| Objective:The gastric cancer is one of the most common cancers with the highest mortality rate in the world,and brings a great burden of disease,especially for china.Precancerous lesions are the stage of transformation of normal gastric mucosa into gastric cancer.If detected and treated in time at this stage,will greatly reduce the risk of precancerous lesions into gastric cancer.Therefore,timely detection and treatment precancerous lesions of gastric cancer become the priority among priorities in the prevention of gastric cancer.Based on metabonomics technology,this study explored the changes in metabolic level during the continuous changes from normal gastric mucosa to gastric cancer,in an attempt to find valuable biomarkers for prediction.Methods:Patients with gastric cancer(GC group),precancerous lesion(GPL group)and gastric polyp(GP group)diagnosed in the first,second and fourth Affiliated Hospitals of Anhui Medical University from June 2020 to December 2021 were enrolled,and healthy persons with stomach diseases excluded from the same hospital were selected as the control group(NC group).collected The subjects’ plasma.based on targeted Gas chromatograph-mass spectrometry(GC-MS/MS)detected the expression levels of metabolites related to energy metabolism in the subjects’ plasma.and constructed a prediction model to screen potential biomarkers of gastric cancer and precancerous lesions.Result:Based on GC-MS/MS technique,absolute quantitative analysis of 14energy-related compounds was performed.Compared with the control group,severe energy metabolism disorders occurred in the gastric polyp group,the gastric precancerous lesion group and the gastric cancer group,which were mainly manifested as inhibition of tricarboxylic acid cycle function,and up-regulation of glycolysis function.Univariate and multivariate receiver curve(ROC)were used to evaluate and detect potential biomarkers.The results showed that the single use of phosphoenolpyruvate(phosphoenolpyruvate),succinic acid and isocitric acid could better distinguish NC from gastric cancer and precancerous lesion patients,and the area under the curve(AUC)was 0.883,0.879 and 0.813,respectively.The combination of phosphoenolpyruvate,succinic acid and isocitric acid could better distinguish NC from gastric cancer and precancerous lesions.The area under curve(AUC)was up to0.970,and the sensitivity and specificity were 91.8% and 94.7%.Conclusion:During the process from normal gastric mucosa to precancerous lesions to gastric cancer,significant energy metabolism disorders occurred in plasma samples,which were mainly reflected in the decrease of tricarboxylic acid circulation and the enhancement of glycolysis pathway.Phosphoenolpyruvate,succinic acid and isocitric acid have great potential in biomarker research of screening for early gastric cancer,which provides certain information for biomarker research of screening and diagnosis of early gastric cancer. |
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