背景:癌代谢物为前列腺癌(PCa)临床进展的诊断和预后提供了新的方法。这项研究是关于一组尿中代谢物(乙醇胺,犬尿氨酸,β-丙氨酸,α-丙氨酸,亮氨酸,异亮氨酸,γ-氨基丁酸,和肌氨酸)以及与诊断为前列腺癌的患者的前列腺特异性抗原(PSA)和Gleason评分的相关性。
方法:这项横断面研究的参与者被分为PCa组(101名符合纳入标准的患者,平均年龄71岁)和对照组(52个人,没有恶性肿瘤的证据,没有肿瘤和其他慢性疾病,没有前列腺病理学,平均年龄40岁)。纳入PCa组的标准如下:i)被诊断为前列腺癌,基于直肠指检(DRE),前列腺超声检查,或活检;ii)未接受手术或任何其他治疗;iii)没有任何其他伴随的肿瘤疾病,肾功能衰竭,糖尿病。通过高效液相色谱-串联质谱检测(HPLC-MS/MS)建立了所选代谢物的尿液浓度。
结果:两组比较发现乙醇胺浓度升高有显著差异,肌氨酸和犬尿氨酸,PCa组β-丙氨酸和异亮氨酸浓度下降明显不同。在PSA水平低于和高于10ng/mL且Gleason评分低于和高于6的PCa组中,未检测到该值的变化(p>0.05)。为了测试多个变量的组合在区分PCa和对照组之间是否更强大,进行了多元逻辑回归分析。一个模型包括乙醇胺,肌氨酸,犬尿氨酸,β-丙氨酸,异亮氨酸阴性预测力(NPP)为76.2%,阳性预测力(PPP)为81.8%。
结论:乙醇胺的尿液浓度,肌氨酸,犬尿氨酸,β-丙氨酸,PCa组异亮氨酸与对照组有显著差异。需要新的扩大人口研究来讨论我们的结果。
BACKGROUND: Oncometabolites provide a new approach towards the diagnostics and prognosis of the clinical progress of prostate cancer (PCa). This
study is about the diagnostic and predictive value of a panel of urinary oncometabolites (ethanolamine, kynurenine, β-alanine, α-alanine, leucine, isoleucine, γ-aminobutyric acid, and sarcosine) and correlation with prostate-specific antigen (PSA) and Gleason score in patients diagnosed with prostate cancer.
METHODS: The participants in this cross-sectional
study were divided into PCa group (101 patients who matched the including criteria, average age 71) and control group (52 individuals, with no evidence of malignancy, without oncological and other chronic diseases, and without prostate gland pathology, average age 40). The criteria to be included in the PCa group were as follows: i) being diagnosed with prostate cancer, based on digital rectal examination (DRE), prostate ultrasound investigation, or biopsy; ii) not being subjected to a surgical or any other treatment; iii) not having any other concomitant oncological diseases, renal failure, diabetes mellitus. The urinary concentration of the selected metabolites was established through high-performance liquid chromatography with tandem mass spectrometry detection (HPLC-MS/MS).
RESULTS: The comparison of both groups established a significantly different elevated concentration of ethanolamine, sarcosine and kynurenine, and a significantly different decreased concentration of β-alanine and isoleucine in PCa group. No changes of the values were detected in the PCa group with PSA levels below and above 10 ng/mL and Gleason score below and above 6 (p > 0.05). To test whether combination of several variables is more powerful in discriminating between PCa and control group multiple logistic regression analysis was performed. A model including ethanolamine, sarcosine, kynurenine, β-alanine, and isoleucine demonstrated negative predictive power (NPP) 76.2% and positive predictive power (PPP) 81.8%.
CONCLUSIONS: Urinary concentrations of ethanolamine, sarcosine, kynurenine, β-alanine, and isoleucine in PCa group differ significantly from that of control group. New expanded population studies are needed to discuss our results.