and HBeAg(-) patients - World Journal of Gastroenterology

and glycerol were found to be lower in the metastasis
group. Alanine and glycerol could get into the glycolytic
pathway through gluconeogenesis, which produced more
energy for the tumor progression and metastasis. The
decreased level of L-proline in the metastasis group may
be interpreted as increased demand for structural proteins
synthesis. These proteins, including receptors, membrane
channels and enzymes, play an important role in tumor
progression and metastasis [37-39] . Moreover, the higher
level of myo-inositol in metastasis group urine, was consistent
with the reduction of myo-inositol in lung cancer
tissues [40] . The amount of myo-inositol may be a potential
indicator for gastric cancer metastasis, as it has been
reported that the Gly:Myo-inositol ratio may be a useful
index for brain tumor classification [41] .
What the difference of metabolite changes of butanoic
acid and pyrimidine between the normal and the cancer
groups, and the decreased levels of butanoic acid and
L-threonic acid in the metastasis group indicates remains
unclear.
In conclusion, GC/MS revealed detailed information
on the metabolic profile of normal and cancer urine and
was found to be suitable, in tandem with the PCA model,
for the identification of metabolic variations characteristic
of the gastric cancer. Furthermore, seven metabolites
have been selected, which constructed a diagnostic model
for distinguishing the non-metastatic and the metastatic
gastric cancer. To our knowledge, this is the first report
on urinary metabolomic investigation of gastric cancer
metastasis by GC/MS. On the basis of this research, we
believe that urinary metabolomic information obtained by
GC/MS might play a significant role in the early diagnosis
and screening metastasis or recurrence of gastric cancer.
COMMENTS
Background
Gastric cancer is the second leading cause of cancer death worldwide, and in
many Asian countries. Tumor metastasis is one of the leading causes of cancer
death. Metabolic alterations play a role in the biology of cancer. The urinary
metabolites as gastric cancer or tumor recurrence biomarkers can be obtained
by investigating the urinary metabolic profiling.
Research frontiers
Metabolomics is a post-genomic research field for analysis of low molecular
weight compounds in biological systems, and its approaches offer an analysis
of metabolite level changes in biological samples. Recently, metabolomic
method has shown great potentials in identifying the new diagnostic markers
and therapeutic targets for cancers. However, metabolomic studies on cancer
metastasis remain scarce.
Innovations and breakthroughs
Recently, metabolomic studies on gastric cancer and colon cancer tissues have
been conducted. Compared with tissues and serum, markers acquired from
urine are noninvasive and convenient, especially in the patients with recurrent
gastric cancer. This is the first report on urinary metabolomic investigation in
gastric cancer using gas chromatography/mass spectrometry (GC/MS).
Applications
Potential metabolic biomarkers in urine could be used for early diagnosis and
screening the metastasis or the recurrence of gastric cancer.
Terminology
Metabolomics is a post-genomic research field for analysis of low molecular
weight compounds in biological systems, and its approaches offer an analysis
of metabolite level changes in biological samples. Because of its peak resolu-
WJG|www.wjgnet.com
Hu JD et al . Urinary metabolomic profile and gastric cancer
tion, high sensitivity and reproducibility, GC/MS has been widely utilized in
metabolomics.
Peer review
This manuscript evaluates tumor metabolism with a goal to identify possible
biomarkers with potential diagnostic value and the potential for prediction of
tumor metastasis. The authors concluded that the urinary metabolomic profiling
of each group is different, and the selected metabolites might be instructive to
clinical diagnosis or screening metastasis for gastric cancer. This is a relevant
randomized control trial using an animal model to evaluate a non-invasive
method for surveillance of gastric cancer.
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