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Title:Odkrivanje bioloških označevalcev s pomočjo orodij metabolomike, z namenom zgodnjega odkrivanja oblik raka pri ženskah
Authors:ID Kozar, Nejc (Author)
ID Takač, Iztok (Mentor) More about this mentor... New window
Files:.pdf DOK_Kozar_Nejc_2018.pdf (4,07 MB)
MD5: C0961B88D8C3B2C22A0BBEBAF63B65CC
PID: 20.500.12556/dkum/3681105e-5293-449f-b6d6-e65db29d173d
 
Language:Slovenian
Work type:Doctoral dissertation
Organization:MF - Faculty of Medicine
Abstract:Izhodišče Rak je ena izmed najtežjih boleznih z visoko smrtnostjo v svetovnem merilu. Kljub številnim znanstvenim odkritjem v zadnjih desetletjih, še vedno obstaja veliko neznank, kar otežuje uspešno zdravljenje. Ključnega pomena ostaja zgodnje odkrivanje bolezni, kar največ prispeva k ugodni prognozi. Namen raziskave je bil s pomočjo orodij metabolomike odkriti potencialne tumorske označevalce, ki bi bili uporabni pri zgodnjem odkrivanju raka jajčnikov, dojk ter endometrija. Preiskovanke in metode dela Delo je prospektivna raziskava, v katero je bilo vključenih 15 bolnic z rakom jajčnikov, 39 bolnic z rakom dojk, 15 bolnic z rakom endometrija, 21 zdravih žensk ter 21 bolnic z benignimi ginekološkimi obolenji, ki so bile zdravljene na Kliniki za ginekologijo in perinatologijo Univerzitetnega kliničnega centra Maribor. Vsem udeleženkam smo po opravljeni diagnostiki ter določenem stadiju bolezni odvzeli vzorce krvi za kvantitativno določitev 232 metabolitov s pomočjo HPLC-TQ/MS. Z multivariatno in univariatno analizo ter metodami strojnega učenja smo nato ob primerjavi bolnic z rakavimi obolenji in zdravih posameznic identificirali metabolite, ki najbolje ločujejo obe skupini. Izbranim označevalcem smo določili še uspešnost klasifikacije z določanjem površine pod krivuljo ter ustrezne občutljivosti in specifičnosti. Rezultati Pri raku jajčnikov smo identificirali 5 označevalcev iz skupine ceramidov in sfingomielinov (C16-ceramid, C22-ceramid, C24-ceramid, C18-sfingomielin, C18:1-sfingomielin), s pomočjo katerih smo uspeli ločiti skupino bolnic z rakom jajčnikov od zdravih žensk in tistih z benignimi ginekološkimi obolenji z občutljivostjo 83 %, specifičnostjo 80 % in AUC 0,920. Pri raku dojk so se za najpomembnejše izkazali 4 označevalci in sicer tetradecenoilkarnitin, tetradekanoilkarnitin, dodekanoilkarnitin in 9,12-linoleinska kislina, ki so dosegli 81 % občutljivost ob 81 % specifičnosti in AUC 0,839. Pri raku endometrija so bili 4 najpomembnejši označevalci C16-ceramid, C22-ceramid, hidroksiheksadecenoilkarnitin in 1-metiladenozin, ki so se izkazali z 93 % občutljivostjo ob 75 % specifičnosti in AUC 0,925. Zaključek V raziskavi smo odkrili 5 pomembnih metabolnih označevalcev, s katerimi je mogoče ločiti obolele ženske od zdravih in tistih z benignimi obolenji s podobno diagnostično natančnostjo, kot jo ponuja kombinacija trenutno uporabljanih tumorskih označevalcev CA 125 in HE4. Pri raku dojk in endometrija smo odkrili pri vsakem po 4 pomembne biološke označevalce, ki po diagnostični učinkovitosti bistveno presežejo vse do sedaj uporabljene tumorske označevalce, kar pomeni velik potencial za uporabo metabolomike v diagnostiki ginekoloških rakov v prihodnosti.
Keywords:metabolomika, rak, rak dojk, rak jajčnikov, rak endometrija, zgodnje odkrivanje, presejanje, ceramid, acilkarnitin, sfingomielin
Place of publishing:Maribor
Year of publishing:2018
PID:20.500.12556/DKUM-70468 New window
COBISS.SI-ID:297697280 New window
NUK URN:URN:SI:UM:DK:HONSSUM9
Publication date in DKUM:18.12.2018
Views:1996
Downloads:114
Metadata:XML DC-XML DC-RDF
Categories:MF
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Licences

License:CC BY-NC-ND 4.0, Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
Link:http://creativecommons.org/licenses/by-nc-nd/4.0/
Description:The most restrictive Creative Commons license. This only allows people to download and share the work for no commercial gain and for no other purposes.
Licensing start date:14.05.2018

Secondary language

Language:English
Title:Metabolomic biomarker discovery for detection of early stage women’s cancers
Abstract:Background Cancer is one of the most severe diseases with high morbidity and mortality. Despite numerous scientific breakthroughs in last decades, many questions still remain unanswered which hinder successful treatment. Early diagnosis remains a key factor to a favorable prognosis. The aim of the research was an identification of potential tumor markers with the use of metabolomics that could aid in early diagnosis of ovarian, breast and endometrial cancer. Patients and methods The research of prospective type included 15 patients with ovarian cancer, 39 patients with breast cancer, 15 patients with endometrial cancer, 21 healthy women and 21 patienst with benign gynecological diseases. All patients were recruited at the Department of gynecology and perinatology at University Medical Centre Maribor, where they received treatment. All patients were diagnosed and staged prior to recruitment. Serum blood samples were collected to quantitatively determine concentrations of 232 known metabolites using HPLC-TQ/MS. Using multivariate and univariate analysis and machine learning algorithms, best classifiers were selected. Best performing metabolited were further analysed using ROC analysis to determine their diagnostic potential. Results 5 potential tumor markers were identified for ovarian cancer that belong to the group of ceramides and sphyngomyelins (C16-ceramide, C22-ceramide, C24-ceramide, C18-sphyngomyelin, C18:1-sphyngomyelin) and demonstrated 83% sensitivity, 80% specificity and AUC 0.920 for discriminating ovarian cancer patients from healthy control group and patients with benign gynecological diseases. For breast cancer, 4 best-performing markers were tetradecenoylcarnitine, tetradecanoylcarnitine, dodecanoylcarnitine and 9,12-linoleic acid that demonstrated 81% sensitivity, 81% specificity and AUC 0.839. For endometrial cancer, 4 best-performing markers were C16-ceramide, C22-ceramide, hidroxyhexadecenoylcarnitine and 1-methyladenosine, that demonstrated 93% sensitivity, 75% specificity and AUC 0.925. Conclusion The research identified 5 potential tumor markers for ovarian cancer that enable similar or better diagnostic potential than currently used CA 125 and HE4. For breast and endometrial cancer, 4 markers were proposed respectively, that outperform all currently used tumor markers. Those findings propose great potential for metabolomics in discovery of early gynecological cancers.
Keywords:metabolomics, cancer, breast cancer, ovarian cancer, endometrial cancer, early discovery, screening, ceramide, acylcarnitine, sphyngomyelin


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