Malignant pleural effusion (MPE) is an important hallmark for late-stage lung cancer with metastasis. Current clinical diagnosis methods require tedious work to distinguish MPE from benign pleural effusion (BPE). The objective of this study was to characterize the metabolic signatures in MPE of lung cancer, and identify potential metabolite biomarkers for diagnosis of MPE. MPE from lung cancer (n = 46) and BPE from tuberculosis patients (n = 32) were investigated by liquid chromatography-tandem mass spectrometry (LC-MS/MS)-based global metabolomic and lipidomic profiling. Multivariate partial least-square discriminative analysis models exhibited distinct metabolic profiles between MPE and BPE. A total of 25 ether lipids, including phosphatidylcholines (PC), lysophosphatidylcholines (LPC) and phosphatidylethanolamines (PE), were observed to be significantly downregulated in MPE with excellent diagnostic potential. Plasmalogen PC(40:3p) showed highest AUC value of 0.953 in receiver operating characteristic (ROC) model. Oxidized polyunsaturated fatty acids (PUFA) were upregulated in MPE. The obtained results implied a high oxidative stress and peroxisome disorder in lung cancer patients. Combined metabolomic and lipidomic profiling have discovered potential biomarkers in MPE with excellent clinical diagnostic capability. Dysregulated ether lipids and oxidized PUFAs have implied an aberrant redox metabolism, which provides novel insights into the pathology of MPE in lung cancer.

中文翻译：

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人肺癌恶性胸腔积液的代谢和脂质组学表征。

恶性胸腔积液（MPE）是晚期肺癌转移的重要标志。当前的临床诊断方法需要繁琐的工作来区分MPE和良性胸腔积液（BPE）。这项研究的目的是表征肺癌MPE中的代谢特征，并确定诊断MPE的潜在代谢物生物标志物。通过基于液相色谱-串联质谱（LC-MS / MS）的全局代谢组学和脂质组分析，研究了肺癌（46例）的MPE和结核病（32例）的BPE。多元偏最小二乘判别分析模型在MPE和BPE之间表现出不同的代谢特征。总共25种醚脂，包括磷脂酰胆碱（PC），溶血磷脂酰胆碱（LPC）和磷脂酰乙醇胺（PE），据观察，它们在MPE中显着下调，具有极好的诊断潜力。血浆血浆PC（40：3p）在接收器工作特征（ROC）模型中显示最高的AUC值为0.953。氧化多不饱和脂肪酸（PUFA）在MPE中上调。获得的结果暗示了肺癌患者中的高氧化应激和过氧化物酶体疾病。组合代谢组学和脂质组学分析已发现MPE中潜在的生物标志物，具有出色的临床诊断能力。醚脂质失调和氧化的PUFA暗示氧化还原代谢异常，这为肺癌MPE的病理学提供了新的见解。在MPE中上调了氧化的多不饱和脂肪酸（PUFA）。获得的结果暗示了肺癌患者中的高氧化应激和过氧化物酶体疾病。组合代谢组学和脂质组学分析已发现MPE中潜在的生物标志物，具有出色的临床诊断能力。醚脂质失调和氧化的PUFA暗示氧化还原代谢异常，这为肺癌中MPE的病理学提供了新的见解。氧化多不饱和脂肪酸（PUFA）在MPE中上调。获得的结果暗示了肺癌患者中的高氧化应激和过氧化物酶体疾病。组合代谢组学和脂质组学分析已发现MPE中潜在的生物标志物，具有出色的临床诊断能力。醚脂质失调和氧化的PUFA暗示氧化还原代谢异常，这为肺癌MPE的病理学提供了新的见解。