Matthew F Buas1, Haiwei Gu2, Danijel Djukovic2, Jiangjiang Zhu2, Lynn Onstad3, Brian J Reid4, Daniel Raftery5, Thomas L Vaughan6. 1. Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, 98109 USA; Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, 14263 USA. 2. Northwest Metabolomics Research Center, Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, WA 98109 USA. 3. Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, 98109 USA. 4. Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, 98109 USA; Division of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, WA 98109 USA. 5. Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, 98109 USA; Northwest Metabolomics Research Center, Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, WA 98109 USA. 6. Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, 98109 USA; Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, 98109 USA.
Abstract
INTRODUCTION/ OBJECTIVES: Incidence of esophageal adenocarcinoma (EA), an often fatal cancer, has increased sharply over recent decades. Several important risk factors (reflux, obesity, smoking) have been identified for EA and its precursor, Barrett's esophagus (BE), but a key challenge remains identifying individuals at highest risk, since most with reflux do not develop BE, and most with BE do not progress to cancer. Metabolomics represents an emerging approach for identifying novel biomarkers associated with cancer development. METHODS: We used targeted liquid chromatography-mass spectrometry (LC-MS) to profile 57 metabolites in 322 serum specimens derived from individuals with gastroesophageal reflux disease (GERD), BE, high-grade dysplasia (HGD), or EA, drawn from two well-annotated epidemiologic parent studies. RESULTS: Multiple metabolites differed significantly (P<0.05) between BE versus GERD (n=9), and between HGD/EA versus BE (n=4). Several top candidates (FDR q≤0.15), including urate, homocysteine, and 3-nitrotyrosine, are linked to inflammatory processes, which may contribute to BE/EA pathogenesis. Multivariate modeling achieved moderate discrimination between HGD/EA and BE (AUC=0.75), with less pronounced separation for BE versus GERD (AUC=0.64). CONCLUSION: Serum metabolite differences can be detected between individuals with GERD versus BE, and between those with BE versus HGD/EA, and may help differentiate patients at different stages of progression to EA.
INTRODUCTION/ OBJECTIVES: Incidence of esophageal adenocarcinoma (EA), an often fatal cancer, has increased sharply over recent decades. Several important risk factors (reflux, obesity, smoking) have been identified for EA and its precursor, Barrett's esophagus (BE), but a key challenge remains identifying individuals at highest risk, since most with reflux do not develop BE, and most with BE do not progress to cancer. Metabolomics represents an emerging approach for identifying novel biomarkers associated with cancer development. METHODS: We used targeted liquid chromatography-mass spectrometry (LC-MS) to profile 57 metabolites in 322 serum specimens derived from individuals with gastroesophageal reflux disease (GERD), BE, high-grade dysplasia (HGD), or EA, drawn from two well-annotated epidemiologic parent studies. RESULTS: Multiple metabolites differed significantly (P<0.05) between BE versus GERD (n=9), and between HGD/EA versus BE (n=4). Several top candidates (FDR q≤0.15), including urate, homocysteine, and 3-nitrotyrosine, are linked to inflammatory processes, which may contribute to BE/EA pathogenesis. Multivariate modeling achieved moderate discrimination between HGD/EA and BE (AUC=0.75), with less pronounced separation for BE versus GERD (AUC=0.64). CONCLUSION: Serum metabolite differences can be detected between individuals with GERD versus BE, and between those with BE versus HGD/EA, and may help differentiate patients at different stages of progression to EA.
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