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目的:应用核磁共振方法检测结直肠肿瘤患者及结直肠癌前病变患者血清代谢物质水平变化。方法:收集新疆医科大学第一附属医院确诊结直肠癌患者血清标本40例,新疆医科大学第一附属医院考虑为癌前病变(包括溃疡性肠病、结直肠腺瘤)患者血清标本20例,健康对照组血清标本60例,应用核磁共振技术结合偏最小二乘法,分析三组中血清代谢物质的变化水平。结果:结直肠肿瘤患者血清中的苯丙氨酸、酪氨酸、乳酸、β-葡萄糖、胆碱、亮氨酸、甘氨酸、α-葡萄糖、肌酸、谷氨酰胺、谷氨酸、乙酰半胱氨酸、缬氨酸、脯氨酸丙氨酸等14种化合物较正常者明显下降,而β-羟丁酸、乙酰乙酸的含量升高,差异有统计学意义(P<0.05)。结直肠癌前病变患者与肿瘤患者血清亮氨酸、胆碱、β-葡萄糖均比健康者低。除了上述三种化合物以外,结直肠癌前病变患者血清异丁酸、甜菜碱、柠檬酸较健康组低(有统计学差异)。结论:以代谢组学为基础的核磁共振技术在结直肠肿瘤的早期诊断中有无创、快速、灵敏度高等临床应用价值。结直肠肿瘤患者与健康者比较,部分血清代谢物质有变化。结直肠癌前病变组患者血清代谢物质的变化呈从正常至肿瘤的过渡变化状态,其部分相关代谢物质的变化间接的预示肿瘤的发生。
Objective: To detect the changes of serum metabolites in patients with colorectal neoplasms and patients with premalignant colorectal lesions by using nuclear magnetic resonance. Methods: Forty patients with colorectal cancer diagnosed in the First Affiliated Hospital of Xinjiang Medical University were collected. Serum samples from 20 patients with precancerous lesions (including ulcerative colitis and colorectal adenoma) were included in the First Affiliated Hospital of Xinjiang Medical University. Serum samples of healthy control group 60 cases, the application of nuclear magnetic resonance technology combined with partial least-squares analysis of changes in the level of serum metabolites. RESULTS: Phenylalanine, tyrosine, lactate, beta-glucose, choline, leucine, glycine, alpha-glucose, creatine, glutamine, glutamate, and acetyl half in serum of patients with colorectal cancer 14 compounds such as cystine, valine and proline alanine decreased significantly compared with those in normal subjects, while the content of β-hydroxybutyric acid and acetoacetic acid increased, with statistical significance (P <0.05). Colorectal precancerous lesions and cancer patients leucine, choline, β-glucose lower than healthy people. In addition to these three compounds, serum isobutyric acid, betaine, and citric acid were significantly lower in patients with premalignant precancerous lesions than those in the healthy group (statistically significant). CONCLUSIONS: Metabonomics-based NMR has clinical value in the early diagnosis of colorectal neoplasms without invasive, rapid and high sensitivity. Colorectal cancer patients compared with healthy subjects, some changes in serum metabolites. Colorectal precancerous lesions in patients with changes in serum metabolites from normal to the state of transition tumor transition, changes in some of its related metabolites indirectly indicate the occurrence of tumors.