Prognostic effects of glycometabolism changes in lung adenocarcinoma: a prospective observational study

Background: Changes in glycometabolism of cancer cells provides cancer cells with growth advantages, which are also of great value in the prognosis prediction of the patients with lung adenocarcinoma. However, currently available studies are controversial. Methods: We successively collected 100 paired surgical specimens from patients with lung adenocarcinoma. The content of glycometabolic intermediates in tissues was tested by liquid chromatography-mass spectrometry. Follow-up was conducted every 6 months for patients enrolled in this study. Results: There were significant differences in the contents of six intermediates, including glucose (P<0.0001), pyruvate (P=0.0009), lactate (P<0.0001), citrate (P=0.0001), alpha-ketoglutarate (P=0.0002), and fumarate (P=0.0096). For different TNM stages, the pyruvate content (P<0.001) and lactate content (P<0.001) in the II/III/IV stage cancer tissues were significantly higher than those in the stage I cancer tissues. The overall survival (OS) of patients with high levels of glucose (P=0.0034), pyruvate (P<0.0001), lactate (P=0.049), and citrate (P=0.024) in cancer tissues was significantly worse than that of patients with low levels. N stage (P<0.001) and the contents of pyruvate (P=0.033) were independent prognostic factors for the OS. Conclusions: The contents of glucose, pyruvate, lactate, and citrate in cancer tissues are higher than that in para-carcinoma tissues, and the long-term survival decrease in patients with higher glucose, pyruvate, lactate, and citrate.