Metabolic Profiles, Phenotypes Classification and Prediction of Clinical Outcomes in Colonic Polyps

Colonic polyps (CP), especially adenomatous polyps with high incidence and recurrence are risk factors for colorectal cancer (CRC). However, data regarding the effective diagnosis of different types of CP have been lacking. To characterize serum metabolomics in different types of colonic polyps, and evaluated the potential biomarkers as non-invasive diagnostic tool for CP. We characterized and identified metabolites in 286 HCs and 286 CP patients with no definite pathologic type to screen potential biomarkers, and further validated in 298 HCs, 413 tubular adenoma (TA) patients, 66 tubulovillous adenoma (TVA) patients, 32 hyperplastic polyps (HP) patients, and 94 inflammatory polyps (IP) patients. Metabolites of four pathological types of CP were evaluated and different potential biomarker panels were screened. A total of 85 differential metabolites were identified. The disturbed metabolic pathways were glycerophospholipid metabolism, sphingolipid metabolism, arachidonic acid metabolism, ether lipid metabolism, and glycerolipid metabolism. The 5 panels of specific biomarkers exhibited strong diagnostic ability with AUC > 0.86, sensitivity > 70.0 %, specificity > 75%, and offered excellent predictive values for distinguishing HCs vs. CP, as well as TA, TVA, HP, and IP. Potential biomarker panels displayed high correlation with gastrointestinal diseases, which may be benefit for the diagnosis of CP. Trial Registration: Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT02986308. Funding Statement: This work was supported by grants from the Key Program of Natural Science Foundation of State (Grant No. 81830110, 81430093, 81373930, 81673586, 81703685, 81302905, 81503386), TCM State Administration Subject of Public Welfare of (Grant No. 2015468004). Declaration of Interests: The authors state: "None declared." Ethics Approval Statement: This study was approved by the institutional review Board of First Affiliated Hospital of Harbin Medical University (201624). The study was performed in accordance with the Helsinki Declaration and rules of good clinical Practice. All participants signed written informed consents after the study protocol was fully explained.