Candidate serum metabolite biomarkers for differentiating gastroesophageal reflux disease, Barrett’s esophagus, and high-grade dysplasia/esophageal adenocarcinoma

Matthew F. Buas, Haiwei Gu, Danijel Djukovic, Jiangjiang Zhu, Lynn Onstad, Brian J. Reid, Daniel Raftery, Thomas L. Vaughan

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Introduction/objectives: Incidence of esophageal adenocarcinoma (EA), an often fatal cancer, has increased sharply over recent decades. Several important risk factors (reflux, obesity, smoking) have been identified for EA and its precursor, Barrett’s esophagus (BE), but a key challenge remains in identifying individuals at highest risk, since most with reflux do not develop BE, and most with BE do not progress to cancer. Metabolomics represents an emerging approach for identifying novel biomarkers associated with cancer development. Methods: We used targeted liquid chromatography-mass spectrometry (LC-MS) to profile 57 metabolites in 322 serum specimens derived from individuals with gastroesophageal reflux disease (GERD), BE, high-grade dysplasia (HGD), or EA, drawn from two well-annotated epidemiologic parent studies. Results: Multiple metabolites differed significantly (P < 0.05) between BE versus GERD (n = 9), and between HGD/EA versus BE (n = 4). Several top candidates (FDR q ≤ 0.15), including urate, homocysteine, and 3-nitrotyrosine, are linked to inflammatory processes, which may contribute to BE/EA pathogenesis. Multivariate modeling achieved moderate discrimination between HGD/EA and BE (AUC = 0.75), with less pronounced separation for BE versus GERD (AUC = 0.64). Conclusion: Serum metabolite differences can be detected between individuals with GERD versus BE, and between those with BE versus HGD/EA, and may help differentiate patients at different stages of progression to EA.

Original languageEnglish (US)
Article number23
JournalMetabolomics
Volume13
Issue number3
DOIs
StatePublished - Mar 1 2017
Externally publishedYes

Fingerprint

Barrett Esophagus
Biomarkers
Gastroesophageal Reflux
Metabolites
Adenocarcinoma
Serum
Liquid chromatography
Homocysteine
Uric Acid
Mass spectrometry
Area Under Curve
Neoplasms
Metabolomics
Liquid Chromatography
Epidemiologic Studies
Mass Spectrometry
Obesity
Smoking

Keywords

  • Barrett’s esophagus
  • Esophageal adenocarcinoma
  • Gastroesophageal reflux disease
  • Metabolomics
  • Risk stratification
  • Serum biomarkers

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Clinical Biochemistry

Cite this

Candidate serum metabolite biomarkers for differentiating gastroesophageal reflux disease, Barrett’s esophagus, and high-grade dysplasia/esophageal adenocarcinoma. / Buas, Matthew F.; Gu, Haiwei; Djukovic, Danijel; Zhu, Jiangjiang; Onstad, Lynn; Reid, Brian J.; Raftery, Daniel; Vaughan, Thomas L.

In: Metabolomics, Vol. 13, No. 3, 23, 01.03.2017.

Research output: Contribution to journalArticle

Buas, Matthew F. ; Gu, Haiwei ; Djukovic, Danijel ; Zhu, Jiangjiang ; Onstad, Lynn ; Reid, Brian J. ; Raftery, Daniel ; Vaughan, Thomas L. / Candidate serum metabolite biomarkers for differentiating gastroesophageal reflux disease, Barrett’s esophagus, and high-grade dysplasia/esophageal adenocarcinoma. In: Metabolomics. 2017 ; Vol. 13, No. 3.
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AB - Introduction/objectives: Incidence of esophageal adenocarcinoma (EA), an often fatal cancer, has increased sharply over recent decades. Several important risk factors (reflux, obesity, smoking) have been identified for EA and its precursor, Barrett’s esophagus (BE), but a key challenge remains in identifying individuals at highest risk, since most with reflux do not develop BE, and most with BE do not progress to cancer. Metabolomics represents an emerging approach for identifying novel biomarkers associated with cancer development. Methods: We used targeted liquid chromatography-mass spectrometry (LC-MS) to profile 57 metabolites in 322 serum specimens derived from individuals with gastroesophageal reflux disease (GERD), BE, high-grade dysplasia (HGD), or EA, drawn from two well-annotated epidemiologic parent studies. Results: Multiple metabolites differed significantly (P < 0.05) between BE versus GERD (n = 9), and between HGD/EA versus BE (n = 4). Several top candidates (FDR q ≤ 0.15), including urate, homocysteine, and 3-nitrotyrosine, are linked to inflammatory processes, which may contribute to BE/EA pathogenesis. Multivariate modeling achieved moderate discrimination between HGD/EA and BE (AUC = 0.75), with less pronounced separation for BE versus GERD (AUC = 0.64). Conclusion: Serum metabolite differences can be detected between individuals with GERD versus BE, and between those with BE versus HGD/EA, and may help differentiate patients at different stages of progression to EA.

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