食管鳞状细胞癌血清中乙酰肉碱的代谢水平及其诊断价值  

Metabolic level of serum acetyl⁃carnitine in esophageal squamous cell carcinoma and its di⁃agnostic value

作　　者：姚庆春 吴龙俊宇 叶春华 黎远冬[1] 张春燕[1] YAO Qingchun;WU Longjunyu;YE Chunhua;LI Yuandong;ZHANG Chunyan(Department of Experimental Research,Guangxi Medical University Cancer Hospital,Nanning 530021,China)

机构地区：[1]广西医科大学附属肿瘤医院实验研究部,南宁530021

出　　处：《中国癌症防治杂志》2024年第2期198-204,共7页CHINESE JOURNAL OF ONCOLOGY PREVENTION AND TREATMENT

基　　金：国家自然科学基金项目(81860527)。

摘　　要：目的探讨肉碱(L‐carnitine)和乙酰肉碱(acetyl‐carnitine,ACar 2∶0)对食管鳞状细胞癌(esophageal squamous cell carcinoma,ESCC)的诊断价值。方法收集2022年4月至2022年10月在广西医科大学附属肿瘤医院收治的31例ESCC患者以及同期就诊的30名健康志愿者的血清样本。采用超高效液相色谱‐四级杆飞行时间串联质谱(UHPLC‐QTOF‐MS/MS)技术靶向分析血清中肉碱和乙酰肉碱的代谢变化,采用受试者工作特征(receiver operating characteristic,ROC)曲线评价诊断效能。结果与健康对照者相比,ESCC患者血清中的肉碱水平差异无统计学意义(P=0.149),两种乙酰肉碱同分异构体(ACar 2∶0同分异构体1和ACar 2∶0同分异构体2)的水平升高(均P<0.001)。多因素分析结果显示,ACar 2∶0同分异构体1含量高于0.0163μmol/L(OR=19.456,95%CI:1.971~192.104,P=0.011)和ACar 2∶0同分异构体2含量高于0.0148μmol/L(OR=7.720,95%CI:1.047~56.915,P=0.045)是ESCC发生的危险因素,而肉碱(OR=1.310,95%CI:0.051~33.951,P=0.871)则与ESCC发生无明显关系。ACar 2∶0同分异构体1诊断ESCC的ROC曲线下面积(area under curve,AUC)及敏感度和特异度分别为0.957、0.900、0.862,ACar 2∶0同分异构体2诊断ESCC的AUC及敏感度和特异度分别为0.901、0.867、0.821,两者联合诊断ESCC的AUC及敏感度和特异度分别为0.952、0.867、0.889。结论ESCC血清中乙酰肉碱水平升高,且其在诊断ESCC中具有良好的效能,可能是潜在的诊断标志物。Objective To investigate the diagnostic values of L‐carnitine and acetyl‐carnitine(ACar 2:0)in esophageal squamous cell carcinoma(ESCC).Methods The serum of 31 ESCC patients from Guangxi Medical University Cancer Hospital from April 2022 to October 2022 were collected and 30 healthy volunteers during the same period were recruited.Ultra‐high performance liquid chromatography and quadrupole time‐of‐flight mass spectrometry(UHPLC‐QTOF‐MS/MS)was used to targetedly analyze the serum metabolic changes of L‐carnitine and acetyl‐carnitine.The diagnostic efficiency was evaluated by receiver operating characteristic(ROC)curve.Results Compared with the case in healthy controls,there was no significant difference in serum carnitine level in ESCC patients(P=0.149),and the levels of two acetyl‐carnitine isomers(ACar 2∶0 isomer1 and ACar 2∶0 isomer 2)were increased(both P<0.001).Multivariable analysis showed that ACar 2∶0 isomer 1>0.0163μmol/L(OR=19.456,95%CI:1.971-192.104,P=0.011)and ACar 2∶0 isomer 2>0.0148μmol/L(OR=7.720,95%CI:1.047-56.915,P=0.045)weretheriskfactorsforESCC,whileL‐carnitine(OR=1.310,95%CI:0.051-33.951,P=0.871)was not significantly associated with ESCC.The two acetyl‐carnitine isomers had a good ability to distinguish between ESCC and healthy controls.The area under curve(AUC),sensitivity and specificity of ACar 2∶0 isomer 1 in the diagnosis of ESCC were 0.957,0.900 and 0.862,respectively.The AUC,sensitivity and specificity of ACar 2∶0 isomer 2 in the diagnosis of ESCC were 0.901,0.867 and 0.821,respectively.The AUC,sensitivity and specificity of combining ACar 2∶0 isomer 1 and ACar 2∶0 isomer 2 in the diagnosis of ESCC were 0.952,0.867 and 0.889,respectively.Conclusions Serum acetylcarnitine level increases in ESCC,showing a good efficacy in the diagnosis of ESCC,and may become a potential diagnostic marker.

关 键 词：食管鳞状细胞癌 乙酰肉碱 靶向代谢组学 诊断 

分 类 号：R733.1[医药卫生—肿瘤]