Lipidomic profiling of colorectal lesions for real-time tissue recognition and risk-stratification using rapid evaporative ionisation mass spectrometry.
File(s)
Author(s)
Type
Journal Article
Abstract
OBJECTIVE: Rapid Evaporative Ionisation Mass Spectrometry (REIMS) is a metabolomic technique analysing tissue metabolites, which can be applied intra-operatively in real-time. The objective of this study was to profile the lipid composition of colorectal tissues using REIMS, assessing its accuracy for real-time tissue recognition and risk-stratification. SUMMARY BACKGROUND DATA: Metabolic dysregulation is a hallmark feature of carcinogenesis, however it remains unknown if this can be leveraged for real-time clinical applications in colorectal disease. METHODS: Patients undergoing colorectal resection were included, with carcinoma, adenoma and paired-normal mucosa sampled. Ex vivo analysis with REIMS was conducted using monopolar diathermy, with the aerosol aspirated into a Xevo G2S QToF mass spectrometer. Negatively charged ions over 600-1000m/z were used for univariate and multivariate functions including linear discriminant analysis. RESULTS: 161 patients were included, generating 1013 spectra. Unique lipidomic profiles exist for each tissue type, with REIMS differentiating samples of carcinoma, adenoma and normal mucosa with 93 1% accuracy and 96 1% negative predictive value for carcinoma. Neoplasia (carcinoma or adenoma) could be predicted with 96 0% accuracy and 91 8% negative predictive value. Adenomas can be risk-stratified by grade of dysplasia with 93 5% accuracy, but not histological subtype. The structure of 61 lipid metabolites was identified, revealing that during colorectal carcinogenesis there is progressive increase in relative abundance of phosphatidylglycerols, sphingomyelins and mono-unsaturated fatty acid containing phospholipids. CONCLUSIONS: The colorectal lipidome can be sampled by REIMS and leveraged for accurate real-time tissue recognition, in addition to risk-stratification of colorectal adenomas. Unique lipidomic features associated with carcinogenesis are described.
Date Issued
2021-08-13
Date Acceptance
2021-08-01
Citation
Annals of Surgery, 2021, 00
ISSN
0003-4932
Publisher
Lippincott, Williams & Wilkins
Journal / Book Title
Annals of Surgery
Volume
00
Copyright Statement
© 2021 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.
Sponsor
Imperial College Healthcare NHS Trust- BRC Funding
Imperial College Healthcare NHS Trust- BRC Funding
Cancer Research UK
Society of American Gastrointestinal & Endoscopic Surgeons (SAGES)
Society of American Gastrointestinal & Endoscopic Surgeons (SAGES)
National Institute of Health Research
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/34387206
PII: 00000658-900000000-93333
Grant Number
RD207
RDB04
25165
n/a
WSSS_P67267
Subjects
11 Medical and Health Sciences
Surgery
Publication Status
Published online
Coverage Spatial
United States
Date Publish Online
2021-08-13