Abu Bakar Maryam Fatimah, Mohammed Nawi Azmawati, Chin Siok Fong, Makpol Suzana
Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia.
UKM Medical Molecular Biology Institute (UMBI), UKM Medical Centre, Cheras, Kuala Lumpur, Malaysia.
Gastroenterol Rep (Oxf). 2024 Dec 13;12:goae106. doi: 10.1093/gastro/goae106. eCollection 2024.
Early detection of colorectal cancer (CRC) is crucial to enhance the disease treatment and prognosis of patients. Colonoscopy remains the gold standard for CRC detection; however, it requires trained personnel with expensive tools. Currently, serum metabolites have been discovered to be used to discriminate patients with polyps and CRC. This study aimed to identify the most commonly detected predictive serum metabolites for polyps and CRC.
A systematic search of the Web of Science, PubMed, and Cochrane Library databases was conducted using PRISMA guidelines. Ten studies investigating serum metabolite biomarkers of CRC and polyps using different analytical platforms and study populations were included. QUADOMICS tool was used to analyse the quality of the included studies. All reported metabolites were then enriched into the pathways using MetaboAnalyst 5.0.
We found that several potential signature metabolites overlapped between studies, including tyrosine, lysine, cystine, arabinose, and lactate for CRC and lactate and glutamate for polyps. The most affected pathways related to CRC were the urea cycle, glutathione metabolism, purine metabolism, glutamate metabolism, and ammonia recycling. In contrast, those affected in the polyps were the urea cycle, glutamate metabolism, glutathione metabolism, arginine and proline metabolism, and carnitine synthesis.
This review has found commonly detected serum metabolites for polyps and CRC with huge potential to be used in clinical settings. However, the differences between altered pathways in polyps and CRC, other external factors, and their effects on the regulation level, sensitivity, and specificity of each identified metabolite remained unclear, which could benefit from a further extensive cohort study and well-defined analysis equipment.
早期发现结直肠癌（CRC）对于改善患者的疾病治疗和预后至关重要。结肠镜检查仍然是CRC检测的金标准；然而，它需要训练有素的人员和昂贵的工具。目前，已发现血清代谢物可用于鉴别息肉和CRC患者。本研究旨在确定息肉和CRC中最常检测到的预测性血清代谢物。
按照PRISMA指南对Web of Science、PubMed和Cochrane图书馆数据库进行系统检索。纳入了10项使用不同分析平台和研究人群调查CRC和息肉血清代谢物生物标志物的研究。使用QUADOMICS工具分析纳入研究的质量。然后使用MetaboAnalyst 5.0将所有报告的代谢物富集到代谢途径中。
我们发现不同研究之间有几种潜在的标志性代谢物重叠，包括CRC的酪氨酸、赖氨酸、胱氨酸、阿拉伯糖和乳酸，以及息肉的乳酸和谷氨酸。与CRC相关的受影响最大的途径是尿素循环、谷胱甘肽代谢、嘌呤代谢、谷氨酸代谢和氨循环。相比之下，息肉中受影响的途径是尿素循环、谷氨酸代谢、谷胱甘肽代谢、精氨酸和脯氨酸代谢以及肉碱合成。
本综述发现了息肉和CRC中常见的血清代谢物，具有很大的临床应用潜力。然而，息肉和CRC中改变的途径之间的差异、其他外部因素以及它们对每种已鉴定代谢物的调节水平、敏感性和特异性的影响仍不清楚，这可能需要进一步广泛的队列研究和明确的分析设备。
