title: Metabolic classification of human rectal adenocarcinomas: a novel guideline for clinical oncologists?
abstract: OBJECTIVE
  Based on previous findings in SCC of the human uterine cervix and of the head and neck, metastasis- and survival-related metabolic classification was performed in human rectal adenocarcinomas. Such a characterization is suggested as basis of a novel clinical guideline for an appropriate therapy of epithelium-derived malignancies.
  
  
  METHODS
  Tissue concentrations of ATP, glucose, and lactate in viable tumor regions of 33 pretherapeutically taken cryobiopsies from 24 patients were measured at a microscopic level using the technique of imaging bioluminescence.
  
  
  RESULTS
  In metastatic carcinomas, lactate levels were significantly higher (mean+/-SD: 13.4+/-3.8 vs 6.9+/-2.5 micro mol/g, P = 0.0046) and glucose levels significantly lower (0.3+/-0.2 vs 1.0+/-0.4 micro mol/g, P = 0.0020) than in non-metastatic carcinomas. No patients had distant metastasis with tumor lactate levels below the population median of 8.0 micro mol/g or glucose levels above 0.9 micro mol/g.
  
  
  CONCLUSIONS
  These results support the hypothesis that lactate and glucose levels measured in human primary carcinomas may serve as an early prognostic tool in the clinic with regard to formation of metastasis and patient survival. The present data encourage further studies on possible strategies for a metabolic classification of tumors as a prognostic tool.
authors.affiliation: Institute of Physiology and Pathophysiology, University of Mainz, Duesbergweg 6, 55099 Mainz, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Walenta
authors.forename: The-Van
authors.initials: TV
authors.lastname: Chau
authors.forename: Thies
authors.initials: T
authors.lastname: Schroeder
authors.forename: Hans-Anton
authors.initials: HA
authors.lastname: Lehr
authors.forename: Leoni A
authors.initials: LA
authors.lastname: Kunz-Schughart
authors.forename: Alois
authors.initials: A
authors.lastname: Fuerst
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Mueller-Klieser
mesh_terms: D000230:Adenocarcinoma / Q000145:classification* / Q000503:physiopathology*; D000255:Adenosine Triphosphate / Q000032:analysis / Q000378:metabolism; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D005260:Female; D006801:Humans; D019344:Lactic Acid / Q000032:analysis / Q000378:metabolism*; D008163:Luminescent Measurements; D008297:Male; D008495:Medical Oncology; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D017410:Practice Guidelines as Topic; D011379:Prognosis; D012004:Rectal Neoplasms / Q000145:classification* / Q000503:physiopathology*; D016019:Survival Analysis
chemical_list: D019344:Lactic Acid; D000255:Adenosine Triphosphate