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Noninvasive Diagnosis and Evaluation of Curative Surgery for Gastric Cancer by Using NMR-based Metabolomic Profiling

  • Translational Research and Biomarkers
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Mass screening for gastric cancer (GC), particularly using endoscopy, may not be the most practical approach as a result of its high cost, lack of acceptance, and poor availability. Thus, novel markers that can be used in cost-effective diagnosis and noninvasive screening for GC are needed.

Methods

A total of 154 urine samples from GC patients and healthy individuals and 30 pairs of matched tumor and normal stomach tissues were collected. Multivariate analysis was performed on urinary and tissue metabolic profiles acquired using 1H nuclear magnetic resonance and 1H high-resolution magic angle spinning spectroscopy, respectively. In addition, metabolic profiling of urine from GC patients after curative surgery was performed.

Results

Multivariate statistical analysis showed significant separation in the urinary and tissue data of GC patients and healthy individuals. The metabolites altered in the urine of GC patients were related to amino acid and lipid metabolism, consistent with changes in GC tissue. In the external validation, the presence of GC (early or advanced) from the urine model was predicted with high accuracy, which showed much higher sensitivity than carbohydrate antigen 19-9 and carcinoembryonic antigen. Furthermore, 4-hydroxyphenylacetate, alanine, phenylacetylglycine, mannitol, glycolate, and arginine levels were significantly correlated with cancer T stage and, together with hypoxanthine level, showed a recovery tendency toward healthy controls in the postoperative samples compared to the preoperative samples.

Conclusions

An urinary metabolomics approach may be useful for the effective diagnosis of GC.

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Acknowledgment

This work was supported by the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future Planning, Korea (2010-0024825, NRF-2010-0019394, 2013M3A9B6046418, and Creative Allied Project (CAP)), the Korea Institute of Oriental Medicine (K14281), and the Korea Basic Science Institute (T33409).

Disclosure

The authors declare no conflict of interest.

Author information

Authors and Affiliations

  1. Integrated Metabolomics Research Group, Western Seoul Center, Korea Basic Science Institute, Seoul, Republic of Korea

    Jeeyoun Jung MD, PhD, Youngae Jung MS, Eun Jung Bang PhD & Geum-Sook Hwang PhD

  2. KM Health Technology Research Group, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea

    Jeeyoun Jung MD, PhD

  3. Department of Surgery, College of Medicine, Korea University, Seoul, Republic of Korea

    Sung-il Cho MD, You-Jin Jang MD, PhD, Jung-Myun Kwak MD, PhD & Sungsoo Park MD, PhD

  4. Department of Chemistry, Sungkyunkwan University, Suwon, Republic of Korea

    Do Hyun Ryu PhD

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  1. Jeeyoun Jung MD, PhD
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  2. Youngae Jung MS
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  4. Sung-il Cho MD
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  8. Sungsoo Park MD, PhD
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Correspondence to Sungsoo Park MD, PhD or Geum-Sook Hwang PhD.

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Jung, J., Jung, Y., Bang, E.J. et al. Noninvasive Diagnosis and Evaluation of Curative Surgery for Gastric Cancer by Using NMR-based Metabolomic Profiling. Ann Surg Oncol 21 (Suppl 4), 736–742 (2014). https://doi.org/10.1245/s10434-014-3886-0

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  • DOI: https://doi.org/10.1245/s10434-014-3886-0

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