Metabolomics represents a promising non-invasive approach that can be applied to identify biochemical changes in colorectal cancer patients (CRC) and is potentially useful for diagnosis and follow-up. Despite the literature regarding metabolomics CRC-specific profiles, discrimination between metabolic changes specifically related to CRC and intra-individual variability is still a problem to be solved. This was a preliminary case-control study, in which ¹H-NMR spectroscopy combined with multivariate statistical analysis was used to profile urine metabolites in subjects undergoing colonoscopy for colon cancer diagnosis. To reduce intra-individual variability, metabolic profiles were evaluated in participants’ urine samples, collected just before the colonoscopy and after a short-term dietary regimen required for the endoscopy procedure. Data obtained highlighted different urinary metabolic profiles between CRC and unaffected subjects (C). The metabolites altered in the CRC urine (acetoacetate, creatine, creatinine, histamine, phenylacetylglycine, and tryptophan) significantly correlated with colon cancer and discriminated with accuracy CRC patients from C patients (receiver operator characteristic (ROC) curve with an area under the curve (AUC) of 0.875; 95% CI: 0.667–1). These results confirm that urinary metabolomic analysis can be a valid tool to improve CRC diagnosis, prognosis, and response to therapy, representing a noninvasive approach that could precede more invasive tests.

中文翻译：

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接受结肠镜检查的结肠癌诊断对象的尿中1H-NMR代谢特征

代谢组学是一种有前途的非侵入性方法，可用于鉴定结直肠癌患者（CRC）的生化变化，并且可能对诊断和随访有用。尽管有关于代谢组学的CRC特异性谱的文献，但是与CRC相关的代谢变化与个体内部变异之间的区别仍然是一个有待解决的问题。这是一项初步的病例对照研究，其中¹H-NMR光谱与多元统计分析相结合，用于对接受结肠镜检查的受试者的尿液代谢产物进行分析，以诊断结肠癌。为了减少个体内部差异，在参与者的尿液样本中评估了代谢状况，这些样本是在结肠镜检查之前和内窥镜检查程序所需的短期饮食方案之后收集的。获得的数据突出显示了CRC和未患病受试者之间的尿液代谢谱不同（C）。CRC尿液中改变的代谢物（乙酰乙酸，肌酸，肌酐，组胺，苯乙酰基甘氨酸和色氨酸）与结肠癌显着相关，并与C患者的CRC患者（接收者操作者特征（ROC）曲线）准确区分开，曲线下的面积（ AUC）为0.875； 95％CI：0.667-1）。