Study Of Differentiating Colorectal Cancer And Colorectal Polyp By Using Dried Blood Spot Mass Spectrometry Metabolomic Approach

Objective Colorectal cancer(CRC)is the third leading cause of cancer mortality,and the early-stage detection could significantly enhance survival rates.An accurate screening and diagnosis strategy performed in an easy-to-operate manner is highly warranted in clinical perspective.Cancer influences the important metabolic pathways.Blood is full of small molecular metabolites with diverse structures and properties and the changes of metabolite levels had been used in many studies as the potential biomarkers.This study is aimed at screening metabolite biomarkers with CRC diagnosis potentials.Methods The direct infusion mass spectrometry(MS)metabolomic analysis based on dried blood plot was used to distinguish CRC and polyp.The target metabolites were composed of 23 amino acids and 26 acylcarnitines using DBS samples from 85 CRC patients,81 colorectal polyp patients.Partial least squares-discriminant analysis(PLS-DA)model was constructed.It was used to analysis the data and check the difference between colorectal cancer patients and colorectal polyp patients.It was to find out the metabolites that distinguish between experimental group and control group,and verification of these metabolites in colorectal cancer patients and colorectal polyp patients discriminating ability.21 CBC-related metabolites in blood were selected via multivariate analysis.A regression model was established based on parameters C16(P<0.0001),Arg(P<0.0001),C4/C8(P=0.0006),C5/C3(P<0.0001),Val(P=0.0042),Phe/Tyr(P=0.0018),Ala(P=0.0187),C4/C3(P=0.0057).Ten-fold cross validation(CV)method was used to test this model.The receiver operating characteristic(ROC)curve was used to evaluate the diagnosis model,and showed sensitivity of 81.18% and specificity of 83.95%,and AUC was 0.909.ResultsConclusions In this study,a reasonable diagnostic regression model with eight blood parameters including C16,Arg,C4/C8,C5/C3,Val,Phe/Tyr,Ala,C4/C3 was established,which could be used to distinguish CRC from polyp.The direct infusion mass spectrometry based on dried blood spot can be used to facilitate CRC screening and early diagnosis.