泌尿上皮癌患者尿液中代謝體分析

李允仁、楊佩珊、侯鎮邦、陳建綸、張慧朗、林友翔、崔克宏

林口長庚紀念醫院外科部 泌尿科系

The Clinical Experiences of Urine Metabolomics of Genitourinary Urothelial Cancer in a Tertiary Hospital in Taiwan

Yun-Ren Li, Pei-Shan Yang, Chen-Pang Hou, Chien-Lun Chen, Phei-Lang Chang, Yu-Hsiang Lin and Ke-Hung Tsui

Department of Urology, Chang-Gung Memorial Hospital, Taoyuan, TAIWAN

Purpose:

There are only a few studies have addressed the impact of diagnostic urine metabolites and clinical outcomes associated with genitourinary urothelial (GU) cancer up till this date. Furthermore, the longitudinal analysis of the dynamics of urine metabolites contributing to the detection of GU cancer has not yet been fully investigated; therefore, the discovery of novel diagnostic urine biomarkers is of our enormous interest.

Materials and Methods:

We explored the correlation of the urine metabolomics profiles to the GU cancers. The aqueous metabolites of the GU cancer and the control were also identified and analyzed through high-resolution1H nuclear magnetic resonance (NMR) spectroscopy. Compared with the control, the urine metabolites of the tumor were studied in relation to changes over time in a linear mixed model for repeated measures.

Results:

The urine metabolom of eighty-two (58 males and 24 female) patients with GU cancers were systemically analyzed. The urine metabolite profile in GU cancer was significantly higher than those in the control group (p < 0.05). Seven urine metabolites including histidine, propylene glycol, valine, leucine, acetylsalicylate, glycine and isoleucine as well as other pathways were identified statistically significantly associated with GU cancer detection with longitudinal analysis. We discovered that histidine, propylene glycol, valine, leucine, acetylsalicylate, glycine, isoleucine, succinic acid, lysine2-aminobutyric acid and acetic acid are involved significantly in the all types of the male patients. We did not find any statistically significance in urine biomarkers between female and male patients. However, a statistically insignificant correlation was found among the grade and stage with the metabolites.

Conclusion:

The urine metabolomic profiles of the GU tumors and the control group are distinct. The urine metabolites of the male patients of the upper tract urothelial carcinoma (UTUC) were found statistically significance compared with the control.