Metabolomic profile and its association with the diagnosis of prostate cancer: a systematic review
Objective: To determine the association of a metabolomic profile with the diagnosis of localized prostate cancer. Methods: We conducted a search strategy in MEDLINE (OVID), EMBASE, LILACS, and the Cochrane Central Register of Controlled Trials (CENTRAL) from 2008 to the present. We included Clinical trials and analytical and descriptive observational studies that reported metabolite results and metabolite profiles in serum, tissue, urine, and seminal fluid. All studies used metabolomic techniques such as MS and MRI to identify patients with localized prostate cancer compared with patients without cancer. We used QUADAS 2 to assess the risk of bias. Results: We found 1248 studies with the search strategy. Finally, 14 case–control studies were included. Serum was the primary sample to identify the metabolites. Low concern was found regarding applying the index test and the reference standard in assessing the risk of bias. The metabolites of interest associated with establishing a metabolomic profile in the diagnosis of localized prostate cancer were amino acids, lipids, androgens, estrogens, nucleotides, and histidine metabolism. Conclusion: Disturbances in the metabolism of fatty acids, amino acids, nucleotides, and steroid hormones were identified, suggesting the presence of localized prostate cancer. Importantly, serum samples showed an increase in amino acid levels. Glutamate and aspartic acid stand out among the amino acids that register high levels. In addition, glycine and serine were consistently decreased metabolites in the three kinds of biological samples analyzed.