| Objective: Breast cancer and lung cancer are the two most threatening malignancies to human beings.Breast cancer has the highest incidence and the second highest death toll in female malignant tumors.Lung cancer remains the leading cause of cancer-related death worldwide.The aim of this study was to investigate the differences in levels of 26 serum amino acids and 11 serum fatty acids between breast cancer and lung cancer patients and healthy peoples,and to explore their value in early screening of breast cancer and lung cancer patients.At the same time,the clinicopathological data of cancer patients were collected to study the relationship of serum amino acids and fatty acids in the stage,classification and distal metastasis of breast cancer and lung cancer patients,as well as the role in predicting overall survival of lung cancer.Methods: Totally 77 breast cancer patients(breast cancer group)and 147 lung cancer patients(lung cancer group)diagnosed by the Department of Pathology,Chongqing University Cancer Hospital from Apr.2015 to Jun.2019 were recruited,and 100 normal healthy women were selected as control group.The levels of 26 amino acids and 11 fatty acids in the sera of recruited people were detected by high performance liquid chromatography-mass spectrometry(HPLC-MS).Furthermore,the clinicopathological parameters and survival data of patients with breast cancer and lung cancer were collected to analyze the relationship of serum amino acids and fatty acids in the stage,classification and distal metastasis of breast cancer and lung cancer patients.Receiver operating characteristic(ROC)curve was used to evaluate the effectiveness of different serum amino acids and fatty acids in the early stage of breast cancer and lung cancer patients screening.Kaplan-meier survival curves of serum amino acids and fatty acids were plotted in lung cancer patients,and a nomogram for predicting the overall survival probability of lung cancer based on serum amino acid combined with fatty acids was plotted.Results: The levels of Asn,Gly,Cit,Ala,Thr,Leu,Ile,Phe,Glu were higher in the breast cancer group than in the control group(all P<0.05),The levels of Orn,Arg,GABA,Aad were lower in the breast cancer group than in the control group(all P<0.05);The level of Ile in early breast cancer was higher than that in advanced breast cancer patients(t=2.240,P=0.028);The level of serum Arg in Luminal A type breast cancer patients was significantly higher than that in HER2-positive breast cancer patients(P<0.05);The levels of serum C16:1,C18:1,r-C18:3,C20:1,C20:4,C20:5,n3-C22:5,n6-C22:5 and C22:6 in breast cancer group were higher than that in normal group(all P<0.05);The level of serum C20:4 was significantly higher in triple-negative breast cancer than that in HER2-positive breast cancer;The level of C20:1 in the non-metastasis group was higher than that in the distant metastasis group in breast cancer(t=2.416,P<0.05).The levels of serum amino acids Asn,Gly,Cit,Ala,Thr,Leu,Ile,Phe and Glu in the early breast cancer group were higher than that in the normal group,while the levels of GABA and Aad in the early breast cancer group were lower than that in the normal group(all P<0.05);The levels of serum fatty acids C16:1,C18:1,r-C18:3,C20:1,C20:4,C20:5,n3-C22:5,n6-C22:5 and C22:6 in early breast cancer group were higher than that in normal group(all P<0.05);ROC curve analysis showed that Ile had the highest diagnostic efficiency(AUC=0.853)and Asn had the lowest diagnostic efficiency(AUC=0.626)among serum amino acids.The combined diagnosis of11 amino acids could improve the diagnostic efficiency of early breast cancer(AUC=0.983);Among serum fatty acids,C20:4 had the highest diagnostic efficiency(AUC=0.712),while C20:5 had the lowest diagnostic efficiency(AUC=0.590).The combined diagnosis of 9 serum fatty acids could improve the diagnostic efficiency of early breast cancer(AUC=0.773);The combination of 11 serum amino acids and 9 serum fatty acids could further improve the diagnostic efficiency of early breast cancer(AUC=1);The levels of serum amino acids Aad,Orn,His,Arg,Cit,Ala,β-Ala,Thr,Pro,Asp,Tyr,Met,Leu,Ile,Phe and Glu in lung cancer group were higher than that in normal group(all P<0.05);The levels of serum Asn,Ser and Kyn in lung cancer group were lower than that in normal group(all P<0.05);The levels of Asp,Aad,Val,Phe and Orn in advanced lung cancer patients were higher than that in early lung cancer patients(all P<0.05);The levels of Asp and Phe in lung squamous cell carcinoma were higher than those in small cell lung cancer and lung adenocarcinoma(all P<0.05);The levels of serum Orn,Kyn,Asp,Glu,Arg,β-Ala,Aad,3-Aib,Tyr and Phe were higher in lung cancer patients with distant metastasis than that in non-metastasis(all P<0.05);The levels of serum fatty acids C20:4,C20:5,C22:6,n3-C22:5 and n6-C22:5 in lung cancer group were higher than that in normal group(all P<0.05);The levels of C18:2,r-C18:3,a-C18:3 and C18:1 in lung cancer group were lower than that in normal group(all P<0.05);The levels of Orn,His,Gly,Ser,Cit,β-Ala,Ala,Thr,Pro,Tyr,Met,Ile,Phe,Glu,n3-C22:5,n6-C22:5,C22:6 in early lung cancer group were higher than that in normal group,and the levels of serum Asn,3-Aib,Kyn,C18:1,C18:2,a-C18:3,r-C18:3 in early lung cancer group were lower than that in normal group(all P<0.05);The ROC curve showed that Thr had the highest diagnostic efficiency(AUC=0.950),while Ala had the lowest diagnostic efficiency(AUC=0.626)and the combined diagnosis of 16 serum amino acids could improve the diagnostic efficiency of early lung cancer(AUC=0.1).Among fatty acids,C18:2 had the highest diagnostic efficiency(AUC=0.966),while n3-C22:5 had the lowest diagnostic efficiency(AUC=0.664).The combined diagnosis of 7 serum fatty acids could improve the diagnostic efficiency of early lung cancer(AUC=0.992).Kaplan-meier survival curve showed that the high level group of serum amino acids Aad,Arg,Glu,Ile,Leu,Orn,Val,Phe,Kyn,Asn,Asp,Lys had a worse OS than the low level group,while the high level group of Cit and Trp had a better OS than the low level group(all P<0.05);The OS of serum fatty acids C22:6 and n3-C22:5 in high level group was better than that of the low level group,and the OS of C20:1and C16:1 in high level group was worse than that of the low level group(all P<0.05);The nomogram based on lung cancer stage,age,Lys,Leu,Trp,C16:1,C20:1 and C22:6 included models can predict the OS of lung cancer patients at1,2 and 3 years.Conclusion: Serum amino acids and fatty acids can be used as biomarkers for early detection and screening of breast cancer and lung cancer.Furthermore,Serum amino acids and fatty acids have certain significance for the staging,classification and prediction of distal metastasis of breast cancer or lung cancer.A clinically developed nomogram based on the combination of serum amino acids and fatty acids can accurately predict the overall survival probability of lung cancer,which might help clinician select better appropriate treatment decisions. |
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