Dipartimento di Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Gemelli 8, I-00168 Rome, Italy.
Istituto di Clinica Otorinolaringoiatrica, Università Cattolica del Sacro Cuore, Rome, Italy.
Dis Markers. 2020 Oct 1;2020:2291759. doi: 10.1155/2020/2291759. eCollection 2020.
Serum amino acid (AA) profiles represent a valuable tool in the metabolic assessment of cancer patients; still, information on the AA pattern in head and neck cancer (HNC) patients is insufficient. The aim of the study was to assess whether serum AA levels were associated with the stage of neoplastic disease and prognosis in primary HNC patients.
Two hundred and two primary HNC patients were included in the study. Thirty-one AAs and derivatives were measured in serum through an ultraperformance liquid chromatography-mass spectrometry (UPLC-MS). The association between AA concentrations and the stage (advanced versus early) of HNC was estimated using a multivariable logistic regression model. A multivariable Cox regression model was used to evaluate the prognostic significance of each AA.
At the multivariable logistic regression analysis, increased levels of alpha-aminobutyric acid, aminoadipic acid, histidine, proline, and tryptophan were associated with a reduced risk of advanced stage HNC, while high levels of beta-alanine, beta-aminobutyric acid, ethanolamine, glycine, isoleucine, 4-hydroxyproline, and phenylalanine were associated with an increased risk of advanced stage HNC. Furthermore, at multivariate analysis, increased levels of alpha-aminobutyric acid were associated with increased overall survival (OS), while high levels of arginine, ethanolamine, glycine, histidine, isoleucine, 4-hydroxyproline, leucine, lysine, 3-methylhistidine, phenylalanine, and serine were associated with decreased OS.
Our study suggests that AA levels are associated with the stage of disease and prognosis in patients with HNC. More study is necessary to evaluate if serum AA levels may be considered a hallmark of HNC and prove to be clinically useful markers of disease status and prognosis in HNC patients.
血清氨基酸（AA）谱是评估癌症患者代谢情况的一种有价值的工具；然而，有关头颈部癌症（HNC）患者 AA 模式的信息还不够充分。本研究旨在评估血清 AA 水平是否与原发性 HNC 患者的肿瘤疾病分期和预后相关。
本研究纳入了 202 例原发性 HNC 患者。通过超高效液相色谱-质谱（UPLC-MS）法检测血清中的 31 种氨基酸及其衍生物。采用多变量逻辑回归模型评估 AA 浓度与 HNC 分期（晚期与早期）之间的关联。采用多变量 Cox 回归模型评估每个 AA 的预后意义。
在多变量逻辑回归分析中，升高的α-氨基丁酸、氨基己二酸、组氨酸、脯氨酸和色氨酸水平与降低晚期 HNC 风险相关，而升高的β-丙氨酸、β-氨基丁酸、乙醇胺、甘氨酸、异亮氨酸、4-羟基脯氨酸和苯丙氨酸水平与升高晚期 HNC 风险相关。此外，在多变量分析中，升高的α-氨基丁酸水平与总生存期（OS）增加相关，而升高的精氨酸、乙醇胺、甘氨酸、组氨酸、异亮氨酸、4-羟基脯氨酸、亮氨酸、赖氨酸、3-甲基组氨酸、苯丙氨酸和丝氨酸水平与 OS 降低相关。
本研究表明，AA 水平与 HNC 患者的疾病分期和预后相关。需要进一步研究以评估血清 AA 水平是否可作为 HNC 的标志，并证明其对头颈部癌症患者疾病状态和预后具有临床应用价值。
