摘要
目的研究非小细胞肺癌(non-small cell lung cancer,NSCLC)中医证型与肿瘤组织代谢组学的相关性。方法 120例NSCLC患者按照中医辨证分为虚证组和实证组,每组60例;同期收集体检为肺部结节良性者60例作为对照组。运用胸腔镜技术获取3组肿瘤或良性结节组织,运用气相色谱-质谱(gas chromatography-mass spectrometry,GC-MS)法观察其代谢物成分的变化,运用主成分分析(PCA)及偏最小二乘法(PLS-DA)对其进行差异性研究,在此基础上,对虚证、实证组具有差异性的代谢化合物进行ROC曲线分析,并计算曲线下面积(AUC)以进一步评估其对证型诊断的敏感性。结果两肿瘤组(虚证组、实证组)与对照组比较:16个化合物存在差异,其中十六酸、柠檬酸、丙酮酸、丙氨酸、磷酸胆碱、甘油磷酸胆碱、亚油酸、油酸、乳酸、肌醇含量肿瘤组高于对照组,缬氨酸、葡萄糖、谷氨酰胺、亮氨酸、异亮氨酸、赖氨酸含量对照组高于肿瘤组;虚证组与实证组比较:10个化合物存在差异,其中柠檬酸、丙酮酸、丙氨酸、磷酸胆碱、甘油磷酸胆碱、乳酸、肌醇含量虚证组高于实证组,缬氨酸、葡萄糖、谷氨酰胺含量实证组高于虚证组。差异化合物的ROC曲线分析示:乳酸及葡萄糖AUC>0.8(P<0.01),肌醇、磷酸胆碱及甘油磷酸胆碱AUC>0.7(P<0.01),而缬氨酸、柠檬酸、谷氨酰胺、丙氨酸及丙酮酸AUC>0.6(P<0.05)。结论NSCLC中医证型与肺癌组织代谢组学存在一定相关性;乳酸、葡萄糖、肌醇、磷酸胆碱、甘油磷酸胆碱、缬氨酸、柠檬酸、谷氨酰胺、丙氨酸及丙酮酸为其敏感的诊断化合物,而以前4者最为敏感。
Objective To study the relationship between Chinese medical syndrome types and metabolomics of non-small cell lung cancer（NSCLC） patients.Methods Totally 120 NSCLC patients were assigned to asthenia syndrome group and sthenia syndrome group,60 in each group.Meanwhile,60 cases of benign pulmonary nodules in physical examinations were recruited as the control group.Tumor tissues or benign pulmonary nodules tissues were obtained by thoracoscope.Changes of their metabolites were observed using gas chromatography-mass spectrometry（GC-MS）.Their differences were studied using principal component analysis（PCA） and partial least-squares discriminant analysis（PLSDA）.ROC curve analysis was performed in different metabolic compounds of sthenia and asthenia syndromes groups.The area under the curve（AUC） was calculated to evaluate the sensitivity of diagnosing syndrome types.Results Compared with the control group,difference existed in 16 compounds.Of them,contents of citric acid,pyruvic acid,alanine,choline phosphate,glycerol phosphate choline,linoleic acid,oleic acid,lactic acid,inositol were more in the two tumors group than in the control group.Difference existed in 10 compounds between the sthenia syndrome group and the asthenia syndrome group.Of them,citric acid,pyruvic acid,alanine,choline phosphate,glycerol phosphate choline,lactic acid,and inositol were more in the asthenia syndrome group than in the sthenia syndrome group.Contents of valine,glucose,and glutamine were more in the sthenia syndrome group than in the asthenia syndrome group.ROC curve analyses of different compounds indicated that AUC of lactic acid and glucose was more than 0.8（P 〈0.01）;AUC of inositol,choline phosphate,and glycerol phosphate choline was more than 0.7（P 〈0.01）;AUC of valine,citric acid,glutamine,alanine,and pyruvic acid was more than 0.6（P〈0.05）.Conclusions There existed certain correlation between CM syndrome types and metabolomics of lung cancer.Lactic acid,glucose,inositol,choline phosphate,glycer
出处
《中国中西医结合杂志》
CAS
CSCD
北大核心
2015年第6期659-663,共5页
Chinese Journal of Integrated Traditional and Western Medicine
基金
国家自然科学基金资助项目(No.81273639)
江苏省中医药管理局科技项目(No.LB13042)
关键词
胸腔镜
中医证型
非小细胞肺癌
代谢组学
thoracoscope
Chinese medical syndrome type
non-small cell lung cancer
metabonomics
