Department of Clinical and Experimental Medicine, University of Florence, Florence 50134, Italy.
Department of Chemistry "Ugo Schiff", University of Florence, Florence 50134, Italy.
World J Gastroenterol. 2021 Oct 14;27(38):6430-6441. doi: 10.3748/wjg.v27.i38.6430.
Colorectal cancer (CRC), the third most common cause of death in both males and females worldwide, shows a positive response to therapy and usually a better prognosis when detected at an early stage. However, the survival rate declines when the diagnosis is late and the tumor spreads to other organs. Currently, the measures widely used in the clinic are fecal occult blood test and evaluation of serum tumor markers, but the lack of sensitivity and specificity of these markers restricts their use for CRC diagnosis. Due to its high sensitivity and precision, colonoscopy is currently the gold-standard screening technique for CRC, but it is a costly and invasive procedure. Therefore, the implementation of custom-made methodologies including those with minimal invasiveness, protection, and reproducibility is highly desirable. With regard to other screening methods, the screening of fecal samples has several benefits, and metabolomics is a successful method to classify the metabolite shift in living systems as a reaction to pathophysiological influences, genetic modifications, and environmental factors.
To characterize the variation groups and potentially recognize some diagnostic markers, we compared with healthy controls (HCs) the fecal nuclear magnetic resonance (NMR) metabolomic profiles of patients with CRC or adenomatous polyposis (AP).
Proton nuclear magnetic resonance spectroscopy was used in combination with multivariate and univariate statistical approaches, to define the fecal metabolic profiles of 32 CRC patients, 16 AP patients, and 38 HCs well matched in age, sex, and body mass index.
NMR metabolomic analyses revealed that fecal sample profiles differed among CRC patients, AP patients, and HCs, and some discriminatory metabolites including acetate, butyrate, propionate, 3-hydroxyphenylacetic acid, valine, tyrosine and leucine were identified.
In conclusion, we are confident that our data can be a forerunner for future studies on CRC management, especially the diagnosis and evaluation of the effectiveness of treatments.
结直肠癌（CRC）是全球男性和女性死亡的第三大常见原因，在早期发现时对治疗有积极反应，通常预后较好。然而，当诊断较晚且肿瘤扩散到其他器官时，存活率会下降。目前，临床上广泛使用的方法是粪便潜血试验和血清肿瘤标志物评估，但这些标志物的敏感性和特异性不足限制了它们在 CRC 诊断中的应用。由于其灵敏度和精度高，结肠镜检查目前是 CRC 的金标准筛查技术，但它是一种昂贵且有创的程序。因此，非常需要实施包括微创性、保护和可重复性在内的定制方法。关于其他筛查方法，粪便样本的筛查具有多种优势，代谢组学是一种成功的方法，可以将生物系统中代谢物变化分类为对病理生理影响、遗传修饰和环境因素的反应。
为了描述变异组并可能识别一些诊断标志物，我们将 CRC 或腺瘤性息肉（AP）患者的粪便核磁共振（NMR）代谢组图谱与健康对照（HC）进行了比较。
我们使用质子核磁共振波谱结合多元和单变量统计方法，对 32 名 CRC 患者、16 名 AP 患者和 38 名年龄、性别和体重指数匹配良好的 HC 的粪便代谢图谱进行了定义。
NMR 代谢组学分析表明，CRC 患者、AP 患者和 HC 之间的粪便样本图谱存在差异，并且鉴定出了一些有区别的代谢物，包括乙酸盐、丁酸盐、丙酸盐、3-羟基苯乙酸、缬氨酸、酪氨酸和亮氨酸。
总之，我们有信心我们的数据可以为未来关于 CRC 管理的研究，特别是诊断和评估治疗效果提供参考。
