Staging of colorectal cancer using serum metabolomics with 1HNMR Spectroscopy

Objective(s): Determination of stages of colon cancer is done by biopsy usually after surgery. Metabolomics is the study of all the metabolites using LC-MS and 1HNMR spectroscopy with chemometric techniques. The stages of colon cancer were detected from patients' sera using 1HNMR. Materials and Methods: Five ml blood was collected from 16 confirmed patients referred for colonoscopy.  One group of eight patients were diagnosed with stage 0 to I colon cancer and the second group of 8 patients with II-IV stage colon cancer.  Sera were sent for 1HNMR. The differentiating metabolites were identified using HMDB  and the metabolic cycles from Metaboanalyst. Results: Six metabolites of which pyridoxine levels lowered, and glycine, cholesterol, taurocholic acid, cholesteryl ester and deoxyinosine increased. Conclusion: The different stages of cancer were identified by the main metabolic cycles such as primary bile acid biosynthesis, purine and vitamin B metabolic pathways and the glutathione cycle.