Getsina Maria, Chernevskaya Ekaterina, Beloborodova Natalia, Golovnya Evgeniy, Polyakov Petr, Kushlinskii Nicolai
Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Petrovka Str., 25-2, 107031 Moscow, Russia.
Federal State Budgetary Institution «N.N. Blokhin National Medical Research Center of Oncology» of the Ministry of Health of the Russian Federation, 115522 Moscow, Russia.
Biomedicines. 2024 Sep 14;12(9):2101. doi: 10.3390/biomedicines12092101.
: In the treatment of oncological diseases in children, the search for opportunities for the earlier detection of complications to improve treatment results is very important. Metabolomic studies are actively conducted to stratify different groups of patients in order to identify the most promising markers. : Three groups of patients participated in this study: healthy children as a control group (n = 18), children with various malignant oncological diseases (leukemia, lymphoma, nephroblastoma, ependymoma, etc.) as patients (n = 40) without complications, and patients (n = 31) with complications (inflammatory and infectious). The mitochondrial metabolites (succinic and fumaric acids); biomarkers related to inflammation such as C-reactive protein (CRP), procalcitonin (PCT), and presepsin (PSP); and sepsis-associated aromatic metabolites, such as phenyllactic (PhLA), hydroxyphenyllactic (-HPhLA), and hydroxyphenylacetic acids (-HPhAA), were identified. : It was found that children with malignant oncological diseases had profound metabolic dysfunction compared to healthy children, regardless of the presence of systemic inflammatory response syndrome (SIRS) or sepsis. The prognostic ability of procalcitonin and presepsin for detecting sepsis was high: AUROC = 0.875, cut-off value (Youden index) = 0.913 ng/mL, and AUROC = 0.774, with cut-off value (Youden index) of 526 pg/mL, respectively. : A significant increase in aromatic microbial metabolites and biomarkers in non-survivor patients that is registered already in the first days of the development of complications indicates the appropriateness of assessing metabolic dysfunction for its timely targeted correction.
在儿童肿瘤疾病的治疗中，寻找早期发现并发症以改善治疗效果的机会非常重要。目前正在积极开展代谢组学研究，以对不同患者群体进行分层，从而确定最有前景的标志物。本研究纳入了三组患者：作为对照组的健康儿童（n = 18）、无并发症的各种恶性肿瘤疾病（白血病、淋巴瘤、肾母细胞瘤、室管膜瘤等）患儿（n = 40）以及有并发症（炎症和感染）的患儿（n = 31）。研究鉴定出线粒体代谢物（琥珀酸和富马酸）、与炎症相关的生物标志物如C反应蛋白（CRP）、降钙素原（PCT）和前降钙素（PSP）以及脓毒症相关的芳香族代谢物，如苯乳酸（PhLA）、羟基苯乳酸（-HPhLA）和羟基苯乙酸（-HPhAA）。结果发现，与健康儿童相比，患有恶性肿瘤疾病的儿童存在严重的代谢功能障碍，无论是否存在全身炎症反应综合征（SIRS）或脓毒症。降钙素原和前降钙素检测脓毒症的预后能力较高：受试者工作特征曲线下面积（AUROC）分别为0.875，临界值（约登指数）为0.913 ng/mL，以及AUROC为0.774，临界值（约登指数）为526 pg/mL。在并发症发生后的头几天就已发现非存活患者体内芳香族微生物代谢物和生物标志物显著增加，这表明评估代谢功能障碍以便及时进行靶向纠正具有合理性。
