Lactate, choline, and creatine levels measured by vitro ¹H‐MRS as prognostic parameters in patients with non‐small‐cell lung cancer

Abstract

PurposeTo determine the biochemical characteristics of lung cancer tissue using in vitro 1H‐MRS, and investigate the correlation between survival probabilities and lactate (Lac), creatine (Cr), and choline (Cho) concentrations measured by in vitro 1H‐MRS.Materials and MethodsA total of 21 patients with lung cancer were included in this retrospective study. 1H‐MRS spectra measurements were performed at 6.35T using a JNM‐EX270, high‐resolution FT‐NMR spectrometer.ResultsWhen normal lung tissue was compared with lung cancer tissue, significant differences were noted most consistently in the levels of Lac and Cho, with lung cancer tissue showing higher values than normal lung tissue. Lac concentrations of lung cancer tissue were significantly higher in patients with recurrence compared to patients without recurrence (0.285 ± 0.096 μmol/g). The mean overall survival of patients in the low‐Lac group was 50.28 ± 6.47 months, which is significantly higher compared to the high‐Lac group, which had a mean survival time of only 30.49 ± 5.41 months.ConclusionKaplan‐Meier analysis of the data showed that the overall and disease‐free survival probabilities were significantly higher in patients with low tumor Lac values than in those with high tumor Lac concentrations. J. Magn. Reson. Imaging 2007. © 2007 Wiley‐Liss, Inc.

Can nuclear magnetic resonance (NMR) spectroscopy reveal different metabolic signatures for lung tumours?

“…In agreement with previous work [32], alterations involving key metabolites in glucose and phospholipid metabolisms were found in all tumour samples relative to the noninvolved pulmonary tissue. In particular, elevated lactate and reduced glucose levels were a typical feature of the tumours, confirming the glycolytic shift (Warburg effect) characterising many types of cancer tissues [25,27], including lung [7]. GPC and PC were also among the most discriminating metabolites, being higher in tumours compared to control tissue, which, again, confirms our previous findings [32] and is a well-known metabolic event in tumours [15,20,24,25,27], related to accelerated cell proliferation and the role of choline-containing compounds as precursors of cell membrane phospholipids [35].…”

“…A few studies involving NMR of tissue extracts have focused on the measurement of specific metabolite levels to determine differences between normal and tumour tissue and within tumours of different histological types [5], as well as to assess the prognostic value of some of these metabolites [6,7], and to evaluate lung tumour responsiveness to erlotinib [8]. Another work, also using NMR of tissue extracts together with blood plasma analysis, demonstrated the value of 13 C stable-isotope-assisted metabolomics to elucidate metabolic perturbations in lung cancer [9].…”

Causes and Consequences of Increased Glucose Metabolism of Cancers

“…Lactate levels can be measured in human tumors by 1 H magnetic resonance spectroscopy (MRS) (244). Such measures have shown that lactate levels are strong indicators of poor prognosis in brain, breast, lung, and liver cancers (245)(246)(247)(248). Notably, lactate levels did not correlate with histopathologic stage of oligodendrogliomas, suggesting that this may not be a universal observation (249).…”

Endostar enhances the antitumor effects of radiation by affecting energy metabolism and alleviating the tumor microenvironment in a Lewis lung carcinoma mouse model

“…Lactate is considered a dead-end product of glycolysis, and its generation and accumulation promote tumor growth and metastasis. With the recent advances in tumor metabolism and gene therapy, lactate was identified as a potential therapeutic target in tumors (17)(18)(19)(20). Tumor cells can also uptake and utilize lactate, and a high concentration of lactate is a sign or marker of tumor metabolic adaptation, suggesting a poor prognosis (17)(18)(19)(20).…”