Metabolomic Profiling for Diagnosis and Prognostication in Surgery: A Scoping Review.
Metabolomic Profiling for Diagnosis and Prognostication in Surgery: A Scoping Review.
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代谢组学分析在外科手术中的诊断和预后：范围综述。
DOI：
10.1097/sla.0000000000003935
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发表时间：
2021-02-01
影响因子：
9
通讯作者：
Bihorac A
中科院分区：
文献类型：
--
作者：
Khan TA;Loftus TJ;Filiberto AC;Ozrazgat-Baslanti T;Ruppert MM;Bandyopadhyay S;Laiakis EC;Arnaoutakis DJ;Bihorac A
这篇综述吸收并批判性地评价了关于在外科决策中使用代谢组学分析的现有文献。代谢组学分析是通过核磁共振光谱或质谱对生物液体和组织进行定量分析，以量化生物标志物（即糖、氨基酸和脂质），产生诊断和预后信息，已应用于心血管疾病、炎症性肠病、癌症和实体器官移植患者。检索了1995-2019年的PubMed，以识别研究手术患者代谢组学特征的研究。根据PRISMA-ScR指南，纳入文献并纳入相关类别。采用描述性分析方法总结结果。纳入了47项研究，其中大多数是回顾性研究，样本量较小，使用了各种分析技术和生物液体和组织类型的组合。结果表明，代谢组学分析有可能有效地筛选外科疾病，建议诊断，并预测结果，如术后并发症和疾病复发。临床采用的主要障碍包括缺乏来自前瞻性研究的高水平证据，关于组织和生物流体采购和分析方法的研究设计的异质性，以及缺乏大型多中心代谢组数据库以促进代谢组学分析诊断和诊断的有效性、再现性和普遍性的系统研究。代谢组学分析研究将受益于研究设计和分析方法的标准化。随着技术的改进和从研究中获得的知识的积累，代谢组学分析有可能提供个性化的诊断和预后信息，以支持从术前到出院后护理阶段的手术决策。外科疾病的诊断和鉴定可以受益于生物流体和组织的代谢组学分析。这篇综述吸收并批判性地评价了现有文献中关于代谢组学分析在手术决策中的应用，重点是潜在的应用筛选，建议诊断和预测结果，如术后并发症和疾病复发。
This review assimilates and critically evaluates available literature regarding the use of metabolomic profiling in surgical decision-making. Metabolomic profiling is performed by nuclear magnetic resonance spectroscopy or mass spectrometry of biofluids and tissues to quantify biomarkers (i.e. sugars, amino acids, and lipids), producing diagnostic and prognostic information that has been applied among patients with cardiovascular disease, inflammatory bowel disease, cancer, and solid organ transplants. PubMed was searched from 1995–2019 to identify studies investigating metabolomic profiling of surgical patients. Articles were included and assimilated into relevant categories per PRISMA-ScR guidelines. Results were summarized with descriptive analytical methods. Forty-seven studies were included, most of which were retrospective studies with small sample sizes using various combinations of analytic techniques and types of biofluids and tissues. Results suggest that metabolomic profiling has potential to effectively screen for surgical diseases, suggest diagnoses, and predict outcomes such as postoperative complications and disease recurrence. Major barriers to clinical adoption include a lack of high-level evidence from prospective studies, heterogeneity in study design regarding tissue and biofluid procurement and analytical methods, and the absence of large, multicenter metabolome databases to facilitate systematic investigation of the efficacy, reproducibility, and generalizability of metabolomic profiling diagnoses and prognoses. Metabolomic profiling research would benefit from standardization of study design and analytic approaches. As technologies improve and knowledge garnered from research accumulates, metabolomic profiling has potential to provide personalized diagnostic and prognostic information to support surgical decision-making from preoperative to post-discharge phases of care. Diagnosis and prognostication of surgical diseases can benefit from metabolomic profiling of biofluids and tissues. This review assimilates and critically evaluates available literature regarding the use of metabolomic profiling in surgical decision-making, focusing on potential applications to screening, suggesting diagnoses, and predicting outcomes such as postoperative complications and disease recurrence.