Risk stratification of patients with diffuse large B-cell lymphoma using plasma NMR-based metabolomics at diagnosis.

Metabolomics applied to biofluids of patients with cancer has emerged as a novel omics that could provide important information to better stratify these patients.

代谢组学应用于癌症患者的生物流体已成为一种新的组学方法，能够提供重要信息，以更好地对这些患者进行分层。

In this work, the authors performed a retrospective study by nuclear magnetic resonance (NMR)-based metabolomics using plasma samples at diagnosis from 154 randomized patients with DLBCL treated by R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) (from the phase 3 REMARC [Reduced-intensity Maintenance therapy with Rituximab After R-CHOP in elderly patients with DLBCL] trial).

在这项研究中，作者们利用核磁共振（NMR）代谢组学技术，对154名接受R-CHOP方案（利妥昔单抗、环磷酰胺、多柔比星、长春新碱和泼尼松）治疗的弥漫性大B细胞淋巴瘤（DLBCL）患者的诊断时血浆样本进行了回顾性分析，这些患者来自第三阶段的REMARC试验（老年DLBCL患者R-CHOP后减少强度维持治疗与利妥昔单抗）。

Remarkably, a combination of 3 circulating metabolites was linked to lipid metabolism (named the "NMR score") that significantly affected overall survival(OS) (P< .0001) and progression-free survival(PFS) (P = .0003).

值得注意的是，一组由3种循环代谢物组成的组合与脂质代谢相关（称为“NMR评分”），显著影响了总生存期（OS）（P< .0001）和无进展生存期（PFS）（P = .0003）。

The optimal cutoff for each metabolite was determined using X-Tile and confirmed by a training validation method.

每个代谢物的最佳截断值是使用X-Tile确定的，并通过训练验证方法进行了确认。

Combining 2-amino-butyrate, 3-hydroxy-butyrate, and LDL-1 lipoprotein yielded 3 risk groups with low- (0-1), intermediate- (2-3), and high-risk (4-5) patients.

结合2-氨基丁酸、3-羟基丁酸和LDL-1脂蛋白，产生了3个风险组，低风险（0-1），中风险（2-3），和高风险（4-5）患者。

Germinal center B-cell (GCB)/non-GCB profile along with Bcl2 and Myc expression did not correlate with NMR score survival. In conclusion, the combination of 3 circulating metabolites linked to lipid metabolism is revealed as a feature that captures heterogeneity among patients with DLBCL.

生发中心B细胞（GCB）/非GCB谱系以及Bcl2和Myc表达与NMR评分生存率无相关性。总之，揭示了与脂质代谢相关的3种循环代谢物的组合是捕获弥漫性大B细胞淋巴瘤（DLBCL）患者异质性的特征。

This NMR score seemed promising for DLBCL risk stratification, even among responder patients after R-CHOP treatment.

这种NMR评分对于DLBCL的风险分层似乎很有前景，即使在R-CHOP治疗后的应答患者中也是如此。

This trial was registered at www.ClinicalTrials.gov as #NCT01122472.

该试验已在www.ClinicalTrials.gov上注册，注册号为#NCT01122472。

Discussion

Metabolomics applied to biofluids of patients with cancer has emerged as a novel omics that could provide important information to better stratify these patients.

代谢组学应用于癌症患者的生物流体已成为一种新的组学方法，能够提供重要信息，以更好地对这些患者进行分层。