The Metabolomics Analysis Of The Serum Changes In Postoperative Patients With Papillary Thyroid Carcinoma

Objective: Analyze patients postoperative metabolic changes after two different surgical approaches to papillary thyroid carcinoma and pre- and postoperative differences in metabolomics of patients, It will provide theoretical support for choice of operation.Method: 1. Select the serum specimens of 34 patients(Group C) 12 months after papillary thyroid carcinoma surgery and 29 patients(Group M) 24 months after papillary thyroid carcinoma surgery from those admitted to Thyroid Surgery Department of Union Hospital Affiliated to Fujian Medical University from July, 2013 to July 2014 in accordance with inclusion criteria. Group C was further divided to C1 and C2 and Group M M1 and M2 according to two different surgical approaches patients had, that is, hemi thyroidectomy and total thyroidectomy. Meanwhile, collect serum specimens of 20 healthy controls(Group H) and 20 brain tumor patients before surgery in accordance with inclusion criteria. 2. The patients were in TSH suppression therapy after operation according to CTA guidelines and indicators met standards and imaging examination showed no tumor residual or recurrence after surgery. 3. The serum specimens were analyzed with Switzerland Bruker 500 Hz NMR. 4. Mest Renova(V7.0) was used to phase and correct the baseline; glucose was taken to calibrate(? 5.23) and subsection integrals(0.002ppm/subsection) were used in the spectra(0.0 – 0.5ppm). 5. Analyzed the differences of serum metabolites between the group with hemi thyroidectomy and the group with total thyroidectomy 12 and 24 months after the operation respectively by studying PCA, PLS-DA, OPLS-DA with SIMCA-P+ and the differences of two groups' serum metabolites at different time.Results: 1. Compared with Group H, Group C1 and C2 showed a clustering tendency in PCA. The established PLS-DA model had a higher reliability and predictability(Group C1 vs Group H R2X=36.1%, R2Y=0.933, Q2=0.853;Group C2 vs Group H R2X=35.0%, R2Y=0.847, Q2=0.711). In the analysis of OPLS-DA and correlation coeciffient, it was found that the serum of patients after operation, compared with healthy controls, had lower leucine, isoleucine, valine, 3-HB, glutamate, glutamine,Citrate,choline, lactate, formc acid and higher glucose. 2. Compared with Group H, Group M1 and M2 showed a clustering tendency in PCA. The established PLS-DA model had a higher reliability and predictability(Group M1 vs Group H R2X=38.2%, R2Y=0.937, Q2=0.887;Group M2 vs Group H R2X=37.1%, R2Y=0.843, Q2=0.657). In the analysis of OPLS-DA and correlation coeciffient, it was found that the serum of patients after operation, compared with healthy controls, had lower leucine, isoleucine, valine, 3-HB, glutamate, glutamine,Citrate,choline, lactate, formc acid and higher glucose. 3. Compared with Group M1 and M2, Group C1 and C2 showed a clustering tendency in PCA. The established PLS-DA model had a higher reliability and predictability(Group C1 vs Group C2 R2X=24.9%, R2Y=0.801, Q2=0.445;Group M1 vs Group M2 R2X=59.3%, R2Y=0.976, Q2=0.549). In the analysis of OPLS-DA and correlation coeciffient, it was found that the serum of patients after two different operations at the same time had lower valine,Alanine, glutamine,Citrate,choline, Glycine and higher lactate. 4. Compared with Group C and T, Group M and T showed a clustering tendency in PCA. The established PLS-DA model had a higher reliability and predictability(Group C vs Group T R2X=25.2%, R2Y=0.888, Q2=0.773;Group M vs Group T R2X=24.9%, R2Y=0.886, Q2=0.747). In the analysis of OPLS-DA and correlation coeciffient, it was found that the serum of postoperative patients had lower valine,3-HB,Alanine, Acetate,OAG,Citrate,Glycine,Choline,Tyrosine,Histidine and higher Glutamine,DMG than preoperative patients.Conclusion:1.After eliminating tumorigenic factors,the pathway of body metabolic is blocked. 2.There are significant metabolic differences in amino acid in the patients with different operative methods at the same time. 3.As the extension of time, the diversity of metabolics with different operative methods are gradually narrow. 4. The postoperative patients with abnormal metabolism of the body with sugars, amino acids, lipid may be associated with the TSH suppression therapy caused by subclinical hyperthyroidism.