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  3. Integrative plasma and fecal metabolomics identify functional metabolites in adenoma-colorectal cancer progression and as early diagnostic biomarkers

Integrative plasma and fecal metabolomics identify functional metabolites in adenoma-colorectal cancer progression and as early diagnostic biomarkers

  • Cancer Cell. 2024 Aug 12;42(8):1386-1400.e8. doi: 10.1016/j.ccell.2024.07.005.
Yang Sun 1,  Xiang Zhang 2,  Dong Hang 3,  Harry Cheuk-Hay Lau 2,  Jie Du 4,  Chuanfa Liu 2,  Mingxu Xie 2,  Yasi Pan 2,  Le Wang 5,  Cong Liang 6,  Xingyu Zhou 2,  Danyu Chen 2,  Jiamei Rong 1,  Zengren Zhao 7,  Alvin Ho-Kwan Cheung 8,  Yuet Wu 2,  Hongyan Gou 2,  Chi Chun Wong 2,  Lingbin Du 5,  Junliang Deng 4,  Zhibin Hu 3,  Hongbing Shen 9,  Yinglei Miao 10,  Jun Yu 11
Affiliations

Affiliations

  • 1 Department of Gastroenterology, The First Affiliated Hospital of Kunming Medical University, Yunnan Province Clinical Research Center for Digestive Disease, Yunan Geiatric Medical Center, Kunming, Yunnan, China.
  • 2 Institute of Digestive Disease, Department of Medicine and Therapeutics, State Key Laboratory of Digestive Disease, Li Ka Shing Institute of Health Sciences, CUHK Shenzhen Research Institute, The Chinese University of Hong Kong, Hong Kong SAR, China.
  • 3 Department of Epidemiology, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China.
  • 4 Biotree Metabolomics Technology Research Center, Shanghai, China.
  • 5 Department of Cancer Prevention, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, China.
  • 6 Institute of Precision Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
  • 7 Department of Gastrointestinal Surgery, Hebei Key Laboratory of Colorectal Cancer Precision Diagnosis and Treatment, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
  • 8 Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Hong Kong SAR, China.
  • 9 Department of Epidemiology, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China. Electronic address: hbshen@njmu.edu.cn.
  • 10 Department of Gastroenterology, The First Affiliated Hospital of Kunming Medical University, Yunnan Province Clinical Research Center for Digestive Disease, Yunan Geiatric Medical Center, Kunming, Yunnan, China. Electronic address: myldu@sina.com.
  • 11 Institute of Digestive Disease, Department of Medicine and Therapeutics, State Key Laboratory of Digestive Disease, Li Ka Shing Institute of Health Sciences, CUHK Shenzhen Research Institute, The Chinese University of Hong Kong, Hong Kong SAR, China. Electronic address: junyu@cuhk.edu.hk.
PMID: 39137727 DOI: 10.1016/j.ccell.2024.07.005
Abstract

Changes in plasma and fecal metabolomes in colorectal Cancer (CRC) progression (normal-adenoma-CRC) remain unclear. Here, plasma and fecal samples were collected from four independent cohorts of 1,251 individuals (422 CRC, 399 colorectal adenoma [CRA], and 430 normal controls [NC]). By metabolomic profiling, signature plasma and fecal metabolites with consistent shift across NC, CRA, and CRC are identified, including CRC-enriched oleic acid and CRC-depleted allocholic acid. Oleic acid exhibits pro-tumorigenic effects in CRC cells, patient-derived organoids, and two murine CRC models, whereas allocholic acid has opposing effects. By integrative analysis, we found that oleic acid or allocholic acid directly binds to α-enolase or farnesoid X receptor-1 in CRC cells, respectively, to modulate cancer-associated pathways. Clinically, we establish a panel of 17 plasma metabolites that accurately diagnoses CRC in a discovery and three validation cohorts (AUC = 0.848-0.987). Overall, we characterize metabolite signatures, mechanistic significance, and diagnostic potential of plasma and fecal metabolomes in CRC.

Keywords

biomarkers; colorectal adenoma; colorectal cancer; cytokines; fecal metabolites; integrative analysis; microbiota; non-invasive diagnosis; plasma metabolites.

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