食管癌相关生物标志物的代谢组学研究进展

Research progress in metabonomics of biomarkers related to esophageal cancer

目的 总结食管癌相关生物标志物的代谢组学研究进展,为临床研究提供参考。方法 应用PubMed、中国知网(CNKI)和万方数据库,以“食管癌、代谢组学、生物标志物、早期诊断、筛查、预后”为中文关键词,以“esophageal cancer/carcinoma、metabonomic(s)/metabolomic(s)、biomarker、early diagnosis、screening、prognosis”为英文关键词,检索2015年1月-2022年3月的相关文献,共检索到190篇。纳入标准:(1)在人群中进行的研究;(2)代谢组学在食管癌筛查与诊断中的应用;(3)与食管癌进展及预后相关的研究;(4)食管癌新辅助放化疗疗效评价的研究。排除标准:(1)非代谢组学研究;(2)在动物或人源肿瘤细胞系中进行的代谢组学研究;(3)结果不明确或质量较低的研究;(4)内容相似或重复的文献。最终纳入44篇文献。结果 代谢组学研究通过分析体内代谢物的变化,已经发现了许多与食管癌的早期诊断、进展和预后等相关的生物标志物,多涉及氨基酸、脂肪酸等物质,且多种代谢物联合较单一者更有诊断或预测价值。同时,对代谢途径研究发现,食管癌多发生氨基酸代谢、脂肪酸代谢、糖代谢、三羧酸循环等代谢紊乱。结论 代谢组学检测方法相对无创,灵敏度和特异度较高,有望成为食管癌诊断、预后及疗效评价的可靠方法之一。体内代谢物变化与病理生理变化之间的关系复杂,将来需要在食管癌的代谢途径变化机制、相关治疗靶点方面开展更深入的研究,为改善食管癌的预后提供科学依据。

Objective To summarize the progress of metabonomics research on biomarkers related to esophageal cancer(EC),so as to provide a reference for clinical research.Methods PubMed, China National Knowledge Infrastructure(CNKI) and WanFang database system were used to retrieve relevant literatures from January 2015 to March 2022,with "esophageal cancer/carcinoma, metabonomic(s)/metabolomic(s),biomarker, early diagnosis, screening, prognosis" as keywords, and 190 articles were retrieved.Inclusion criteria:(1)studies conducted in populations;(2)application of metabolomics in the screening and diagnosis of EC;(3)studies related to the progression and prognosis of EC;(4)studies on the efficacy evaluation of neoadjuvant chemoradiotherapy for EC.Elimination criteria:(1)non-metabolomics studies;(2)metabolomics studies performed in animal or human tumor cell lines;(3)studies with unclear results or low quality;(4)articles with similar or repeated content.Finally, 44 literatures were included in the analysis.Results Metabonomics research has found many biomarkers related to the early diagnosis, progression and prognosis of EC by analyzing the changes of metabolites in vivo,mostly involving amino acids, fatty acids and other substances, and the combination of multiple metabolites has more diagnostic or predictive value than the single one.At the same time, the studies on metabolic pathways have showed that amino acid, lipid acid, glucose and tricarboxylic acid cycle metabolism have been changed in EC.Conclusions The metabonomics detection method has the characteristics of relative non-invasiveness, high sensitivity and specificity, and is expected to become one of the reliable methods for the diagnosis, prognosis and efficacy evaluation of EC.The relationship between metabolite changes in vivo and pathophysiological changes is complex.In the future, more in-depth research should be performed on the mechanism of metabolic pathway changes and related therapeutic targets of EC,so as to provide a scientific basis for improving the prognosis of EC.