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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
Associations between blood metabolite levels and gastrointestinal cancer risk: A preliminary untargeted metabolomics study
Tian-Hao Guo, Wen-Jian Zhu, Yi-Fan Hui, Shuo-Qi Zhao, Ting-Ting Zhou, Xue-Meng Wang, Qin-Chang Zhang, Wei Wang, Liu Li, Wei-Xing Shen, Xiao-Yu Wu, Hai-Bo Cheng
Tian-Hao Guo, Institute of Health and Regimen, Jiangsu Open University, Nanjing 210036, Jiangsu Province, China
Tian-Hao Guo, Yi-Fan Hui, Shuo-Qi Zhao, Xue-Meng Wang, Qin-Chang Zhang, Liu Li, Wei-Xing Shen, Hai-Bo Cheng, The First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China
Tian-Hao Guo, Hai-Bo Cheng, Department of Oncology, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu Province, China
Wen-Jian Zhu, Department of Oncology, The Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210017, Jiangsu Province, China
Ting-Ting Zhou, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China
Wei Wang, OE Biotech Co., Ltd., Shanghai 201112, China
Xiao-Yu Wu, Department of Surgical Oncology, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu Province, China
Co-first authors: Tian-Hao Guo and Wen-Jian Zhu.
Co-corresponding authors: Xiao-Yu Wu and Hai-Bo Cheng.
Author contributions: Guo TH, Wu XY and Cheng HB made substantial contributions to the conception and design of the study; Guo TH, Zhu WJ and Hui YF were primarily responsible for writing the manuscript; Guo TH, Zhu WJ, Hui YF, Zhao SQ, Zhou TT, Wang XM, Zhang QC, Wang W, Li L, Shen WX and Wu XY were responsible for collecting the patient’s clinical data and data analysis; Guo TH, Hui YF and Cheng HB confirmed the authenticity of all the raw data; All authors have read and approved the final manuscript. Guo TH proposed, designed and performed data analysis and prepared the first draft of the manuscript. Zhu WJ and Guo TH were responsible for patient screening, enrollment, collection of clinical data and blood specimens. Both authors have made crucial and indispensable contributions towards the completion of the project and thus qualified as the co-first authors of the paper. Both Wu XY and Cheng HB have played important and indispensable roles in the experimental design, data interpretation and manuscript preparation as the co-corresponding authors. Wu XY and Cheng HB applied for and obtained the funds for this research project. Cheng HB conceptualized, designed, and supervised the whole process of the project. He searched the literature, revised and submitted the early version of the manuscript. Wu XY was instrumental and responsible for data re-analysis and re-interpretation, figure plotting, comprehensive literature search, preparation and submission of the current version of the manuscript. This collaboration between Wu XY and Cheng HB is crucial for the publication of this manuscript and other manuscripts still in preparation.
Supported by the National Key R and D Program of China, No. 2022YFC3500200, No. 2022YFC3500202 and No. 2022YFC3500204; Innovation Team and Talents Cultivation Program of National Administration of Traditional Chinese Medicine, No. ZYYCXTD-C-202208; NATCM’s Project of High-Level Construction of Key TCM Disciplines, No. [2023]85; Qing Lan Project of Jiangsu Higher Education Institutions, No. [2023]27; Postgraduate Research & Practice Innovation Program of Jiangsu Province, No. SJCX22_0706; General Project of Universities’ Philosophy and Social Science in Jiangsu Province, No. 2024SJYB0564; and Jiangsu Provincial Leading Talents Program in Traditional Chinese Medicine, No. SLJ0314.
Institutional review board statement: The protocol and informed consent were reviewed and approved by the Affiliated Hospital of Nanjing University of Chinese Medicine Ethics Committee (No. 2023NL-003-02).
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The data used and/or investigated during the present study are available from the corresponding author upon reasonable request at
2068324936@qq.com.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Hai-Bo Cheng, PhD, Chief Physician, Professor, The First Clinical Medical College, Nanjing University of Chinese Medicine, No. 138 Xianlin Road, Nanjing 210023, Jiangsu Province, China.
2068324936@qq.com
Received: January 6, 2025
Revised: April 24, 2025
Accepted: June 6, 2025
Published online: July 15, 2025
Processing time: 191 Days and 19.3 Hours
BACKGROUND
Gastrointestinal cancers are among the most commonly diagnosed cancers globally. Traditional Chinese medicine (TCM) offers distinct advantages in preventing and treating these cancers.
AIM
To investigate the metabolic basis of a common TCM syndrome in gastrointestinal cancers, exploring underlying metabolic mechanisms and identifying potential biomarkers.
METHODS
Thirty healthy controls (normal group), 30 patients with gastric cancer (GC), and 30 patients with colorectal cancer (CRC) were enrolled in 2023. Plasma metabolic profiles were detected using gas chromatography-mass spectrometry and liquid chromatography-mass spectrometry, and pathway enrichment analysis was conducted using the Kyoto Encyclopedia of Genes and Genomes.
RESULTS
Metabolic profiling revealed distinct alterations in gastrointestinal cancers. CRC samples exhibited 455 differentially expressed metabolites (234 upregulated and 221 downregulated). Similarly, GC samples exhibited 459 differentially expressed metabolites (251 upregulated and 208 downregulated). Additionally, 352 shared metabolites were identified among gastrointestinal cancers. Enrichment analysis highlighted the involvement of these shared metabolites in 10 metabolic pathways.
CONCLUSION
To some extent, this study revealed the metabolomic characteristics of spleen deficiency and blood stasis toxin (PXYD) syndrome in gastrointestinal cancers. It provides the rationale for the "same treatment for different diseases" approach in PXYD syndrome of gastrointestinal cancers, and for identifying potential metabolomics-based biomarkers.
Core Tip: This study identified differentially expressed metabolites in colorectal cancer and gastric cancer, unraveling the metabolomic characteristics of spleen deficiency and blood stasis toxin (PXYD) syndrome in gastrointestinal cancers. It preliminarily identified 352 common metabolites and 10 metabolic pathways in gastrointestinal cancers, providing a theoretical basis for the "same treatment for different diseases" approach in PXYD syndrome of gastrointestinal cancers.
