Background
Methods
Patient population
-
44 samples from patients who did not receive any neoadjuvant chemotherapy
-
62 samples from patients who did
-
9 samples from patients who did not receive any neoadjuvant chemotherapy
-
8 samples from patients who did
-
Long-term survivors (survival >3 years), 8 samples, no neoadjuvant chemotherapy
-
Short-term survivors (survival <1 year), 9 samples, no neoadjuvant chemotherapy
Tissue sample preparation for HRMAS NMR spectroscopy
HRMAS NMR data acquisition
Metabolite | Group |
1H chemical shift (ppm) |
13C chemical shift (ppm) | |
---|---|---|---|---|
1 | Leucine | δCH3
| 0.95 | 23.43 |
δ'CH3
| 0.95 | 24.75 | ||
2 | Lactate | CH3
| 1.33 | 22.69 |
CH
| 4.13 | 71.22 | ||
3 | Glycine |
CH
2
| 3.56 | 44.05 |
4 | Glycerol | CH2-OH (d 2X) | 3.55 | 65.03 |
CH
2
-OH (u 2X)
| 3.64 | 65.07 | ||
CH-OH | 3.77 | 74.69 | ||
5 | Glutamine | αCH | 3.77 | 57.23 |
γCH
2
| 2.44 | 33.52 | ||
6 | Serine | γCH2
| 3.97 | 62.90 |
7 | Taurine | CH2-NH3+ | 3.27 | 50.01 |
CH
2
-SO
3
-
| 3.43 | 37.93 | ||
8 | Valine | γ'CH3
| 1.04 | 20.44 |
αCH-NH2
| 3.60 | 63.05 | ||
9 | Arginine | γCH2
| 1.65 | 25.90 |
βCH2
| 1.92 | 30.13 | ||
δCH2
| 3.22 | 43.23 | ||
10 | β-Glucose | C6H(d) | 3.89 | 63.48 |
C1H
| 4.65 | 98.70 | ||
11 | α-Glucose | CH2
| 3.83 | 62.08 |
C1H
| 5.22 | 94.94 | ||
12 | Lysine | δCH2
| 1.73 | 29.17 |
βCH2
| 1.90 | 32.48 | ||
γCH2
| 1.91 | 30.25 | ||
13 | Glutamic acid | βCH2
| 2.08 | 29.67 |
γCH
2
| 2.35 | 35.96 | ||
14 | Alanine | βCH3
| 1.48 | 18.87 |
15 | Myo-Inositol | (CH)2 | 3.54 | 73.81 |
(CH)2 | 3.63 | 75.11 | ||
CH | 4.05 | 74.79 | ||
16 | Ornithine | αCH-NH2
| 3.77 | 57.05 |
δCH2-NH2
| 3.05 | 41.83 | ||
β-CH2
| 1.93 | 30.28 | ||
γ-CH2
| 1.74 | 25.52 | ||
17 | 3-Hydroxybutyric acid | CH3
| 1.20 | 24.30 |
18 | Creatine |
CH
2
| 3.93 | 56.23 |
19 | Choline |
N
+
-(CH
3
)
3
| 3.23 | 56.48 |
20 | Fatty acids (a) | (1)CH2
| 1.30 | 32.16 |
21 | Fatty acids (b) | CH2
| 2.80 | 28.50 |
22 | Fatty acids (c) | (1)CH2
| 2.26 | 36.60 |
23 | Succinic acid |
(CH
2
)2
| 2.39 | 34.00 |
24 | Ascorbate |
CH-O
| 4.52 | 80.87 |
25 | Ethanolamine |
CH
2
-NH
2
| 3.13 | 43.90 |
26 | Phosphorylcholine |
CH
2
-O
| 4.11 | 63.60 |
N+-(CH3)3
| 3.22 | 56.57 | ||
27 | Threonine |
βCH
| 4.25 | 68.50 |
28 | Glycerophosphocholine | N+-(CH3)3
| 3.21 | 56.56 |
βCH2
| 3.72 | 68.49 | ||
αCH
2
| 4.33 | 62.16 | ||
CH2OH | 3.93 | 73.32 | ||
CH2-HPO4(d) | 3.89 | 69.22 | ||
29 | Tyrosine |
meta CH ortho CH βCH2(d) | 6.88 7.18 3.02 | 118.44 133.30 39.40 |
30 | Phenylalanine | ortho CH para CH meta CH | 7.31 7.36 7.42 | 131.91 132.28 131.59 |
31 | Aspartic acid |
βCH
2
(d) βCH2(u) | 2.63 2.81 | 40.20 40.82 |
HRMAS NMR data processing and statistical analyses
-
Choline, phosphorylcholine, glycerophosphocholine, ethanolamine
-
Glycerol, glucose
-
Glucose, lactate
-
Aspartate, threonine
-
Glucose, glycine
-
Aspartate, taurine
-
Aspartate, succinate
-
Glucose, ascorbate, glycine, glutamate
-
Glutamate, glutamine
-
Glutamate, glutamine, glycine
-
Glutamate, glycine, creatine
-
Tyrosine, phenylalanine
Metabolite | No neoadjuvant chemotherapy | Mean (nmol/mg) |
p value |
---|---|---|---|
Ascorbate | PP | 0.3488 ± 0.2191 | 0.4454 |
PA | 0.3988 ± 0.2221 | ||
Aspartic acid | PP | 0.7577 ± 0.3284 | 0.2926 |
PA | 0.6229 ± 0.2255 | ||
Choline | PP | 1.5580 ± 0.5921 |
0.0014
|
PA | 0.8849 ± 0.3887 | ||
Creatine | PP | 1.7371 ± 0.9568 | 0.5047 |
PA | 1.3561 ± 0.5057 | ||
Ethanolamine | PP | 0.9314 ± 0.4502 |
0.0226
|
PA | 0.6188 ± 0.2620 | ||
Glutamate | PP | 2.9830 ± 0.8698 | 0.1114 |
PA | 2.4650 ± 0.7699 | ||
Glycerol | PP | 8.1840 ± 7.3988 |
0.0037
|
PA | 2.2750 ± 1.1994 | ||
Glycine | PP | 6.0920 ± 5.0908 |
0.0005
|
PA | 2.2663 ± 0.8577 | ||
Glycerophosphocholine | PP | 2.4215 ± 2.6084 | 0.3516 |
PA | 1.0319 ± 0.5029 | ||
Lactate | PP | 11.0040 ± 2.4733 |
0.0006
|
PA | 16.1370 ± 4.7272 | ||
Phosphorylcholine | PP | 1.1696 ± 0.6396 | 0.5201 |
PA | 0.9764 ± 0.5008 | ||
Taurine | PP | 2.9660 ± 1.9594 |
0.0021
|
PA | 4.4630 ± 1.4063 | ||
Threonine | PP | 1.1202 ± 0.2821 | 0.6512 |
PA | 1.1931 ± 0.4230 | ||
Glutamine | PP | 0.6855 ± 0.2518 | 0.6859 |
PA | 0.6394 ± 0.2272 | ||
Succinic acid | PP | 0.3068 ± 0.2121 | 0.1786 |
PA | 0.1762 ± 0.0763 | ||
Glucose | PP | 1.2247 ± 0.6158 | 0.7937 |
PA | 1.3141 ± 1.1020 | ||
Tyrosine | PP | 0.0521 ± 0.0443 | 0.0583 |
PA | 0.0741 ± 0.0472 | ||
Phenylalanine | PP | 0.1449 ± 0.0771 | 0.0866 |
PA | 0.0741 ± 0.0811 |
Metabolite | Neoadjuvant chemotherapy | Mean (nmol/mg) |
p value |
---|---|---|---|
Ascorbate | No | 0.3488 ± 0.2191 | 0.6730 |
Yes | 0.3592 ± 0.1671 | ||
Aspartic acid | No | 0.7577 ± 0.3284 | 0.9626 |
Yes | 0.6730 ± 0.1776 | ||
Choline | No | 1.5580 ± 0.5921 | 0.7430 |
Yes | 1.7649 ± 0.7624 | ||
Creatine | No | 1.7371 ± 0.9568 | 0.5414 |
Yes | 1.7760 ± 0.6579 | ||
Ethanolamine | No | 0.9314 ± 0.4502 | 0.6058 |
Yes | 1.1115 ± 0.5408 | ||
Glutamate | No | 2.9830 ± 0.8698 | 0.8148 |
Yes | 2.3800 ± 0.4264 | ||
Glycerol | No | 8.1840 ± 7.3988 | 0.6730 |
Yes | 8.2990 ± 7.2904 | ||
Glycine | No | 6.0920 ± 5.0908 | 0.5414 |
Yes | 6.5590 ± 5.7401 | ||
Glycerophosphocholine | No | 2.4215 ± 2.6084 | 0.9626 |
Yes | 2.2208 ± 2.1689 | ||
Lactate | No | 11.0040 ± 2.4733 | 0.3704 |
Yes | 9.6770 ± 2.1588 | ||
Phosphorylcholine | No | 1.1690 ± 0.6396 | 0.8148 |
Yes | 0.9469 ± 0.3644 | ||
Taurine | No | 2.9660 ± 1.9594 | 0.9626 |
Yes | 2.7060 ± 1.3103 | ||
Threonine | No | 1.1202 ± 0.2821 | 0.6730 |
Yes | 1.1678 ± 0.2801 | ||
Glutamine | No | 0.6855 ± 0.2518 | 0.5414 |
Yes | 0.5633 ± 0.1466 | ||
Succinic acid | No | 0.3069 ± 0.2121 | 0.8884 |
Yes | 0.2595 ± 0.1406 | ||
Glucose | No | 1.2247 ± 0.6158 | 0.4807 |
Yes | 1.0736 ± 0.7355 | ||
Tyrosine | No | 0.0520 ± 0.0442 | 0.6058 |
Yes | 0.0552 ± 0.0599 | ||
Phenylalanine | No | 0.1449 ± 0.0771 | 0.8148 |
Yes | 0.1495 ± 0.0880 |
Metabolite | Neoadjuvant chemotherapy | Mean (nmol/mg) |
p value |
---|---|---|---|
Ascorbate | No | 0.3988 ± 0.2221 | 0.6648 |
Yes | 0.4062 ± 0.2227 | ||
Aspartic acid | No | 0.6229 ± 0.2255 | 0.0017 |
Yes | 0.9658 ± 0.6074 | ||
Choline | No | 0.8849 ± 0.3887 | 0.6600 |
Yes | 0.9539 ± 0.4702 | ||
Creatine | No | 1.3561 ± 0.5057 | 0.4285 |
Yes | 1.4464 ± 0.5971 | ||
Ethanolamine | No | 0.6148 ± 0.2620 | 0.1958 |
Yes | 0.7511 ± 0.4177 | ||
Glutamate | No | 2.4650 ± 0.7699 | 0.0908 |
Yes | 2.8070 ± 0.9767 | ||
Glycerol | No | 2.7550 ± 1.1994 | 0.1339 |
Yes | 3.5300 ± 2.6914 | ||
Glycine | No | 2.2663 ± 0.8577 | 0.1265 |
Yes | 2.9025 ± 1.8798 | ||
Glycerophosphocholine | No | 1.0319 ± 0.5029 | 0.7421 |
Yes | 1.0810 ± 0.7982 | ||
Lactate | No | 16.1370 ± 4.7272 | 0.7969 |
Yes | 15.9030 ± 5.3324 | ||
Phosphorylcholine | No | 0.9764 ± 0.5008 | 0.9092 |
Yes | 0.9518 ± 0.4822 | ||
Taurine | No | 4.4630 ± 1.4062 | 0.8886 |
Yes | 4.3490 ± 1.3425 | ||
Threonine | No | 1.1931 ± 0.4229 | 0.6273 |
Yes | 1.2957 ± 0.6961 | ||
Glutamine | No | 0.6394 ± 0.2272 | 0.5864 |
Yes | 0.6870 ± 0.2668 | ||
Succinic acid | No | 0.1762 ± 0.0763 | 0.4400 |
Yes | 0.1866 ± 0.0739 | ||
Glucose | No | 1.3141 ± 1.1020 | 0.0813 |
Yes | 2.3227 ± 2.7375 | ||
Tyrosine | No | 0.0730 ± 0.0493 | 0.3140 |
Yes | 0.1097 ± 0.1479 | ||
Phenylalanine | No | 0.1789 ± 0.0811 | 0.1622 |
Yes | 0.1097 ± 0.1958 |
Metabolite | No neoadjuvant chemotherapy | Mean (nmol/mg) |
p value |
---|---|---|---|
Ascorbate | LongSurv | 0.3988 ± 0.2221 | 0.5414 |
ShortSurv | 0.4062 ± 0.2227 | ||
Aspartic acid | LongSurv | 0.6229 ± 0.2255 | 0.7430 |
ShortSurv | 0.9658 ± 0.6074 | ||
Choline | LongSurv | 0.8849 ± 0.3887 | 0.0150 |
ShortSurv | 0.9539 ± 0.4702 | ||
Creatine | LongSurv | 1.3561 ± 0.5057 | 0.2766 |
ShortSurv | 1.4464 ± 0.5971 | ||
Ethanolamine | LongSurv | 0.6148 ± 0.2620 | 0.0078 |
ShortSurv | 0.7511 ± 0.4177 | ||
Glutamate | LongSurv | 2.4650 ± 0.7699 | 0.2766 |
ShortSurv | 2.8070 ± 0.9767 | ||
Glycerol | LongSurv | 2.7550 ± 1.1994 | 0.6730 |
ShortSurv | 3.5300 ± 2.6914 | ||
Glycine | LongSurv | 2.2663 ± 0.8577 | 0.2359 |
ShortSurv | 2.9025 ± 1.8798 | ||
Glycerophosphocholine | LongSurv | 1.0319 ± 0.5029 | 0.7430 |
ShortSurv | 1.0810 ± 0.7982 | ||
Lactate | LongSurv | 16.1370 ± 4.7272 | 0.0360 |
ShortSurv | 15.9030 ± 5.3324 | ||
Phosphorylcholine | LongSurv | 0.9764 ± 0.5008 | 0.6730 |
ShortSurv | 0.9518 ± 0.4822 | ||
Taurine | LongSurv | 4.4630 ± 1.4062 | 0.4807 |
ShortSurv | 4.3490 ± 1.3425 | ||
Threonine | LongSurv | 1.1931 ± 0.4229 | 0.3213 |
ShortSurv | 1.2957 ± 0.6961 | ||
Glutamine | LongSurv | 0.6394 ± 0.2272 | 0.1672 |
ShortSurv | 0.6870 ± 0.2668 | ||
Succinic acid | LongSurv | 0.1762 ± 0.0763 | 0.0747 |
ShortSurv | 0.1866 ± 0.0739 | ||
Glucose | LongSurv | 1.3141 ± 1.1020 | 0.4807 |
ShortSurv | 2.3227 ± 2.7375 | ||
Tyrosine | LongSurv | 0.0730 ± 0.0493 | 0.0592 |
ShortSurv | 0.1097 ± 0.1479 | ||
Phenylalanine | LongSurv | 0.1789 ± 0.0811 | 0.0055 |
ShortSurv | 0.1097 ± 0.1958 |
Results
Impact of neoadjuvant chemotherapy on PP and PA
Long-term versus short-term survival in patients with PA
Age | Gender | Tumor size (mm) | CEA | CA 19-9 | T | N | LNR | Margin (mm) | Differ | Vasc invas | G | |
---|---|---|---|---|---|---|---|---|---|---|---|---|
LongS 1 | 70 | F | 50 | 8 | 52.3 | 3 | 1 | 1/57 | 2 | W | No | IIB |
LongS 2 | 70 | M | 25 | 2.1 | 202.56 | 3 | 0 | 0/21 | 1 | M-P | No | IIA |
LongS 3 | 63 | M | 35 | 2 | 200 | 4 | 0 | 0/16 | 3 | M | Vein | III |
LongS 4 | 66 | F | 50 | 1.1 | 1007 | 3 | 1 | 8/65 | 0 | W-M | Vein | IIB |
LongS 5 | 59 | M | 40 | NA | NA | 4 | 1 | 4/39 | 3 | W-M | No | III |
LongS 6 | 76 | M | 40 | 1.8 | 43.2 | 3 | 1 | 3/25 | 2 | P | Vein | IIB |
LongS 7 | 67 | F | 60 | 3.6 | 1626 | 3 | 1 | 4/43 | 3 | M | No | IIB |
LongS 8 | 69 | F | 25 | 1.4 | 220.4 | 3 | 0 | 0/16 | 3 | M | No | IIA |
ShortS 1 | 47 | M | 40 | NA | 112 | 3 | 1 | 6/64 | 2 | P | No | IIB |
ShortS 2 | 65 | M | 30 | 144 | 97.4 | 3 | 1 | 5/83 | 2 | P | No | IIB |
ShortS 3 | 78 | F | 30 | 3.6 | 250 | 3 | 1 | NA | 2 | M | No | IIB |
ShortS 4 | 72 | F | 35 | 2 | 13 | 3 | 1 | NA | 0 | M-P | No | IIB |
ShortS 5 | 82 | F | 25 | NA | 178 | 3 | 0 | 0/18 | 0 | W | Vein | IIA |
ShortS 6 | 49 | F | 30 | 2.3 | 451.5 | 3 | 1 | 6/42 | 1 | P | Vein | IIB |
ShortS 7 | 62 | M | 70 | 4.5 | 293.7 | 4 | 1 | 1/36 | 0 | W | Vein | III |
ShortS 8 | 60 | M | 40 | 4.2 | 916 | 3 | 1 | 18/33 | 0 | Coll | Vein | IIB |
ShortS 9 | 61 | F | 30 | 4.7 | 246.4 | 3 | 1 | 2/38 | 0 | M | Vein | IIB |