Zhang Yijie, Ye Lizhen, Qin Ying, Qiu Cheng, Sun Qinsheng, Fan Tingting, Chen Yan, Jiang Yuyang
Guangdong Provincial Key Laboratory of Chinese Medicine Ingredients and Gut Microbiomics, School of Pharmacy, Shenzhen University Medical School, Shenzhen University, Shenzhen, China.
State Key Laboratory of Chemical Oncogenomics, Tsinghua Shenzhen International Graduate School, Shenzhen, China.
Sci Rep. 2025 Apr 21;15(1):13671. doi: 10.1038/s41598-025-97463-9.
Colorectal cancer (CRC) is one of the most common cancers; however, accurately predicting prognosis based on existing molecular subtypes remains challenging. The XELOX regimen, which combines oxaliplatin and capecitabine, is the cornerstone of chemotherapy for CRC treatment. However, there is a notable lack of reliable predictive models for determining the sensitivity of this treatment. This study aimed to establish a novel classification system for CRC and develop a predictive model for XELOX chemotherapeutic sensitivity using serum metabolomics. We recruited 89 patients with CRC and 89 age- and sex-matched healthy controls for untargeted metabolomic studies to identify tumor-specific serum metabolites. The patients were grouped into distinct metabolic subtypes using unsupervised clustering. A serum metabolite combination predictive of the efficacy of XELOX was established using Cox regression analysis in 34 patients with stage III CRC. Using unsupervised clustering based on the serum metabolites, three distinct clusters were identified. Notably, Cluster 3, which was characterized by uniform lipid and amino acid levels, demonstrated the best prognosis. Our analysis revealed that D-glucose 6-phosphate, presqualene diphosphate, and leukotriene B4 levels were negatively correlated with XELOX sensitivity, whereas 15-HETE and N-acetyl-l-methionine levels were positively correlated. Based on these findings, we constructed a predictive model validated in an independent cohort of 34 patients with stage III CRC. In summary, this study identified a novel classification of CRC based on serum metabolites and developed a potential prognostic model for XELOX chemotherapeutic efficacy, which may have direct effects on the treatment and prognosis of CRC.
结直肠癌(CRC)是最常见的癌症之一;然而,基于现有的分子亚型准确预测预后仍然具有挑战性。奥沙利铂和卡培他滨联合的XELOX方案是CRC治疗化疗的基石。然而,对于确定这种治疗的敏感性,明显缺乏可靠的预测模型。本研究旨在建立一种新的CRC分类系统,并使用血清代谢组学开发一种XELOX化疗敏感性预测模型。我们招募了89例CRC患者和89例年龄和性别匹配的健康对照进行非靶向代谢组学研究,以鉴定肿瘤特异性血清代谢物。使用无监督聚类将患者分为不同的代谢亚型。在34例III期CRC患者中,使用Cox回归分析建立了预测XELOX疗效的血清代谢物组合。基于血清代谢物使用无监督聚类,鉴定出三个不同的簇。值得注意的是,以脂质和氨基酸水平均匀为特征的簇3显示出最佳预后。我们的分析表明,6-磷酸-D-葡萄糖、前鲨烯二磷酸和白三烯B4水平与XELOX敏感性呈负相关,而15-羟基二十碳四烯酸和N-乙酰-L-蛋氨酸水平呈正相关。基于这些发现,我们构建了一个在34例III期CRC患者的独立队列中得到验证的预测模型。总之,本研究基于血清代谢物鉴定了一种新的CRC分类,并开发了一种针对XELOX化疗疗效的潜在预后模型,这可能对CRC的治疗和预后有直接影响。
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