The combination of GCA, C17:0 and C18:2 improve diagnostic accuracy of colorectal cancer liver metastases

Background: Colorectal cancer (CRC) is a globally prevalent malignancy with high mortality. The diagnostic and therapeutic strategies for particularly metastatic CRC (mCRC) remain limited. Thus, the novel biomarkers and therapeutic avenues for mCRC are needed to be identified. Methods: To identify different metabolite profiles distinguishing between patients with mCRC and CRC, plasma samples from a cohort of 100 patients with CRC (n=50) and mCRC (n=50) were analyzed using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Results: In training setting, the analysis revealed 13 metabolites that differed significantly between the 27 amino acids, 9 bile acids and 16 fatty acids. The area under the curve (AUC) of the classifier for C18:2 was 0.8089. In addition, the combined area under the curve (AUC) reached 0.86, which was significantly better than those of the traditional markers CEA (0.70) and CA19-9 (0.80). The data of pearson correlation analysis showed a significant correlation between GCA and CA19-9. Furthermore, the individual AUC values for GCA, CEA and CA19-9 in a specific analysis of 25 patients with mCRC were 0.74, 0.74 and 0.70, respectively. However, the AUC of GCA and CEA in combination with CA19-9 significantly increased to 0.87. Conclusions: This study emphasized the excellent performance of the combination of GCA, C17:0 and C18:2in differentiating CRC from mCRC. In addition, the integration of GCA, CEA and CA19-9 significantly improved the diagnostic accuracy of mCRC with liver metastasis. As expected, this research might develop novel diagnostic indicators and innovative therapeutic approaches against mCRC.