Identification of Plasma Metabolites Associated with Lung Cancer Survival

Limited knowledge has been reported regarding the performance of plasma metabolomics for predicting lung cancer prognosis. In this chapter, we compared the plasma metabolomics of lung cancer patients with differential disease-free survival (DFS, <3 years vs. >4 years) using liquid chromatography-mass spectrometry. We identified 29 survival-related aqueous metabolites but no lipid metabolites. Amino acids and organic acids constitute the majority of these metabolites. The metabolic pathways of these metabolites were cysteine and methionine metabolism and arginine biosynthesis. The Cox proportional hazards regression models confirmed the predictive values of 18 metabolites for DFS, while the phosphocholine and xanthine showed independent predictive values. Regarding cancer phenotypes, thelephoric acid, phosphocholine, inosine, 3-hydroxyanthranilic acid, hypoxanthine, xanthine, and 4-hydroxybenzoic acid showed good correction with lymph node metastasis. Taken together, plasma metabolomics is a powerful tool for identifying prognostic metabolites of lung cancer.