Colorectal neoplasia-specific amino acid profiles and their diagnostic potential: a systematic review.
Roza C M Opperman, Sofie Bosch, Eduard A Struys et al.
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In 30 seconds
This systematic review assessed amino acid alterations in colorectal cancer (CRC) and advanced precursors, and their potential as non-invasive diagnostic biomarkers. It included 77 studies measuring amino acids in faeces, urine, serum, plasma, tissue, or saliva. Findings varied substantially across biological matrices; tissue studies more consistently reported increased amino acids in CRC. Diagnostic performance also varied widely, with reported AUCs of 0.28-0.91 and limited external validation. Few studies examined advanced adenomas, and none assessed advanced serrated polyps. The review concludes that amino acids have limited standalone diagnostic value but may contribute to multi-metabolite panels.
Key findings
- Across 77 studies, amino acid findings were heterogeneous across matrices, while tissue studies mostly reported upregulation in CRC.
- Reported diagnostic performance varied widely, with AUC 0.28-0.91 and limited external validation.
- Few studies included advanced adenomas, and none assessed advanced serrated polyps.
- The review found limited standalone diagnostic value, while noting potential to enhance multi-metabolite panels.
Why it matters
The review highlights that amino acid profiles are not yet consistent or sufficiently validated to support standalone CRC diagnosis. It also identifies gaps in evidence for advanced precursor lesions, which are important to assess when evaluating early detection biomarkers. These findings help frame amino acid testing as an area for further biomarker research rather than an established diagnostic approach.
What to keep in mind
The underlying studies were heterogeneous across biological matrices, and external validation was limited; evidence on advanced adenomas was sparse and advanced serrated polyps were not assessed.