Preoperative profiles of plasma amino acids and derivatives distinguish periampullary cancer and benign disease

BMC Cancer. 2024 May 3;24(1):555. doi: 10.1186/s12885-024-12320-8.

Abstract

Periampullary cancers, including pancreatic ductal adenocarcinoma, ampullary-, cholangio-, and duodenal carcinoma, are frequently diagnosed in an advanced stage and are associated with poor overall survival. They are difficult to differentiate from each other and challenging to distinguish from benign periampullary disease preoperatively. To improve the preoperative diagnostics of periampullary neoplasms, clinical or biological markers are warranted.In this study, 28 blood plasma amino acids and derivatives from preoperative patients with benign (N = 45) and malignant (N = 72) periampullary disease were analyzed by LC-MS/MS.Principal component analysis and consensus clustering both separated the patients with cancer and the patients with benign disease. Glutamic acid had significantly higher plasma expression and 15 other metabolites significantly lower plasma expression in patients with malignant disease compared with patients having benign disease. Phenylalanine was the only metabolite associated with improved overall survival (HR = 0.50, CI 0.30-0.83, P < 0.01).Taken together, plasma metabolite profiles from patients with malignant and benign periampullary disease were significantly different and have the potential to distinguish malignant from benign disease preoperatively.

Keywords: Amino acid; Blood plasma; Metabolite; PDAC; Periampullary cancer.

MeSH terms

  • Adult
  • Aged
  • Amino Acids* / blood
  • Ampulla of Vater / pathology
  • Biomarkers, Tumor* / blood
  • Carcinoma, Pancreatic Ductal / blood
  • Carcinoma, Pancreatic Ductal / diagnosis
  • Carcinoma, Pancreatic Ductal / pathology
  • Chromatography, Liquid
  • Common Bile Duct Neoplasms / blood
  • Common Bile Duct Neoplasms / diagnosis
  • Common Bile Duct Neoplasms / pathology
  • Common Bile Duct Neoplasms / surgery
  • Diagnosis, Differential
  • Duodenal Neoplasms / blood
  • Duodenal Neoplasms / diagnosis
  • Duodenal Neoplasms / pathology
  • Duodenal Neoplasms / surgery
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pancreatic Neoplasms / blood
  • Pancreatic Neoplasms / diagnosis
  • Pancreatic Neoplasms / mortality
  • Pancreatic Neoplasms / surgery
  • Principal Component Analysis
  • Tandem Mass Spectrometry

Substances

  • Amino Acids
  • Biomarkers, Tumor