Mariën Hanne, Derveaux Elien, Vanhove Karolien, Adriaensens Peter, Thomeer Michiel, Mesotten Liesbet
Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, B-3500 Hasselt, Belgium.
Department of Respiratory Medicine, Algemeen Ziekenhuis Vesalius, B-3717 Tongeren, Belgium.
Metabolites. 2022 Jun 14;12(6):545. doi: 10.3390/metabo12060545.
Lung cancer is the leading cause of cancer-related mortality worldwide, with five-year survival rates varying from 3-62%. Screening aims at early detection, but half of the patients are diagnosed in advanced stages, limiting therapeutic possibilities. Positron emission tomography-computed tomography (PET-CT) is an essential technique in lung cancer detection and staging, with a sensitivity reaching 96%. However, since elevated 18F-fluorodeoxyglucose (F-FDG) uptake is not cancer-specific, PET-CT often fails to discriminate between malignant and non-malignant PET-positive hypermetabolic lesions, with a specificity of only 23%. Furthermore, discrimination between lung cancer types is still impossible without invasive procedures. High mortality and morbidity, low survival rates, and difficulties in early detection, staging, and typing of lung cancer motivate the search for biomarkers to improve the diagnostic process and life expectancy. Metabolomics has emerged as a valuable technique for these pitfalls. Over 150 metabolites have been associated with lung cancer, and several are consistent in their findings of alterations in specific metabolite concentrations. However, there is still more variability than consistency due to the lack of standardized patient cohorts and measurement protocols. This review summarizes the identified metabolic biomarkers for early diagnosis, staging, and typing and reinforces the need for biomarkers to predict disease progression and survival and to support treatment follow-up.
肺癌是全球癌症相关死亡的主要原因，其五年生存率在3%至62%之间不等。筛查旨在早期发现，但半数患者在晚期才被诊断出来，这限制了治疗的可能性。正电子发射断层扫描-计算机断层扫描（PET-CT）是肺癌检测和分期的一项重要技术，其灵敏度可达96%。然而，由于18F-氟脱氧葡萄糖（F-FDG）摄取升高并非癌症特异性表现，PET-CT常常无法区分恶性和非恶性PET阳性高代谢病变，其特异性仅为23%。此外，在没有侵入性检查的情况下，仍然无法区分肺癌类型。肺癌的高死亡率和高发病率、低生存率以及早期检测、分期和分型的困难促使人们寻找生物标志物以改善诊断过程和提高预期寿命。代谢组学已成为解决这些难题的一项有价值的技术。超过150种代谢物已被证实与肺癌有关，并且有几种代谢物在特定代谢物浓度变化的研究结果中是一致的。然而，由于缺乏标准化的患者队列和测量方案，差异仍然多于一致性。本综述总结了已确定的用于早期诊断、分期和分型的代谢生物标志物，并强调了需要生物标志物来预测疾病进展和生存情况以及支持治疗随访。
