Thus, identifying novel potential biomarkers for CRC and investigating the molecular mechanisms of CRC metastasis are essential for diagnosis, treatment and prognosis of this disease.Ĭancer cells exhibit distinct metabolic phenotypes, which are essential for supporting high proliferative rates. Unfortunately, mechanisms underlying metastasis are still largely unknown. The overall five-year survival rate (FYSR) can reach 80-90% for non-metastatic CRC patients, while those diagnosed at advanced stages have only a 13% FYSR (5). Unfortunately, only 40% of CRC patients are diagnosed at early, localized stages of the disease. In theory, CRC patients with localized tumor and without lymph node or distant metastases (i.e., stages I and II), may be cured by surgical resection alone.
Among various metastatic pathways, the lymph node system plays an important role in affecting the prognosis of CRC patients, and serves as the most frequent pathway for metastasis. Although the disease has good therapeutic response at early stages, advanced stages are associated with poor prognosis. Most CRC patients are diagnosed at an advanced stage with lymph node metastasis. In fact, current estimates predict that 5% of the population will be diagnosed with CRC at some point in their lifetime (4). According to the American Cancer Society, CRC is the third most common malignancy among both genders in the USA (2), and more than 136,000 new CRC cases were diagnosed in 2014 and an estimated 50,000 deaths were reported in 2015 in the USA alone (3). The results suggest the promising application of these metabolites in clinical therapy, and further understanding of the related mechanism warrants further investigation.Ĭolorectal cancer (CRC) is one of the most prevalent types of cancer worldwide (1). The identified metabolites may be associated with the neoplasia, invasion and metastasis of the tumor. The present study firstly staged CRC patients by lymph node metastasis by metabolomic approach. In total, 10 tissue metabolites were significantly disturbed between non-metastatic and metastatic CRC patients. Excellent separation was obtained between CRC patients and normal controls, and CRC patients were also perfectly classified according to lymph node metastasis.įorty-two distinguishing metabolites were identified, which revealed disturbance of glycolysis, glutaminolysis, fatty acid metabolism, choline metabolism and amino acids, suggesting that cellular functions in energy production, macromolecular synthesis, oxidative stress and immune escape of cancer cells are affected in CRC. The metabolic profiling of tissue samples from a large cohort of lymph node non-metastatic CRC patients (n=73), lymph node metastatic CRC patients (n=52) and normal controls (n=41) was performed using nuclear magnetic resonance (NMR) together with multivariate statistical analyses. Lymph node metastasis is a decisive prognostic and therapeutic staging factor for colorectal cancer (CRC), which is one of the most prevalent types of cancer and a malignant tumor.
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