Plasma Metabolomic Profiling Distinguishes Right-Sided From Left-Sided Colon Cancer

Clin Chim Acta. 2018 Dec;487:357-362. doi: 10.1016/j.cca.2018.10.010. Epub 2018 Oct 5.


Background: Many studies have demonstrated that right-sided colon cancer (RCC) has a higher mortality rate and worse prognosis than left-sided colon cancer (LCC). However, the underlying biological mechanism that can account for these differences is unclear.

Methods: In this study, plasma metabolic profiles in 147 LCC patients and 105 RCC patients were systematically analyzed by the ultra high performance liquid chromatography quadruple time-of-flight mass spectrometry (UHPLC-QTOF/MS) platform in conjunction with univariate and multivariate statistical analysis.

Results: Metabolic signatures revealed considerable differences between patients with RCC and LCC, and clear separations were observed between the two groups in partial least-squares discriminant analysis score plots. In total, six metabolites were identified as potential metabolite markers for tumor location in RCC compared with LCC, including upregulated trimethylamine N-oxide and indoxyl sulfate, and downregulated anserine, L-targinine, gamma-glutamyl-gamma-aminobutyraldehyde and pyridoxal 5'-phosphate. These differences highlight that significant alternations occur in the pathways of methane metabolism, arginine and proline metabolism, histidine metabolism, beta-alanine metabolism and vitamin B6 metabolism in RCC compared with LCC.

Conclusions: Identified biomarkers and metabolic pathways may facilate our understanding of the different mortality rates and prognoses between RCC and LCC.

Keywords: Colorectal cancer; Left-sided colon cancer; Metabolomics; Plasma; Right-sided colon cancer; Tumor location.

MeSH terms

  • Biomarkers, Tumor / blood
  • Biomarkers, Tumor / metabolism*
  • Chromatography, High Pressure Liquid
  • Colonic Neoplasms / blood
  • Colonic Neoplasms / diagnosis
  • Colonic Neoplasms / metabolism*
  • Female
  • Humans
  • Male
  • Mass Spectrometry
  • Metabolomics*
  • Middle Aged
  • Multivariate Analysis


  • Biomarkers, Tumor