phenotypically similar. However, shortcomings in study design have led to inconsistencies between studies. To support future studies and ultimately clinical adoption, these limitations are discussed.
气消化道鳞状细胞癌（ASCC）是全球癌症死亡的主要原因之一。患者通常表现为晚期、无法治愈的疾病，因此检测早期疾病的新方法是研究的重点。代谢物定量适用于即时检测分析，并且可以在ASCC的替代样本如呼吸和唾液中进行。本系统评价的目的是总结ASCC代谢组学研究的进展，重点是对方法学质量和报告的批判性评价。
进行系统的在线文献检索，以确定报告ASCC代谢生物标志物的研究。本评价按照Cochrane图书馆和MOOSE指南的建议进行。
本评价纳入了30项研究，共2117例患者。所有出版物均代表I期生物标志物发现研究，且均未在独立队列中验证其结果。研究设计、方法学和报告质量存在异质性。与肺鳞状细胞癌相比，食管和头颈部鳞状细胞癌的敏感性和特异性更高。这些癌症的代谢表型相似，比较血液、组织和呼吸/唾液浓度时代谢物组的动力学也相似。氨基酸代谢失调是最常报道的主题。
代谢物分析已显示出有前景的诊断性能，特别是对于表型相似的食管和头颈部ASCC亚型。然而，研究设计的缺陷导致了研究之间的不一致。为支持未来的研究并最终实现临床应用，对这些局限性进行了讨论。
