Patients and samplesīetween 20 February 2014 and patients who met the following criteria were retrospectively enrolled in the study: (1) pathologically verified peripheral NSCLC, (2) stage IIIB or IV, (3) chemotherapy-naive (except patients with recurrence treated with adjuvant chemotherapy or adjuvant radiation), (4) an Eastern Cooperation Oncology Group (ECOG) performance status of 0 to 2, and (5) adequate pulmonary, cardiac, hepatic, renal and hematological functions to allow anticancer treatment. A written informed consent was obtained from all participants involved in this study. The study was approved by the Institutional Ethics Committee of the Jiangxi Provincial People’s Hospital. To further investigate the overall metabolic profiling of NSCLC patients and the efficacy of microwave thermal ablation in the treatment of NSCLC, metabolomics approach was introduced to give a holistic view of endogenous metabolites of the patients, which could deepen our knowledge about non-small cell lung cancer and promote the thermal ablation treatment for lung cancer, and these should be benefit for human health in the future. However, few studies take advantage of NMR spectroscopy’s ability to obtain a metabolic fingerprint of NSCLC patients after MWA treatment. In another study of temporal characterization of serum metabolite signatures in lung cancer patients undergoing chemotherapy ± radiation treatment, the feasibility of metabolites in the plasma of lung cancer patients as temporal biomarkers of clinical outcomes were discussed. Relatively lower high density lipoprotein (HDL) and higher very low density lipoprotein (VLDL) and low-density lipoprotein (LDL) in the patients’ plasma, together with increased lactate and pyruvate and decreased levels of glucose, citrate, formate, acetate, several amino acids and methanol, were detected. Rocha investigated the metabolic profile variations of plasma from lung cancer patients and healthy controls through NMR-based metabolomics. Deja and co-workers proposed that the the following metabolite biomarkers could potentially be useful in distinguishing lung cancer states: isoleucine, acetoacetate, and creatine as well as the two NMR signals of N-acetylated glycoproteins and glycerol. Ī number of NMR-based metabolomics studies have reported biomarkers that effectively discriminate between NSCLC subjects and healthy controls. The major disadvantages of these traditional indicators include poor sensitivity and specificity, which cannot effectively estimate the curative effects and predict prognosis of NSCLC patients. Efficacy evaluation of thermal ablation is currently based on the anatomical imaging, morphology or pathology examination. Therapeutic effect evaluation of MWA is very important for doctors to easily and timely adjust the treatment plan to maximize the efficacy of thermal ablation therapy. MWA has several advantages such better heating of larger tumour volumes, which is consider to be more suitable for lung tissues. At present, minimally invasive thermal therapy including radiofrequency ablation (RFA) and microwave ablation (MWA) are widely used in lung cancer patients in clinic, which use heat generated by the biological effects of tumor cells directly to cause irreversible damage or coagulation necrosis in tumor tissues. However, many patients are inoperable such as advanced non-small cell lung cancer patients and lung metastases patients. Surgery is the most preferred and effective method for lung cancer patients. It was reported that 486,555 patients died from lung cancer and the 5 year survival rate for patients was less than 20% in 2010. In China, lung cancer is the most common incident cancer and the leading cause of cancer death for both men and women in 2015. The above disturbed serum metabolites were proposed to be the potential biomarkers that may help to predict NSCLC and to evaluate the efficacy of MWA in the treatment of NSCLC. ConclusionsġH NMR-based metabolomics analysis enhanced the current understanding of the mechanisms involved in NSCLC, and uncovered the therapeutic potential of MWA for treatment of NSCLC. MWA treatment reversed the metabolic profiles of NSCLC patients towards the control group.
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ResultsĬompared with healthy controls, NSCLC patients showed significantly elevated serum levels of lactate, alanine, glutamate, proline, glycoprotein, phenylalanine, tyrosine and tryptophan, and markedly decreased serum levels of glucose, taurine, glutamine, glycine, phosphocreatine and threonine ( p < 0.05).
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Partial least squares discriminant analysis was used to analyze the data. Serum specimens collected from 43 healthy individuals, 39 patients with advanced non-small cell lung cancer (NSCLC) and 38 NSCLC patients treated with MWA, were subjected to 1H NMR-based metabolomics analysis. To find potential serum biomarkers of microwave ablation (MWA) for treatment of human lung cancer by 1H nuclear magnetic resonance (NMR)-based metabolomics analysis.