Study On The Value Of Serum Monosaccharide In The Diagnosis Of Colorectal Cancer

Objective: To compare the hydrolyzed monosaccharides and free monosaccharides in serum from colorectal cancer(CRC)patients and healthy patients based on high performance liquid chromatography(HPLC),then to analyze the difference of hydrolyzed monosaccharides and free monosaccharides in different clinical pathology groups,so as to provide a new direction and research basis for the auxiliary diagnosis of CRC from the aspect of monosaccharides which constitute the sugar chain.Methods: A total of 210 sera were collected,including 105 patients with CRC and 105 healthy controls.The patients with CRC were firstly treated at the Affiliated Hospital of Qingdao University and were confirmed by histopathology from July 2017 to March 2018.The healthy controls were volunteers for health checkups at the Affiliated Hospital of Qingdao University during the same period.The chromatograms of monosaccharides were obtained by PMP derivatization and HPLC analysis.Then the standard curves and equations of different kinds of monosaccharides were drawn according to the concentrations and peak area.The hydrolyzed serum samples and unhydrolyzed samples were derived by PMP and analyzed by HPLC to obtain chromatograms.The peak area of the different kinds of monosaccharides in the sample were taken to the equations of monosaccharide standard,and the concentrations of the corresponding monosaccharides were calculated.Compared the differences between CRC patients and healthy patients of hydrolyzed monosaccharides and free monosaccharides concentrations.Then CRC patients were divided into groups according to age,gender,tumor infiltration degree,lymph node metastasis,distant metastasis,tumor location and TNM staging in order to compare the differences of monosaccharides in different clinical pathology grouping.After the ROC curve was drawn to evaluate the value of monosaccharides in the diagnosis of CRC.At the same time by combining different monosaccharide indicators to improve diagnostic efficiency.Results: 1.The concentrations of GlcN?Glc A?Glc?Fuc in CRC patients were significantly higher than healthy patient(P<0.05).2.The concentrations of Man and Gal in patients of 60 years old and more than 60 years old were significantly higher than patients under 60 years old(P<0.05);Compared with the non-penetrating muscle layer group,the concentrations of GlcN?Glc A?Glc were significantly decreased,while the concentration of Fuc was significantly increased in penetrating muscle layer group(P<0.05);Compared with the negative lymph node metastasis,the concentration of Fuc was significantly increased,while the concentrations of GlcN?Glc A?Glc were significantly decreased in positive patients with significant differences(P<0.05);Compared with the non-distant metastasis group,the concentration of Fuc was significantly increased,while the concentrations of Glc A?Glc were significantly decreased in distant metastasis group(P<0.05);The concentrations of Man?Gal N?Glc?Gal?Fuc were different among left colon caner patients?right colon cancer patients and rectal cancer patients,the differences were statistically significant(P<0.05);The concentrations of GlcN?Glc A?Glc?Fuc were different among different TNM staging patients,and the above differences were statistically significant(P<0.05);There were no significant differences in the concentrations of eight kinds of monosaccharides in the gender group(P>0.05).3.The diagnostic sensitivity of Glc A was 84.8%,and the specificity of Fuc was 74.3%.The sensitivity and specificity of a set of monosaccharides inculing GlcN?Glc A?Glc?Fuc to diagnose CRC was 85.7% and 78.1%.The specificity and sensitivity of this set were better than any kinds of monosaccharides.4.The concentration of free Man in CRC patients was significantly lower than healthy patients(P<0.05).5.There were no significant differences in the concentration of free Man in serum among age,gender,tumor infiltration depth,lymph node metastasis,distant metastasis,tumor location and TNM staging groups(P>0.05).6.The diagnostic sensitivity of free Man was 84.8%,but the specificity was only 37.1%.Conclusion: 1.Glc?GlcA?GlcN and Fuc are significantly elevated in CRC patients,while free Man is significantly reduced.2.The combination of four kinds of monosaccharides including of Glc?Glc A?GlcN?Fuc and free Man maybe have high diagnostic value for CRC.