原发性肝癌阳虚证患者血清代谢组特征初步研究  

Preliminary Study of Serum Metabonomics on Yang Deficiency Syndrome of Patients with Primary Liver Cancer

作　　者：陈群伟[1,2] 黄雪强[1] 杨根金[3] 戴卫星[3] 郎庆波[1] 严诗楷[3] 周俊[1] 张卫东[3] 凌昌全[1] 

机构地区：[1]上海长海医院中医科,上海200433 [2]浙江省中医院肿瘤科,浙江杭州310006 [3]第二军医大学药学院,上海200433

出　　处：《中华中医药学刊》2012年第3期526-529,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(30873219)

摘　　要：目的:探讨原发性肝癌阳虚证患者血清代谢组模式改变特征,为实现肝癌阳虚证诊断的客观化、规范化提供依据。方法:应用肝癌基本证候定性诊断标准和量化分析模型判定原发性肝癌基本证候类别,将42例原发性肝癌患者分成阳虚证组21例,非阳虚证组21例作为对照病例。应用基于核磁共振波谱(NMR)技术的代谢组学研究方法获得血清1H NMR谱,用偏最小二乘法-判别分析(PLS-DA)等模式识别、多元统计分析方法,发掘不同基本证候样本代谢组变化模式,并对主要差异代谢物进行鉴定,分析其生物学意义。结果:利用1H NMR谱信息,用PLS-DA分析可以把阳虚证组和非阳虚证组代谢谱变化区分开,代谢物鉴定发现,肝癌阳虚证组和非阳虚证组有显著统计学意义(P<0.05)的差异代谢物有6类,分别是极低密度脂蛋白/低密度脂蛋白(VLDL/LDL)、异亮氨酸、乳酸、脂类、胆碱、葡萄糖/糖类。这些差异代谢物浓度肝癌阳虚证组较非阳虚证组明显下降。结论:肝癌阳虚证与非阳虚证代谢谱的差异提示阳虚证特征性代谢网络的失调,主要表现为脂类代谢、氨基酸代谢、糖代谢、能量代谢等多种代谢的紊乱或衰减,VLDL/LDL、异亮氨酸、乳酸、脂类、胆碱、葡萄糖/糖类等代谢物浓度的下降可能是肝癌阳虚证特征性的代谢物改变,是潜在的肝癌阳虚证生物标志物。Objective：In this study, we try to investigate the serum metabolic variations in Yang deficiency syndrome of patients with primary liver cancer（PLC） ,and try to provide evidence for objectification and standardization in TCM syndromes diagnosis of PLC. Methods ： Basic syndrome types of 42 patients with PLC were classified by PLC TCM syndrome qualitative diagnosis criteria and quantitative diagnosis model into two groups, including Yang deficiency syndrome group （21 cases） and non- Yang deficiency syndrome group （21 cases）. Serum samples were analyzed to acquire metabolic profiles using the metabonomics technology based on nuclear magnetic resonance（NMR）. Partial least squares discrimi- nant analysis（ PLS -DA） was applied to visualize the variation patterns in metabolic profiles of sera from different groups, then to identify the differential metabolites and analyze the biological characteristics. Results ： The difference of serum metabolite profiling was differentiated by PLS - DA model between Yang deficiency syndrome group and non - Yang deficiency syndrome group. We found and identified 6 kinds of Significant differential metabolites （P 〈 0.05 ） ） between PLC Yang deficiency syndrome group and non - Yang deficiency syndrome group ： VLDL/LDL, isoleucine, lactate, lip- ids, choline, glucose/sugars. The concentration of these differential metabolites in serum of Yang deficient patients with PLC were decreased than non - Yang deficient patients. Conclusions ： Multiple metabolisms, including amino acid metab- olism, lipid metabolism, glycometabolism, energy metabolism, and so on, are unbalanced or weak in Yang deficient patients with PLC. The decreased concentration of metabolites, including VLDL/LDL, isoleucine, lactate, lipids, choline and glucose/sugars in serum may be the distinctive metabolic variations of Yang deficient patients with PLC. And these metabolites may be potential biomarkers for diagnosis of Yang deficiency syndrome in PLC patients.

关 键 词：原发性肝癌 代谢组学 阳虚证 核磁共振波谱 血清 偏最小二乘法判别分析 

分 类 号：R735.7[医药卫生—肿瘤]