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Wang Q, Fang Y, Tan S, Li Z, Zheng R, Ren Y, Jiang Y, Huang X. Diagnostic performance of volatile organic compounds analysis and electronic noses for detecting colorectal cancer: a systematic review and meta-analysis. Front Oncol 2024; 14:1397259. [PMID: 38817891 PMCID: PMC11138104 DOI: 10.3389/fonc.2024.1397259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 04/24/2024] [Indexed: 06/01/2024] Open
Abstract
Introduction The detection of Volatile Organic Compounds (VOCs) could provide a potential diagnostic modality for the early detection and surveillance of colorectal cancers. However, the overall diagnostic accuracy of the proposed tests remains uncertain. Objective This systematic review is to ascertain the diagnostic accuracy of using VOC analysis techniques and electronic noses (e-noses) as noninvasive diagnostic methods for colorectal cancer within the realm of clinical practice. Methods A systematic search was undertaken on PubMed, EMBASE, Web of Science, and the Cochrane Library to scrutinize pertinent studies published from their inception to September 1, 2023. Only studies conducted on human subjects were included. Meta-analysis was performed using a bivariate model to obtain summary estimates of sensitivity, specificity, and positive and negative likelihood ratios. The Quality Assessment of Diagnostic Accuracy Studies 2 tool was deployed for quality assessment. The protocol for this systematic review was registered in PROSPERO, and PRISMA guidelines were used for the identification, screening, eligibility, and selection process. Results This review encompassed 32 studies, 22 studies for VOC analysis and 9 studies for e-nose, one for both, with a total of 4688 subjects in the analysis. The pooled sensitivity and specificity of VOC analysis for CRC detection were 0.88 (95% CI, 0.83-0.92) and 0.85 (95% CI, 0.78-0.90), respectively. In the case of e-nose, the pooled sensitivity was 0.87 (95% CI, 0.83-0.90), and the pooled specificity was 0.78 (95% CI, 0.62-0.88). The area under the receiver operating characteristic analysis (ROC) curve for VOC analysis and e-noses were 0.93 (95% CI, 0.90-0.95) and 0.90 (95% CI, 0.87-0.92), respectively. Conclusion The outcomes of this review substantiate the commendable accuracy of VOC analysis and e-nose technology in detecting CRC. VOC analysis has a higher specificity than e-nose for the diagnosis of CRC and a sensitivity comparable to that of e-nose. However, numerous limitations, including a modest sample size, absence of standardized collection methods, lack of external validation, and a notable risk of bias, were identified. Consequently, there exists an imperative need for expansive, multi-center clinical studies to elucidate the applicability and reproducibility of VOC analysis or e-nose in the noninvasive diagnosis of colorectal cancer. Systematic review registration https://www.crd.york.ac.uk/prospero/#recordDetails, identifier CRD42023398465.
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Affiliation(s)
- Qiaoling Wang
- TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yu Fang
- Second Department of Oncology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Shiyan Tan
- Second Department of Oncology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Zhuohong Li
- Second Department of Oncology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Ruyi Zheng
- Second Department of Oncology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yifeng Ren
- TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yifang Jiang
- TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Xiaopeng Huang
- TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
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Picciariello A, Dezi A, Vincenti L, Spampinato MG, Zang W, Riahi P, Scott J, Sharma R, Fan X, Altomare DF. Colorectal Cancer Diagnosis through Breath Test Using a Portable Breath Analyzer-Preliminary Data. SENSORS (BASEL, SWITZERLAND) 2024; 24:2343. [PMID: 38610554 PMCID: PMC11014225 DOI: 10.3390/s24072343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 03/28/2024] [Accepted: 04/05/2024] [Indexed: 04/14/2024]
Abstract
Screening methods available for colorectal cancer (CRC) to date are burdened by poor reliability and low patient adherence and compliance. An altered pattern of volatile organic compounds (VOCs) in exhaled breath has been proposed as a non-invasive potential diagnostic tool for distinguishing CRC patients from healthy controls (HC). The aim of this study was to evaluate the reliability of an innovative portable device containing a micro-gas chromatograph in enabling rapid, on-site CRC diagnosis through analysis of patients' exhaled breath. In this prospective trial, breath samples were collected in a tertiary referral center of colorectal surgery, and analysis of the chromatograms was performed by the Biomedical Engineering Department. The breath of patients with CRC and HC was collected into Tedlar bags through a Nafion filter and mouthpiece with a one-way valve. The breath samples were analyzed by an automated portable gas chromatography device. Relevant volatile biomarkers and discriminant chromatographic peaks were identified through machine learning, linear discriminant analysis and principal component analysis. A total of 68 subjects, 36 patients affected by histologically proven CRC with no evidence of metastases and 32 HC with negative colonoscopies, were enrolled. After testing a training set (18 CRC and 18 HC) and a testing set (18 CRC and 14 HC), an overall specificity of 87.5%, sensitivity of 94.4% and accuracy of 91.2% in identifying CRC patients was found based on three VOCs. Breath biopsy may represent a promising non-invasive method of discriminating CRC patients from HC.
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Affiliation(s)
| | - Agnese Dezi
- Department of Precision and Regenerative Medicine and Ionian Area and Interdepartmental Research Center for Pelvic Floor Diseases (CIRPAP), University Aldo Moro of Bari, 70124 Bari, Italy
| | - Leonardo Vincenti
- Surgical Unit, IRCCS de Bellis, Castellana Grotte, 70013 Bari, Italy;
| | | | - Wenzhe Zang
- Biomedical Engineering Department, University of Michigan, 1101 Beal Ave., Ann Arbor, MI 48109, USA; (W.Z.); (J.S.); (R.S.); (X.F.)
| | - Pamela Riahi
- Biomedical Engineering Department, University of Michigan, 1101 Beal Ave., Ann Arbor, MI 48109, USA; (W.Z.); (J.S.); (R.S.); (X.F.)
| | - Jared Scott
- Biomedical Engineering Department, University of Michigan, 1101 Beal Ave., Ann Arbor, MI 48109, USA; (W.Z.); (J.S.); (R.S.); (X.F.)
| | - Ruchi Sharma
- Biomedical Engineering Department, University of Michigan, 1101 Beal Ave., Ann Arbor, MI 48109, USA; (W.Z.); (J.S.); (R.S.); (X.F.)
| | - Xudong Fan
- Biomedical Engineering Department, University of Michigan, 1101 Beal Ave., Ann Arbor, MI 48109, USA; (W.Z.); (J.S.); (R.S.); (X.F.)
| | - Donato F. Altomare
- Department of Precision and Regenerative Medicine and Ionian Area and Interdepartmental Research Center for Pelvic Floor Diseases (CIRPAP), University Aldo Moro of Bari, 70124 Bari, Italy
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Angioli R, Santonico M, Pennazza G, Montera R, Luvero D, Gatti A, Zompanti A, Finamore P, Incalzi RA. Use of Sensor Array Analysis to Detect Ovarian Cancer through Breath, Urine, and Blood: A Case-Control Study. Diagnostics (Basel) 2024; 14:561. [PMID: 38473033 DOI: 10.3390/diagnostics14050561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 03/14/2024] Open
Abstract
Ovarian cancer (OC) is the eighth most common cancer in women. Since screening programs do not exist, it is often diagnosed in advanced stages. Today, the detection of OC is based on clinical examination, transvaginal ultrasound (US), and serum biomarker (Carbohydrate Antigen 125 (CA 125) and Human Epididymis Protein 4 (HE4)) dosage, with a sensitivity of 88% and 95%, respectively, and a specificity of 84% for US and 76% for biomarkers. These methods are clearly not enough, and OC in its early stages is often missed. Many scientists have recently focused their attention on volatile organic compounds (VOCs). These are gaseous molecules, found in the breath, that could provide interesting information on several diseases, including solid tumors. To detect VOCs, an electronic nose was invented by a group of researchers. A similar device, the e-tongue, was later created to detect specific molecules in liquids. For the first time in the literature, we investigated the potential use of the electronic nose and the electronic tongue to detect ovarian cancer not just from breath but also from urine, blood, and plasma samples.
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Affiliation(s)
- Roberto Angioli
- Unit of Gynecology, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - Marco Santonico
- Unit of Electronics for Sensor Systems, Department of Science and Technology for Sustainable Development and One Health, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 21, 00128 Rome, Italy
| | - Giorgio Pennazza
- Unit of Electronics for Sensor Systems, Department of Engineering, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 21, 00128 Rome, Italy
| | - Roberto Montera
- Unit of Gynecology, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - Daniela Luvero
- Unit of Gynecology, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - Alessandra Gatti
- Unit of Gynecology, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - Alessandro Zompanti
- Unit of Electronics for Sensor Systems, Department of Engineering, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 21, 00128 Rome, Italy
| | - Panaiotis Finamore
- Unit of Geriatrics, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - Raffaele Antonelli Incalzi
- Unit of Geriatrics, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 200, 00128 Rome, Italy
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Zhou M, Wang Q, Lu X, Zhang P, Yang R, Chen Y, Xia J, Chen D. Exhaled breath and urinary volatile organic compounds (VOCs) for cancer diagnoses, and microbial-related VOC metabolic pathway analysis: a systematic review and meta-analysis. Int J Surg 2024; 110:1755-1769. [PMID: 38484261 PMCID: PMC10942174 DOI: 10.1097/js9.0000000000000999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 12/04/2023] [Indexed: 03/17/2024]
Abstract
BACKGROUND The gradual evolution of the detection and quantification of volatile organic compounds (VOCs) has been instrumental in cancer diagnosis. The primary objective of this study was to assess the diagnostic potential of exhaled breath and urinary VOCs in cancer detection. As VOCs are indicative of tumor and human metabolism, our work also sought to investigate the metabolic pathways linked to the development of cancerous tumors. MATERIALS AND METHODS An electronic search was performed in the PubMed database. Original studies on VOCs within exhaled breath and urine for cancer detection with a control group were included. A meta-analysis was conducted using a bivariate model to assess the sensitivity and specificity of the VOCs for cancer detection. Fagan's nomogram was designed to leverage the findings from our diagnostic analysis for the purpose of estimating the likelihood of cancer in patients. Ultimately, MetOrigin was employed to conduct an analysis of the metabolic pathways associated with VOCs in relation to both human and/or microbiota. RESULTS The pooled sensitivity, specificity and the area under the curve for cancer screening utilizing exhaled breath and urinary VOCs were determined to be 0.89, 0.88, and 0.95, respectively. A pretest probability of 51% can be considered as the threshold for diagnosing cancers with VOCs. As the estimated pretest probability of cancer exceeds 51%, it becomes more appropriate to emphasize the 'ruling in' approach. Conversely, when the estimated pretest probability of cancer falls below 51%, it is more suitable to emphasize the 'ruling out' approach. A total of 14, 14, 6, and 7 microbiota-related VOCs were identified in relation to lung, colorectal, breast, and liver cancers, respectively. The enrichment analysis of volatile metabolites revealed a significant enrichment of butanoate metabolism in the aforementioned tumor types. CONCLUSIONS The analysis of exhaled breath and urinary VOCs showed promise for cancer screening. In addition, the enrichment analysis of volatile metabolites revealed a significant enrichment of butanoate metabolism in four tumor types, namely lung, colorectum, breast and liver. These findings hold significant implications for the prospective clinical application of multiomics correlation in disease management and the exploration of potential therapeutic targets.
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Affiliation(s)
- Min Zhou
- Department of Breast Surgery, The Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical University, Wuxi Maternity and Child Health Care Hospital
| | - Qinghua Wang
- Research Institute for Reproductive Health and Genetic Diseases, Women’s Hospital of Jiangnan University
| | - Xinyi Lu
- Department of Breast Surgery, The Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical University, Wuxi Maternity and Child Health Care Hospital
| | - Ping Zhang
- Department of Breast Surgery, The Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical University, Wuxi Maternity and Child Health Care Hospital
| | - Rui Yang
- Research Institute for Reproductive Health and Genetic Diseases, Women’s Hospital of Jiangnan University
| | - Yu Chen
- Research Institute for Reproductive Health and Genetic Diseases, Women’s Hospital of Jiangnan University
| | - Jiazeng Xia
- Department of General Surgery and Translational Medicine Center, The Affiliated Wuxi No. 2 People’s Hospital of Nanjing Medical University, Jiangnan University Medical Center, Wuxi, People’s Republic of China
| | - Daozhen Chen
- Department of Breast Surgery, The Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical University, Wuxi Maternity and Child Health Care Hospital
- Research Institute for Reproductive Health and Genetic Diseases, Women’s Hospital of Jiangnan University
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Kononova E, Mežmale L, Poļaka I, Veliks V, Anarkulova L, Vilkoite I, Tolmanis I, Ļeščinska AM, Stonāns I, Pčolkins A, Mochalski P, Leja M. Breath Fingerprint of Colorectal Cancer Patients Based on the Gas Chromatography-Mass Spectrometry Analysis. Int J Mol Sci 2024; 25:1632. [PMID: 38338911 PMCID: PMC10855950 DOI: 10.3390/ijms25031632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/25/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024] Open
Abstract
The human body emits a multitude of volatile organic compounds (VOCs) via tissues and various bodily fluids or exhaled breath. These compounds collectively create a distinctive chemical profile, which can potentially be employed to identify changes in human metabolism associated with colorectal cancer (CRC) and, consequently, facilitate the diagnosis of this disease. The main goal of this study was to investigate and characterize the VOCs' chemical patterns associated with the breath of CRC patients and controls and identify potential expiratory markers of this disease. For this purpose, gas chromatography-mass spectrometry was applied. Collectively, 1656 distinct compounds were identified in the breath samples provided by 152 subjects. Twenty-two statistically significant VOCs (p-xylene; hexanal; 2-methyl-1,3-dioxolane; 2,2,4-trimethyl-1,3-pentanediol diisobutyrate; hexadecane; nonane; ethylbenzene; cyclohexanone; diethyl phthalate; 6-methyl-5-hepten-2-one; tetrahydro-2H-pyran-2-one; 2-butanone; benzaldehyde; dodecanal; benzothiazole; tetradecane; 1-dodecanol; 1-benzene; 3-methylcyclopentyl acetate; 1-nonene; toluene) were observed at higher concentrations in the exhaled breath of the CRC group. The elevated levels of these VOCs in CRC patients' breath suggest the potential for these compounds to serve as biomarkers for CRC.
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Affiliation(s)
- Elīna Kononova
- Institute of Clinical and Preventive Medicine, University of Latvia, LV-1586 Riga, Latvia; (E.K.); (I.P.); (V.V.); (L.A.); (A.M.Ļ.); (I.S.); (A.P.); (M.L.)
- Faculty of Medicine, Riga Stradins University, LV-1007 Riga, Latvia;
| | - Linda Mežmale
- Institute of Clinical and Preventive Medicine, University of Latvia, LV-1586 Riga, Latvia; (E.K.); (I.P.); (V.V.); (L.A.); (A.M.Ļ.); (I.S.); (A.P.); (M.L.)
- Riga East University Hospital, LV-1038 Riga, Latvia
- Health Centre 4, LV-1012 Riga, Latvia;
| | - Inese Poļaka
- Institute of Clinical and Preventive Medicine, University of Latvia, LV-1586 Riga, Latvia; (E.K.); (I.P.); (V.V.); (L.A.); (A.M.Ļ.); (I.S.); (A.P.); (M.L.)
- Department of Modelling and Simulation, Riga Technical University, LV-1048 Riga, Latvia
| | - Viktors Veliks
- Institute of Clinical and Preventive Medicine, University of Latvia, LV-1586 Riga, Latvia; (E.K.); (I.P.); (V.V.); (L.A.); (A.M.Ļ.); (I.S.); (A.P.); (M.L.)
| | - Linda Anarkulova
- Institute of Clinical and Preventive Medicine, University of Latvia, LV-1586 Riga, Latvia; (E.K.); (I.P.); (V.V.); (L.A.); (A.M.Ļ.); (I.S.); (A.P.); (M.L.)
- Health Centre 4, LV-1012 Riga, Latvia;
- Liepaja Regional Hospital, LV-3414 Liepaja, Latvia
| | - Ilona Vilkoite
- Health Centre 4, LV-1012 Riga, Latvia;
- Department of Doctoral Studies, Riga Stradins University, LV-1007 Riga, Latvia
- Digestive Diseases Centre GASTRO, LV-1079 Riga, Latvia
| | - Ivars Tolmanis
- Faculty of Medicine, Riga Stradins University, LV-1007 Riga, Latvia;
- Digestive Diseases Centre GASTRO, LV-1079 Riga, Latvia
| | - Anna Marija Ļeščinska
- Institute of Clinical and Preventive Medicine, University of Latvia, LV-1586 Riga, Latvia; (E.K.); (I.P.); (V.V.); (L.A.); (A.M.Ļ.); (I.S.); (A.P.); (M.L.)
- Riga East University Hospital, LV-1038 Riga, Latvia
- Digestive Diseases Centre GASTRO, LV-1079 Riga, Latvia
| | - Ilmārs Stonāns
- Institute of Clinical and Preventive Medicine, University of Latvia, LV-1586 Riga, Latvia; (E.K.); (I.P.); (V.V.); (L.A.); (A.M.Ļ.); (I.S.); (A.P.); (M.L.)
| | - Andrejs Pčolkins
- Institute of Clinical and Preventive Medicine, University of Latvia, LV-1586 Riga, Latvia; (E.K.); (I.P.); (V.V.); (L.A.); (A.M.Ļ.); (I.S.); (A.P.); (M.L.)
- Riga East University Hospital, LV-1038 Riga, Latvia
- Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia
| | - Pawel Mochalski
- Institute for Breath Research, University of Innsbruck, 6020 Innsbruck, Austria;
- Institute of Chemistry, Jan Kochanowski University of Kielce, 25-369 Kielce, Poland
| | - Mārcis Leja
- Institute of Clinical and Preventive Medicine, University of Latvia, LV-1586 Riga, Latvia; (E.K.); (I.P.); (V.V.); (L.A.); (A.M.Ļ.); (I.S.); (A.P.); (M.L.)
- Riga East University Hospital, LV-1038 Riga, Latvia
- Digestive Diseases Centre GASTRO, LV-1079 Riga, Latvia
- Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia
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Bajo-Fernández M, Souza-Silva ÉA, Barbas C, Rey-Stolle MF, García A. GC-MS-based metabolomics of volatile organic compounds in exhaled breath: applications in health and disease. A review. Front Mol Biosci 2024; 10:1295955. [PMID: 38298553 PMCID: PMC10828970 DOI: 10.3389/fmolb.2023.1295955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 12/05/2023] [Indexed: 02/02/2024] Open
Abstract
Exhaled breath analysis, with particular emphasis on volatile organic compounds, represents a growing area of clinical research due to its obvious advantages over other diagnostic tests. Numerous pathologies have been extensively investigated for the identification of specific biomarkers in exhalates through metabolomics. However, the transference of breath tests to clinics remains limited, mainly due to deficiency in methodological standardization. Critical steps include the selection of breath sample types, collection devices, and enrichment techniques. GC-MS is the reference analytical technique for the analysis of volatile organic compounds in exhalates, especially during the biomarker discovery phase in metabolomics. This review comprehensively examines and compares metabolomic studies focusing on cancer, lung diseases, and infectious diseases. In addition to delving into the experimental designs reported, it also provides a critical discussion of the methodological aspects, ranging from the experimental design and sample collection to the identification of potential pathology-specific biomarkers.
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Affiliation(s)
- María Bajo-Fernández
- Centro de Metabolómica y Bioanálisis (CEMBIO), Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, Boadilla del Monte, Spain
| | - Érica A. Souza-Silva
- Centro de Metabolómica y Bioanálisis (CEMBIO), Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, Boadilla del Monte, Spain
- Departmento de Química, Universidade Federal de São Paulo (UNIFESP), Diadema, Brazil
| | - Coral Barbas
- Centro de Metabolómica y Bioanálisis (CEMBIO), Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, Boadilla del Monte, Spain
| | - Ma Fernanda Rey-Stolle
- Centro de Metabolómica y Bioanálisis (CEMBIO), Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, Boadilla del Monte, Spain
| | - Antonia García
- Centro de Metabolómica y Bioanálisis (CEMBIO), Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, Boadilla del Monte, Spain
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Gallos IK, Tryfonopoulos D, Shani G, Amditis A, Haick H, Dionysiou DD. Advancing Colorectal Cancer Diagnosis with AI-Powered Breathomics: Navigating Challenges and Future Directions. Diagnostics (Basel) 2023; 13:3673. [PMID: 38132257 PMCID: PMC10743128 DOI: 10.3390/diagnostics13243673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 12/12/2023] [Accepted: 12/13/2023] [Indexed: 12/23/2023] Open
Abstract
Early detection of colorectal cancer is crucial for improving outcomes and reducing mortality. While there is strong evidence of effectiveness, currently adopted screening methods present several shortcomings which negatively impact the detection of early stage carcinogenesis, including low uptake due to patient discomfort. As a result, developing novel, non-invasive alternatives is an important research priority. Recent advancements in the field of breathomics, the study of breath composition and analysis, have paved the way for new avenues for non-invasive cancer detection and effective monitoring. Harnessing the utility of Volatile Organic Compounds in exhaled breath, breathomics has the potential to disrupt colorectal cancer screening practices. Our goal is to outline key research efforts in this area focusing on machine learning methods used for the analysis of breathomics data, highlight challenges involved in artificial intelligence application in this context, and suggest possible future directions which are currently considered within the framework of the European project ONCOSCREEN.
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Affiliation(s)
- Ioannis K. Gallos
- Institute of Communication and Computer Systems, National Technical University of Athens, Zografos Campus, 15780 Athens, Greece; (D.T.); (A.A.)
| | - Dimitrios Tryfonopoulos
- Institute of Communication and Computer Systems, National Technical University of Athens, Zografos Campus, 15780 Athens, Greece; (D.T.); (A.A.)
| | - Gidi Shani
- Laboratory for Nanomaterial-Based Devices, Technion—Israel Institute of Technology, Haifa 3200003, Israel; (G.S.); (H.H.)
| | - Angelos Amditis
- Institute of Communication and Computer Systems, National Technical University of Athens, Zografos Campus, 15780 Athens, Greece; (D.T.); (A.A.)
| | - Hossam Haick
- Laboratory for Nanomaterial-Based Devices, Technion—Israel Institute of Technology, Haifa 3200003, Israel; (G.S.); (H.H.)
| | - Dimitra D. Dionysiou
- Institute of Communication and Computer Systems, National Technical University of Athens, Zografos Campus, 15780 Athens, Greece; (D.T.); (A.A.)
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Le T, Priefer R. Detection technologies of volatile organic compounds in the breath for cancer diagnoses. Talanta 2023; 265:124767. [PMID: 37327663 DOI: 10.1016/j.talanta.2023.124767] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/31/2023] [Accepted: 06/03/2023] [Indexed: 06/18/2023]
Abstract
Although there are new approaches in both cancer treatment and diagnosis, overall mortality is a major concern. New technologies have attempted to look at breath volatile organic compounds (VOCs) detection to diagnose cancer. Gas Chromatography and Mass Spectrometry (GC - MS) have remained the gold standard of VOC analysis for decades, but it has limitations in differentiating VOCs between cancer subtypes. To increase efficacy and accuracy, new methods to analyze these breath VOCs have been introduced, such as Solid Phase Microextraction/Gas Chromatography-Mass Spectrometry (SPME/GC-MS), Selected Ion Flow Tube - Mass Spectrometry (SIFT-MS), Proton Transfer Reaction - Mass Spectrometry (PRT-MS), Ion Mobility Spectrometry (IMS), and Colorimetric Sensors. This article highlights new technologies that have been studied and applied in the detection and quantification of breath VOCs for possible cancer diagnoses.
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Affiliation(s)
- Tien Le
- Massachusetts College of Pharmacy and Health Sciences University, Boston, Ma, United States
| | - Ronny Priefer
- Massachusetts College of Pharmacy and Health Sciences University, Boston, Ma, United States.
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Moura PC, Ribeiro PA, Raposo M, Vassilenko V. The State of the Art on Graphene-Based Sensors for Human Health Monitoring through Breath Biomarkers. SENSORS (BASEL, SWITZERLAND) 2023; 23:9271. [PMID: 38005657 PMCID: PMC10674474 DOI: 10.3390/s23229271] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 11/13/2023] [Accepted: 11/17/2023] [Indexed: 11/26/2023]
Abstract
The field of organic-borne biomarkers has been gaining relevance due to its suitability for diagnosing pathologies and health conditions in a rapid, accurate, non-invasive, painless and low-cost way. Due to the lack of analytical techniques with features capable of analysing such a complex matrix as the human breath, the academic community has focused on developing electronic noses based on arrays of gas sensors. These sensors are assembled considering the excitability, sensitivity and sensing capacities of a specific nanocomposite, graphene. In this way, graphene-based sensors can be employed for a vast range of applications that vary from environmental to medical applications. This review work aims to gather the most relevant published papers under the scope of "Graphene sensors" and "Biomarkers" in order to assess the state of the art in the field of graphene sensors for the purposes of biomarker identification. During the bibliographic search, a total of six pathologies were identified as the focus of the work. They were lung cancer, gastric cancer, chronic kidney diseases, respiratory diseases that involve inflammatory processes of the airways, like asthma and chronic obstructive pulmonary disease, sleep apnoea and diabetes. The achieved results, current development of the sensing sensors, and main limitations or challenges of the field of graphene sensors are discussed throughout the paper, as well as the features of the experiments addressed.
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Affiliation(s)
| | | | | | - Valentina Vassilenko
- Laboratory for Instrumentation, Biomedical Engineering and Radiation Physics (LIBPhys-NOVA), Department of Physics, NOVA School of Science and Technology, NOVA University of Lisbon, Campus FCT-NOVA, 2829-516 Caparica, Portugal; (P.C.M.); (P.A.R.); (M.R.)
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10
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Vassilenko V, Moura PC, Raposo M. Diagnosis of Carcinogenic Pathologies through Breath Biomarkers: Present and Future Trends. Biomedicines 2023; 11:3029. [PMID: 38002028 PMCID: PMC10669878 DOI: 10.3390/biomedicines11113029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 11/26/2023] Open
Abstract
The assessment of volatile breath biomarkers has been targeted with a lot of interest by the scientific and medical communities during the past decades due to their suitability for an accurate, painless, non-invasive, and rapid diagnosis of health states and pathological conditions. This paper reviews the most relevant bibliographic sources aiming to gather the most pertinent volatile organic compounds (VOCs) already identified as putative cancer biomarkers. Here, a total of 265 VOCs and the respective bibliographic sources are addressed regarding their scientifically proven suitability to diagnose a total of six carcinogenic diseases, namely lung, breast, gastric, colorectal, prostate, and squamous cell (oesophageal and laryngeal) cancers. In addition, future trends in the identification of five other forms of cancer, such as bladder, liver, ovarian, pancreatic, and thyroid cancer, through perspective volatile breath biomarkers are equally presented and discussed. All the results already achieved in the detection, identification, and quantification of endogenous metabolites produced by all kinds of normal and abnormal processes in the human body denote a promising and auspicious future for this alternative diagnostic tool, whose future passes by the development and employment of newer and more accurate collection and analysis techniques, and the certification for utilisation in real clinical scenarios.
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Affiliation(s)
- Valentina Vassilenko
- Laboratory for Instrumentation, Biomedical Engineering and Radiation Physics (LIBPhys-UNL), Department of Physics, NOVA School of Science and Technology, NOVA University of Lisbon, Campus FCT-UNL, 2829-516 Caparica, Portugal;
| | - Pedro Catalão Moura
- Laboratory for Instrumentation, Biomedical Engineering and Radiation Physics (LIBPhys-UNL), Department of Physics, NOVA School of Science and Technology, NOVA University of Lisbon, Campus FCT-UNL, 2829-516 Caparica, Portugal;
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11
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Poļaka I, Mežmale L, Anarkulova L, Kononova E, Vilkoite I, Veliks V, Ļeščinska AM, Stonāns I, Pčolkins A, Tolmanis I, Shani G, Haick H, Mitrovics J, Glöckler J, Mizaikoff B, Leja M. The Detection of Colorectal Cancer through Machine Learning-Based Breath Sensor Analysis. Diagnostics (Basel) 2023; 13:3355. [PMID: 37958251 PMCID: PMC10648537 DOI: 10.3390/diagnostics13213355] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/24/2023] [Accepted: 10/27/2023] [Indexed: 11/15/2023] Open
Abstract
Colorectal cancer (CRC) is the third most common malignancy and the second most common cause of cancer-related deaths worldwide. While CRC screening is already part of organized programs in many countries, there remains a need for improved screening tools. In recent years, a potential approach for cancer diagnosis has emerged via the analysis of volatile organic compounds (VOCs) using sensor technologies. The main goal of this study was to demonstrate and evaluate the diagnostic potential of a table-top breath analyzer for detecting CRC. Breath sampling was conducted and CRC vs. non-cancer groups (105 patients with CRC, 186 non-cancer subjects) were included in analysis. The obtained data were analyzed using supervised machine learning methods (i.e., Random Forest, C4.5, Artificial Neural Network, and Naïve Bayes). Superior accuracy was achieved using Random Forest and Evolutionary Search for Features (79.3%, sensitivity 53.3%, specificity 93.0%, AUC ROC 0.734), and Artificial Neural Networks and Greedy Search for Features (78.2%, sensitivity 43.3%, specificity 96.5%, AUC ROC 0.735). Our results confirm the potential of the developed breath analyzer as a promising tool for identifying and categorizing CRC within a point-of-care clinical context. The combination of MOX sensors provided promising results in distinguishing healthy vs. diseased breath samples. Its capacity for rapid, non-invasive, and targeted CRC detection suggests encouraging prospects for future clinical screening applications.
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Affiliation(s)
- Inese Poļaka
- Institute of Clinical and Preventive Medicine, University of Latvia, LV-1586 Riga, Latvia; (I.P.); (L.A.); (E.K.); (V.V.); (A.M.Ļ.); (I.S.); (A.P.); (M.L.)
- Department of Modelling and Simulation, Riga Technical University, LV-1048 Riga, Latvia
| | - Linda Mežmale
- Institute of Clinical and Preventive Medicine, University of Latvia, LV-1586 Riga, Latvia; (I.P.); (L.A.); (E.K.); (V.V.); (A.M.Ļ.); (I.S.); (A.P.); (M.L.)
- Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia
- Riga East University Hospital, LV-1038 Riga, Latvia
- Faculty of Residency, Riga Stradins University, LV-1007 Riga, Latvia
- Health Centre 4, LV-1012 Riga, Latvia;
| | - Linda Anarkulova
- Institute of Clinical and Preventive Medicine, University of Latvia, LV-1586 Riga, Latvia; (I.P.); (L.A.); (E.K.); (V.V.); (A.M.Ļ.); (I.S.); (A.P.); (M.L.)
- Faculty of Residency, Riga Stradins University, LV-1007 Riga, Latvia
- Health Centre 4, LV-1012 Riga, Latvia;
- Liepaja Regional Hospital, LV-3414 Liepaja, Latvia
| | - Elīna Kononova
- Institute of Clinical and Preventive Medicine, University of Latvia, LV-1586 Riga, Latvia; (I.P.); (L.A.); (E.K.); (V.V.); (A.M.Ļ.); (I.S.); (A.P.); (M.L.)
- Faculty of Medicine, Riga Stradins University, LV-1007 Riga, Latvia;
| | - Ilona Vilkoite
- Health Centre 4, LV-1012 Riga, Latvia;
- Department of Doctoral Studies, Riga Stradins University, LV-1007 Riga, Latvia
| | - Viktors Veliks
- Institute of Clinical and Preventive Medicine, University of Latvia, LV-1586 Riga, Latvia; (I.P.); (L.A.); (E.K.); (V.V.); (A.M.Ļ.); (I.S.); (A.P.); (M.L.)
| | - Anna Marija Ļeščinska
- Institute of Clinical and Preventive Medicine, University of Latvia, LV-1586 Riga, Latvia; (I.P.); (L.A.); (E.K.); (V.V.); (A.M.Ļ.); (I.S.); (A.P.); (M.L.)
- Riga East University Hospital, LV-1038 Riga, Latvia
- Digestive Diseases Centre GASTRO, LV-1079 Riga, Latvia
| | - Ilmārs Stonāns
- Institute of Clinical and Preventive Medicine, University of Latvia, LV-1586 Riga, Latvia; (I.P.); (L.A.); (E.K.); (V.V.); (A.M.Ļ.); (I.S.); (A.P.); (M.L.)
| | - Andrejs Pčolkins
- Institute of Clinical and Preventive Medicine, University of Latvia, LV-1586 Riga, Latvia; (I.P.); (L.A.); (E.K.); (V.V.); (A.M.Ļ.); (I.S.); (A.P.); (M.L.)
- Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia
- Riga East University Hospital, LV-1038 Riga, Latvia
| | - Ivars Tolmanis
- Faculty of Medicine, Riga Stradins University, LV-1007 Riga, Latvia;
- Digestive Diseases Centre GASTRO, LV-1079 Riga, Latvia
| | - Gidi Shani
- Laboratory for Nanomaterial-Based Devices, Technion—Israel Institute of Technology, Haifa 3200003, Israel; (G.S.); (H.H.)
| | - Hossam Haick
- Laboratory for Nanomaterial-Based Devices, Technion—Israel Institute of Technology, Haifa 3200003, Israel; (G.S.); (H.H.)
| | | | - Johannes Glöckler
- Institute of Analytical and Bioanalytical Chemistry, Ulm University, 89081 Ulm, Germany; (J.G.); (B.M.)
| | - Boris Mizaikoff
- Institute of Analytical and Bioanalytical Chemistry, Ulm University, 89081 Ulm, Germany; (J.G.); (B.M.)
- Hahn-Schickard, 89077 Ulm, Germany
| | - Mārcis Leja
- Institute of Clinical and Preventive Medicine, University of Latvia, LV-1586 Riga, Latvia; (I.P.); (L.A.); (E.K.); (V.V.); (A.M.Ļ.); (I.S.); (A.P.); (M.L.)
- Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia
- Riga East University Hospital, LV-1038 Riga, Latvia
- Digestive Diseases Centre GASTRO, LV-1079 Riga, Latvia
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12
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Hanevelt J, Schoenaker IJH, Brohet RM, Schrauwen RWM, Baas FJN, Tanis PJ, van Westreenen HL, de Vos tot Nederveen Cappel WH. Alteration of the Exhaled Volatile Organic Compound Pattern in Colorectal Cancer Patients after Intentional Curative Surgery-A Prospective Pilot Study. Cancers (Basel) 2023; 15:4785. [PMID: 37835479 PMCID: PMC10571749 DOI: 10.3390/cancers15194785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/25/2023] [Accepted: 09/26/2023] [Indexed: 10/15/2023] Open
Abstract
As current follow-up modalities for colorectal carcinoma (CRC) have restricted sensitivity, novel diagnostic tools are needed. The presence of CRC changes the endogenous metabolism, resulting in the release of a specific volatile organic compounds (VOC) pattern that can be detected with an electronic nose or AeonoseTM. To evaluate the use of an electronic nose in the follow-up of CRC, we studied the effect of curative surgery on the VOC pattern recognition using AeonoseTM. A prospective cohort study was performed, in which 47 patients diagnosed with CRC were included, all of whom underwent curative surgical resection. Breath testing was performed before and after surgery using the AeonoseTM. A machine learning model was developed by discerning between the 94 pre-and postoperative breath samples. The training model differentiated between the pre-and postoperative CRC breath samples with a sensitivity and specificity of 0.78 (95%CI 0.61-0.90) and 0.73 (95%CI 0.56-0.86), respectively, with an accuracy of 0.76 (95%CI 0.66-0.85), and an area under the curve of 0.79 (95%CI 0.68-0.89). The internal validation of the test set resulted in an accuracy of 0.75 (95%CI 0.51-0.91) and AUC of 0.82 (95%CI 0.61-1). In conclusion, our results suggest that the VOC pattern of CRC patients is altered by curative surgery in a short period, indicating that the exhaled VOCs might be closely related to the presence of CRC. However, to use AeonoseTM as a potential diagnostic tool in the clinical follow-up of CRC patients, the performance of the models needs to be improved through further large-scale prospective research.
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Affiliation(s)
- Julia Hanevelt
- Department of Gastroenterology and Hepatology, Isala, Dokter van Heesweg 2, 8025 AB Zwolle, The Netherlands
| | | | - Richard M. Brohet
- Department of Epidemiology and Statistics, Isala, Dokter van Heesweg 2, 8025 AB Zwolle, The Netherlands
| | - Ruud W. M. Schrauwen
- Department of Gastroenterology and Hepatology, Bernhoven, Nistelrodeseweg 10, 5406 PT Uden, The Netherlands
| | - Frederique J. N. Baas
- Department of Gastroenterology and Hepatology, Isala, Dokter van Heesweg 2, 8025 AB Zwolle, The Netherlands
| | - Pieter J. Tanis
- Department of Surgery, University Medical Center Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
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13
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Jiang H, Zhou S, Li G. Novel biomarkers used for early diagnosis and tyrosine kinase inhibitors as targeted therapies in colorectal cancer. Front Pharmacol 2023; 14:1189799. [PMID: 37719843 PMCID: PMC10502318 DOI: 10.3389/fphar.2023.1189799] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 08/14/2023] [Indexed: 09/19/2023] Open
Abstract
Colorectal cancer (CRC) is the third most common and second most lethal type of cancer worldwide, presenting major health risks as well as economic costs to both people and society. CRC survival chances are significantly higher if the cancer is diagnosed and treated early. With the development of molecular biology, numerous initiatives have been undertaken to identify novel biomarkers for the early diagnosis of CRC. Pathological disorders can be diagnosed at a lower cost with the help of biomarkers, which can be detected in stool, blood, and tissue samples. Several lines of evidence suggest that the gut microbiota could be used as a biomarker for CRC screening and treatment. CRC treatment choices include surgical resection, chemotherapy, immunotherapy, gene therapy, and combination therapies. Targeted therapies are a relatively new and promising modality of treatment that has been shown to increase patients' overall survival (OS) rates and can inhibit cancer cell development. Several small-molecule tyrosine kinase inhibitors (TKIs) are being investigated as potential treatments due to our increasing awareness of CRC's molecular causes and oncogenic signaling. These compounds may inhibit critical enzymes in controlling signaling pathways, which are crucial for CRC cells' development, differentiation, proliferation, and survival. On the other hand, only one of the approximately 42 TKIs that demonstrated anti-tumor effects in pre-clinical studies has been licensed for clinical usage in CRC. A significant knowledge gap exists when bringing these tailored medicines into the clinic. As a result, the emphasis of this review is placed on recently discovered biomarkers for early diagnosis as well as tyrosine kinase inhibitors as possible therapy options for CRC.
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14
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Katsaounou K, Yiannakou D, Nikolaou E, Brown C, Vogazianos P, Aristodimou A, Chi J, Costeas P, Agapiou A, Frangou E, Tsiaoussis G, Potamitis G, Antoniades A, Shammas C, Apidianakis Y. Fecal Microbiota and Associated Volatile Organic Compounds Distinguishing No-Adenoma from High-Risk Colon Adenoma Adults. Metabolites 2023; 13:819. [PMID: 37512526 PMCID: PMC10383435 DOI: 10.3390/metabo13070819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/26/2023] [Accepted: 06/29/2023] [Indexed: 07/30/2023] Open
Abstract
Microbiota and the metabolites they produce within the large intestine interact with the host epithelia under the influence of a range of host-derived metabolic, immune, and homeostatic factors. This complex host-microbe interaction affects intestinal tumorigenesis, but established microbial or metabolite profiles predicting colorectal cancer (CRC) risk are missing. Here, we aimed to identify fecal bacteria, volatile organic compounds (VOC), and their associations that distinguish healthy (non-adenoma, NA) from CRC prone (high-risk adenoma, HRA) individuals. Analyzing fecal samples obtained from 117 participants ≥15 days past routine colonoscopy, we highlight the higher abundance of Proteobacteria and Parabacteroides distasonis, and the lower abundance of Lachnospiraceae species, Roseburia faecis, Blautia luti, Fusicatenibacter saccharivorans, Eubacterium rectale, and Phascolarctobacterium faecium in the samples of HRA individuals. Volatolomic analysis of samples from 28 participants revealed a higher concentration of five compounds in the feces of HRA individuals, isobutyric acid, methyl butyrate, methyl propionate, 2-hexanone, and 2-pentanone. We used binomial logistic regression modeling, revealing 68 and 96 fecal bacteria-VOC associations at the family and genus level, respectively, that distinguish NA from HRA endpoints. For example, isobutyric acid associations with Lachnospiraceae incertae sedis and Bacteroides genera exhibit positive and negative regression lines for NA and HRA endpoints, respectively. However, the same chemical associates with Coprococcus and Colinsella genera exhibit the reverse regression line trends. Thus, fecal microbiota and VOC profiles and their associations in NA versus HRA individuals indicate the significance of multiple levels of analysis towards the identification of testable CRC risk biomarkers.
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Affiliation(s)
- Kyriaki Katsaounou
- Department of Biological Sciences, University of Cyprus, Nicosia 2109, Cyprus
| | | | | | | | | | | | | | | | - Agapios Agapiou
- Department of Chemistry, University of Cyprus, Nicosia 2109, Cyprus
| | | | | | | | | | | | - Yiorgos Apidianakis
- Department of Biological Sciences, University of Cyprus, Nicosia 2109, Cyprus
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Pecere S, Ciuffini C, Chiappetta MF, Petruzziello L, Papparella LG, Spada C, Gasbarrini A, Barbaro F. Increasing the accuracy of colorectal cancer screening. Expert Rev Anticancer Ther 2023; 23:583-591. [PMID: 37099725 DOI: 10.1080/14737140.2023.2207828] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
INTRODUCTION Colorectal cancer (CRC) is a major health issue, being responsible for nearly 10% of all cancer-related deaths. Since CRC is often an asymptomatic or paucisymptomatic disease until it reaches advanced stages, screening is crucial for the diagnosis of preneoplastic lesions or early CRC. AREAS COVERED The aim of this review is to summarize the literature evidence on currently available CRC screening tools, with their pros and cons, focusing on the level of accuracy reached by each test over time. We also provide an overview of novel technologies and scientific advances that are currently being investigated and that in the future may represent real game-changers in the field of CRC screening. EXPERT OPINION We suggest that best screening modalities are annual or biennial FIT and colonoscopy every 10 years. We believe that the introduction of artificial intelligence (AI)-tools in the CRC screening field could lead to a significant improvement of the screening efficacy in reducing CRC incidence and mortality in the future. More resources should be put into implementing CRC programmes and support research project to further increase accuracy of CRC screening tests and strategies.
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Affiliation(s)
- Silvia Pecere
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome
- Università Cattolica Del Sacro Cuore di Roma, Rome
| | - Cristina Ciuffini
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome
- Università Cattolica Del Sacro Cuore di Roma, Rome
| | - Michele Francesco Chiappetta
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome
- Università Cattolica Del Sacro Cuore di Roma, Rome
| | - Lucio Petruzziello
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome
- Università Cattolica Del Sacro Cuore di Roma, Rome
| | - Luigi Giovanni Papparella
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome
- Università Cattolica Del Sacro Cuore di Roma, Rome
| | - Cristiano Spada
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome
- Università Cattolica Del Sacro Cuore di Roma, Rome
| | - Antonio Gasbarrini
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome
- Università Cattolica Del Sacro Cuore di Roma, Rome
| | - Federico Barbaro
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome
- Università Cattolica Del Sacro Cuore di Roma, Rome
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16
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Song D, Wang F, Ju Y, He Q, Sun T, Deng W, Ding R, Zhang C, Xu Q, Qi C, Bao J. Application and development of noninvasive biomarkers for colorectal cancer screening: a systematic review. Int J Surg 2023; 109:925-935. [PMID: 36974713 PMCID: PMC10389553 DOI: 10.1097/js9.0000000000000260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 01/22/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND Colorectal cancer (CRC) is the second most common cause of cancer-related death (9.4% of the 9.9 million cancer deaths). However, CRC develops slowly, and early detection and intervention can effectively improve the survival rate and quality of life. Although colonoscopy can detect and diagnose CRC, it is unsuitable for CRC screening in average-risk populations. Some commercial kits based on DNA mutation or methylation are approved for screening, but the low sensitivity for advanced adenoma or early-stage CRC would limit the applications. MAIN RESULTS Recently, researchers have focused on developing noninvasive or minimally invasive, easily accessible biomarkers with higher sensitivity and accuracy for CRC screening. Numerous reports describe advances in biomarkers, including DNA mutations and methylation, mRNA and miRNA, gut microbes, and metabolites, as well as low-throughput multiomics panels. In small cohorts, the specificity and sensitivity improved when fecal immunochemical testing combined with other biomarkers; further verification in large cohorts is expected. In addition, the continuous improvement of laboratory technology has also improved the sensitivity of detection technology, such as PCR, and the application of CRISPR/Cas technology. Besides, artificial intelligence has extensively promoted the mining of biomarkers. Machine learning was performed to construct a diagnosis model for CRC screening based on the cfDNA fragment features from whole-genome sequencing data. In another study, multiomics markers, including cfDNA, epigenetic, and protein signals, were also discovered by machine learning. Finally, advancements in sensor technology promote the applicability of volatile organic compounds in CRC early detection. CONCLUSION Here, the authors review advances in early detection and screening of CRC based on different biomarker types. Most studies reported optimistic findings based on preliminary research, and prospective clinical studies are ongoing. These promising biomarkers are expected to more accurately identify early-stage patients with CRC and be applied in the future.
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Affiliation(s)
| | - Fei Wang
- The Medical Department, Jiangsu Simcere Diagnostics Co. Ltd, Nanjing Simcere Medical Laboratory Science Co. Ltd, The State Key Lab of Translational Medicine and Innovative Drug Development, Jiangsu Simcere Diagnostics Co. Ltd, Xuanwu District, Nanjing, Jiangsu Province, China
| | - Yongzhi Ju
- The Medical Department, Jiangsu Simcere Diagnostics Co. Ltd, Nanjing Simcere Medical Laboratory Science Co. Ltd, The State Key Lab of Translational Medicine and Innovative Drug Development, Jiangsu Simcere Diagnostics Co. Ltd, Xuanwu District, Nanjing, Jiangsu Province, China
| | - Qianru He
- The Medical Department, Jiangsu Simcere Diagnostics Co. Ltd, Nanjing Simcere Medical Laboratory Science Co. Ltd, The State Key Lab of Translational Medicine and Innovative Drug Development, Jiangsu Simcere Diagnostics Co. Ltd, Xuanwu District, Nanjing, Jiangsu Province, China
| | - Tingting Sun
- The Medical Department, Jiangsu Simcere Diagnostics Co. Ltd, Nanjing Simcere Medical Laboratory Science Co. Ltd, The State Key Lab of Translational Medicine and Innovative Drug Development, Jiangsu Simcere Diagnostics Co. Ltd, Xuanwu District, Nanjing, Jiangsu Province, China
| | - Wanglong Deng
- The Medical Department, Jiangsu Simcere Diagnostics Co. Ltd, Nanjing Simcere Medical Laboratory Science Co. Ltd, The State Key Lab of Translational Medicine and Innovative Drug Development, Jiangsu Simcere Diagnostics Co. Ltd, Xuanwu District, Nanjing, Jiangsu Province, China
| | - Ran Ding
- The Medical Department, Jiangsu Simcere Diagnostics Co. Ltd, Nanjing Simcere Medical Laboratory Science Co. Ltd, The State Key Lab of Translational Medicine and Innovative Drug Development, Jiangsu Simcere Diagnostics Co. Ltd, Xuanwu District, Nanjing, Jiangsu Province, China
| | - Chao Zhang
- The Medical Department, Jiangsu Simcere Diagnostics Co. Ltd, Nanjing Simcere Medical Laboratory Science Co. Ltd, The State Key Lab of Translational Medicine and Innovative Drug Development, Jiangsu Simcere Diagnostics Co. Ltd, Xuanwu District, Nanjing, Jiangsu Province, China
| | - Qing Xu
- The Medical Department, Jiangsu Simcere Diagnostics Co. Ltd, Nanjing Simcere Medical Laboratory Science Co. Ltd, The State Key Lab of Translational Medicine and Innovative Drug Development, Jiangsu Simcere Diagnostics Co. Ltd, Xuanwu District, Nanjing, Jiangsu Province, China
| | - Chuang Qi
- The Medical Department, Jiangsu Simcere Diagnostics Co. Ltd, Nanjing Simcere Medical Laboratory Science Co. Ltd, The State Key Lab of Translational Medicine and Innovative Drug Development, Jiangsu Simcere Diagnostics Co. Ltd, Xuanwu District, Nanjing, Jiangsu Province, China
| | - Jun Bao
- Medical Oncology, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research and The Affiliated Cancer Hospital of Nanjing Medical University, Baiziting
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17
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van Liere ELSA, van Dijk LJ, Bosch S, Vermeulen L, Heymans MW, Burchell GL, de Meij TGJ, Ramsoekh D, de Boer NKH. Urinary volatile organic compounds for colorectal cancer screening, a systematic review and meta-analysis. Eur J Cancer 2023; 186:69-82. [PMID: 37030079 DOI: 10.1016/j.ejca.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/02/2023] [Accepted: 03/03/2023] [Indexed: 03/08/2023]
Abstract
BACKGROUND The faecal immunochemical test (FIT) suffers from suboptimal performance and participation in colorectal cancer (CRC) screening. Urinary volatile organic compounds (VOCs) may be a useful alternative. We aimed to determine the diagnostic potential of urinary VOCs for CRC/adenomas. By relating VOCs to known pathways, we aimed to gain insight into the pathophysiology of colorectal neoplasia. METHODS A systematic search was performed in PubMed, EMBASE and Web of Science. Original studies on urinary VOCs for CRC/adenoma detection with a control group were included. QUADAS-2 tool was used for quality assessment. Meta-analysis was performed by adopting a bivariate model for sensitivity/specificity. Fagan's nomogram estimated the performance of combined FIT-VOC. Neoplasm-associated VOCs were linked to pathways using the KEGG database. RESULTS Sixteen studies-involving 837 CRC patients and 1618 controls-were included; 11 performed chemical identification and 7 chemical fingerprinting. In all studies, urinary VOCs discriminated CRC from controls. Pooled sensitivity and specificity for CRC based on chemical fingerprinting were 84% (95% CI 73-91%) and 70% (95% CI 63-77%), respectively. The most distinctive individual VOC was butanal (AUC 0.98). The estimated probability of having CRC following negative FIT was 0.38%, whereas 0.09% following negative FIT-VOC. Combined FIT-VOC would detect 33% more CRCs. In total 100 CRC-associated urinary VOCs were identified; particularly hydrocarbons, carboxylic acids, aldehydes/ketones and amino acids, and predominantly involved in TCA-cycle or alanine/aspartate/glutamine/glutamate/phenylalanine/tyrosine/tryptophan metabolism, which is supported by previous research on (colorectal)cancer biology. The potential of urinary VOCs to detect precancerous adenomas or gain insight into their pathophysiology appeared understudied. CONCLUSION Urinary VOCs hold potential for non-invasive CRC screening. Multicentre validation studies are needed, especially focusing on adenoma detection. Urinary VOCs elucidate underlying pathophysiologic processes.
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Affiliation(s)
- Elsa L S A van Liere
- Amsterdam University Medical Centres, Department of Gastroenterology and Hepatology, Amsterdam, the Netherlands; Amsterdam Gastroenterology Endocrinology Metabolism (AGEM) Research Institute, Amsterdam, the Netherlands; Vrije Universiteit, School of Medicine, Amsterdam, the Netherlands.
| | - Laura J van Dijk
- Amsterdam University Medical Centres, Department of Gastroenterology and Hepatology, Amsterdam, the Netherlands; Vrije Universiteit, School of Medicine, Amsterdam, the Netherlands
| | - Sofie Bosch
- Amsterdam University Medical Centres, Department of Gastroenterology and Hepatology, Amsterdam, the Netherlands; Amsterdam Gastroenterology Endocrinology Metabolism (AGEM) Research Institute, Amsterdam, the Netherlands
| | - Louis Vermeulen
- Amsterdam Gastroenterology Endocrinology Metabolism (AGEM) Research Institute, Amsterdam, the Netherlands; Amsterdam UMC location University of Amsterdam, Laboratory for Experimental Oncology and Radiobiology, Centre for Experimental and Molecular Medicine, Amsterdam, the Netherlands; Cancer Centre Amsterdam, Amsterdam, the Netherlands; Oncode Institute, Amsterdam, the Netherlands
| | - Martijn W Heymans
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam, the Netherlands
| | - George L Burchell
- Medical Library, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Tim G J de Meij
- Amsterdam Gastroenterology Endocrinology Metabolism (AGEM) Research Institute, Amsterdam, the Netherlands; Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Paediatric Gastroenterology, Amsterdam, the Netherlands
| | - Dewkoemar Ramsoekh
- Amsterdam University Medical Centres, Department of Gastroenterology and Hepatology, Amsterdam, the Netherlands; Amsterdam Gastroenterology Endocrinology Metabolism (AGEM) Research Institute, Amsterdam, the Netherlands; Vrije Universiteit, School of Medicine, Amsterdam, the Netherlands
| | - Nanne K H de Boer
- Amsterdam University Medical Centres, Department of Gastroenterology and Hepatology, Amsterdam, the Netherlands; Amsterdam Gastroenterology Endocrinology Metabolism (AGEM) Research Institute, Amsterdam, the Netherlands; Vrije Universiteit, School of Medicine, Amsterdam, the Netherlands
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Analysis of Volatile Organic Compounds in Exhaled Breath Following a COMEX-30 Treatment Table. Metabolites 2023; 13:metabo13030316. [PMID: 36984755 PMCID: PMC10056109 DOI: 10.3390/metabo13030316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 02/17/2023] [Accepted: 02/20/2023] [Indexed: 02/24/2023] Open
Abstract
The COMEX-30 hyperbaric treatment table is used to manage decompression sickness in divers but may result in pulmonary oxygen toxicity (POT). Volatile organic compounds (VOCs) in exhaled breath are early markers of hyperoxic stress that may be linked to POT. The present study assessed whether VOCs following COMEX-30 treatment are early markers of hyperoxic stress and/or POT in ten healthy, nonsmoking volunteers. Because more oxygen is inhaled during COMEX-30 treatment than with other treatment tables, this study hypothesized that VOCs exhaled following COMEX-30 treatment are indicators of POT. Breath samples were collected before and 0.5, 2, and 4 h after COMEX-30 treatment. All subjects were followed-up for signs of POT or other symptoms. Nine compounds were identified, with four (nonanal, decanal, ethyl acetate, and tridecane) increasing 33–500% in intensity from before to after COMEX-30 treatment. Seven subjects reported pulmonary symptoms, five reported out-of-proportion tiredness and transient ear fullness, and four had signs of mild dehydration. All VOCs identified following COMEX-30 treatment have been associated with inflammatory responses or pulmonary diseases, such as asthma or lung cancer. Because most subjects reported transient pulmonary symptoms reflecting early-stage POT, the identified VOCs are likely markers of POT, not just hyperbaric hyperoxic exposure.
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GC-MS Techniques Investigating Potential Biomarkers of Dying in the Last Weeks with Lung Cancer. Int J Mol Sci 2023; 24:ijms24021591. [PMID: 36675106 PMCID: PMC9867309 DOI: 10.3390/ijms24021591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 12/27/2022] [Accepted: 01/06/2023] [Indexed: 01/15/2023] Open
Abstract
Predicting when a patient with advanced cancer is dying is a challenge and currently no prognostic test is available. We hypothesised that a dying process from cancer is associated with metabolic changes and specifically with changes in volatile organic compounds (VOCs). We analysed urine from patients with lung cancer in the last weeks of life by headspace gas chromatography mass spectrometry. Urine was acidified or alkalinised before analysis. VOC changes in the last weeks of life were identified using univariate, multivariate and linear regression analysis; 12 VOCs increased (11 from the acid dataset, 2 from the alkali dataset) and 25 VOCs decreased (23 from the acid dataset and 3 from the alkali dataset). A Cox Lasso prediction model using 8 VOCs predicted dying with an AUC of 0.77, 0.78 and 0.85 at 30, 20 and 10 days and stratified patients into a low (median 10 days), medium (median 50 days) or high risk of survival. Our data supports the hypothesis there are specific metabolic changes associated with the dying. The VOCs identified are potential biomarkers of dying in lung cancer and could be used as a tool to provide additional prognostic information to inform expert clinician judgement and subsequent decision making.
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Systematic Review: Contribution of the Gut Microbiome to the Volatile Metabolic Fingerprint of Colorectal Neoplasia. Metabolites 2022; 13:metabo13010055. [PMID: 36676980 PMCID: PMC9865897 DOI: 10.3390/metabo13010055] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/16/2022] [Accepted: 12/22/2022] [Indexed: 12/31/2022] Open
Abstract
Colorectal cancer (CRC) has been associated with changes in volatile metabolic profiles in several human biological matrices. This enables its non-invasive detection, but the origin of these volatile organic compounds (VOCs) and their relation to the gut microbiome are not yet fully understood. This systematic review provides an overview of the current understanding of this topic. A systematic search using PubMed, Embase, Medline, Cochrane Library, and the Web of Science according to PRISMA guidelines resulted in seventy-one included studies. In addition, a systematic search was conducted that identified five systematic reviews from which CRC-associated gut microbiota data were extracted. The included studies analyzed VOCs in feces, urine, breath, blood, tissue, and saliva. Eight studies performed microbiota analysis in addition to VOC analysis. The most frequently reported dysregulations over all matrices included short-chain fatty acids, amino acids, proteolytic fermentation products, and products related to the tricarboxylic acid cycle and Warburg metabolism. Many of these dysregulations could be related to the shifts in CRC-associated microbiota, and thus the gut microbiota presumably contributes to the metabolic fingerprint of VOC in CRC. Future research involving VOCs analysis should include simultaneous gut microbiota analysis.
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21
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Khan H, Shah MR, Barek J, Malik MI. Cancer biomarkers and their biosensors: A comprehensive review. Trends Analyt Chem 2022. [DOI: 10.1016/j.trac.2022.116813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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22
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Cheng HR, van Vorstenbosch RW, Pachen DM, Meulen LW, Straathof JWA, Dallinga JW, Jonkers DM, Masclee AA, van Schooten FJ, Mujagic Z, Smolinska A. Detecting Colorectal Adenomas and Cancer Using Volatile Organic Compounds in Exhaled Breath: A Proof-of-Principle Study to Improve Screening. Clin Transl Gastroenterol 2022; 13:e00518. [PMID: 35981245 PMCID: PMC10476860 DOI: 10.14309/ctg.0000000000000518] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 05/16/2022] [Accepted: 06/30/2022] [Indexed: 01/31/2023] Open
Abstract
INTRODUCTION Early detection of colorectal cancer (CRC) by screening programs is crucial because survival rates worsen at advanced stages. However, the currently used screening method, the fecal immunochemical test (FIT), suffers from a high number of false-positives and is insensitive for detecting advanced adenomas (AAs), resulting in false-negatives for these premalignant lesions. Therefore, more accurate, noninvasive screening tools are needed. In this study, the utility of analyzing volatile organic compounds (VOCs) in exhaled breath in a FIT-positive population to detect the presence of colorectal neoplasia was studied. METHODS In this multicenter prospective study, breath samples were collected from 382 FIT-positive patients with subsequent colonoscopy participating in the national Dutch bowel screening program (n = 84 negative controls, n = 130 non-AAs, n = 138 AAs, and n = 30 CRCs). Precolonoscopy exhaled VOCs were analyzed using thermal desorption-gas chromatography-mass spectrometry, and the data were preprocessed and analyzed using machine learning techniques. RESULTS Using 10 discriminatory VOCs, AAs could be distinguished from negative controls with a sensitivity and specificity of 79% and 70%, respectively. Based on this biomarker profile, CRC and AA combined could be discriminated from controls with a sensitivity and specificity of 77% and 70%, respectively, and CRC alone could be discriminated from controls with a sensitivity and specificity of 80% and 70%, respectively. Moreover, the feasibility to discriminate non-AAs from controls and AAs was shown. DISCUSSION VOCs in exhaled breath can detect the presence of AAs and CRC in a CRC screening population and may improve CRC screening in the future.
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Affiliation(s)
- Hao Ran Cheng
- Division of Gastroenterology-Hepatology, Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands;
- Department of Gastroenterology and Hepatology, Máxima Medical Center, Veldhoven, the Netherlands;
- GROW, School for Oncology and Reproduction, Maastricht University, Maastricht, the Netherlands;
| | - Robert W.R. van Vorstenbosch
- NUTRIM, School of Nutrition & Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands;
- Department of Pharmacology and Toxicology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.
| | - Daniëlle M. Pachen
- NUTRIM, School of Nutrition & Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands;
- Department of Pharmacology and Toxicology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.
| | - Lonne W.T. Meulen
- Division of Gastroenterology-Hepatology, Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands;
- GROW, School for Oncology and Reproduction, Maastricht University, Maastricht, the Netherlands;
| | - Jan Willem A. Straathof
- Division of Gastroenterology-Hepatology, Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands;
- Department of Gastroenterology and Hepatology, Máxima Medical Center, Veldhoven, the Netherlands;
| | - Jan W. Dallinga
- NUTRIM, School of Nutrition & Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands;
- Department of Pharmacology and Toxicology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.
| | - Daisy M.A.E. Jonkers
- Division of Gastroenterology-Hepatology, Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands;
- NUTRIM, School of Nutrition & Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands;
| | - Ad A.M. Masclee
- Division of Gastroenterology-Hepatology, Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands;
- NUTRIM, School of Nutrition & Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands;
| | - Frederik-Jan van Schooten
- NUTRIM, School of Nutrition & Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands;
- Department of Pharmacology and Toxicology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.
| | - Zlatan Mujagic
- Division of Gastroenterology-Hepatology, Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands;
- NUTRIM, School of Nutrition & Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands;
| | - Agnieszka Smolinska
- NUTRIM, School of Nutrition & Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands;
- Department of Pharmacology and Toxicology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.
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Mass spectrometry for breath analysis. Trends Analyt Chem 2022. [DOI: 10.1016/j.trac.2022.116823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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24
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Analysis of volatile organic compounds from deep airway in the lung through intubation sampling. Anal Bioanal Chem 2022; 414:7647-7658. [PMID: 36018334 DOI: 10.1007/s00216-022-04295-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/14/2022] [Accepted: 08/17/2022] [Indexed: 11/09/2022]
Abstract
Exhaled volatile organic compounds (VOCs) have been widely applied for the study of disease biomarkers. Oral exhalation and nasal exhalation are two of the most common sampling methods. However, VOCs released from food residues and bacteria in the mouth or upper respiratory tract were also sampled and usually mistaken as that produced from body metabolism. In this study, exhalation from deep airway was first directly collected through intubation sampling and analyzed. The exhalation samples of 35 subjects were collected through a catheter, which was inserted into the trachea or bronchus through the mouth and upper respiratory tract. Then, the VOCs in these samples were detected by proton transfer reaction mass spectrometry (PTR-MS). In addition, fast gas chromatography proton transfer reaction mass spectrometry (FGC-PTR-MS) was used to further determine the VOCs with the same mass-to-charge ratios. The results showed that there was methanol, acetonitrile, ethanol, methyl mercaptan, acetone, isoprene, and phenol in the deep airway. Compared with that in oral exhalation, ethanol, methyl mercaptan, and phenol had lower concentrations. In detail, the median concentrations of ethanol, methyl mercaptan, and phenol were 7.3, 0.6, and 23.9 ppbv, while those in the oral exhalation were 80.0, 5.1, and 71.3 ppbv, respectively, which meant the three VOCs mainly originated from the food residues and bacteria in the mouth or upper respiratory tract, rather than body metabolism. The research results in our study can provide references for expiratory VOC research based on oral and nasal exhalation samplings, which are more feasible in clinical practice.
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Gasparri R, Capuano R, Guaglio A, Caminiti V, Canini F, Catini A, Sedda G, Paolesse R, Di Natale C, Spaggiari L. Volatolomic urinary profile analysis for diagnosis of the early stage of lung cancer. J Breath Res 2022; 16. [PMID: 35952625 DOI: 10.1088/1752-7163/ac88ec] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 08/11/2022] [Indexed: 12/24/2022]
Abstract
Nowadays in clinical practice there is a pressing need for potential biomarkers that can identify lung cancer at early stage before becoming symptomatic or detectable by conventional means. Several researchers have independently pointed out that the volatile organic compounds (VOCs) profile can be considered as a lung cancer fingerprint useful for diagnosis. In particular, 16% of volatiles contributing to the human volatilome are found in urine, which is therefore an ideal sample medium. Its analysis through non-invasive, relatively low-cost and straightforward techniques could offer great potential for the early diagnosis of lung cancer. In this study, urinary VOCs were analysed with a gas chromatography-ion mobility spectrometer (GC-IMS) and an electronic nose (e-nose) made by a matrix of twelve quartz microbalances (QMBs) complemented by a photoionization detector (PID). This clinical prospective study involved 127 individuals, divided into two groups: 46 with lung cancer stage I-II-III confirmed by computerized tomography (CT) or positron emission tomography-(PET) imaging techniques and histology (biopsy), and 81 healthy controls. Both instruments provided a multivariate signal which, after being analysed by a machine learning algorithm, identified eight VOCs that could distinguish lung cancer patients from healthy ones. The eight VOCs are 2-pentanone, 2-hexenal, 2-hexen-1-ol, hept-4-en-2-ol, 2-heptanone, 3-octen-2-one, 4-methylpentanol, 4-methyl-octane. Results show that GC-IMS identifies lung cancer with respect to the control group with a diagnostic accuracy of 88%. Sensitivity resulted as being 85%, and specificity was 90% - Area Under the Receiver Operating Characteristics (AUROC): 0.91. The contribution made by the e-nose was also important, even though the results were slightly less sensitive with an accuracy of 71.6%. Moreover, of the eight VOCs identified as potential biomarkers, five VOCs had a high sensitivity (p≤ 0.06) for early stage (stage I) lung cancer.
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Affiliation(s)
- Roberto Gasparri
- Department of Thoracic Surgery, Istituto Europeo di Oncologia, Via Giuseppe Ripamonti, 435, Milan, Milan, 20141, ITALY
| | - Rosamaria Capuano
- Department of Electronic Engineering, Universita di Roma 'Tor Vergata', via di tor Vergata 133, 00133 Roma, Roma, 00133, ITALY
| | - Alessandra Guaglio
- General toracic surgery, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Milano, Lombardia, 20141, ITALY
| | - Valentina Caminiti
- Department of Thoracic Surgery, European Institute of Oncology, Via Giuseppe Ripamonti, 435, Milan, Milan, 20141, ITALY
| | - Federico Canini
- Department of Electronic Engineering, Universita di Roma 'Tor Vergata', via di tor Vergata 133, 00133 Roma, Roma, 00133, ITALY
| | - Alexandro Catini
- Department of Electronic Engineering, Universita di Roma 'Tor Vergata', via di tor Vergata 133, 00133 Roma, Roma, 00133, ITALY
| | - Giulia Sedda
- Department of Thoracic Surgery, European Institute of Oncology, Via Giuseppe Ripamonti, 435, Milan, Milan, 20141, ITALY
| | - Roberto Paolesse
- Department of Chemical Science and Technology, Via della Ricerca Scientifica, University of Rome 'Tor Vergata', Rome, Rome, 00133, ITALY
| | - Corrado Di Natale
- Department of Electronic Engineering, Universita di Roma 'Tor Vergata', via di tor Vergata 133, 00133 Roma, Roma, 00133, ITALY
| | - Lorenzo Spaggiari
- Division of Thoracic Surgery, European Institute of Oncology, Via Ripamonti 435, Milano, Lombardia, 20141, ITALY
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Yang H, Mou Y, Hu B. Diagnostic Ability of Volatile Organic Compounds in Digestive Cancer: A Systematic Review With Meta-Analysis. Clin Med Insights Oncol 2022; 16:11795549221105027. [PMID: 35754925 PMCID: PMC9218909 DOI: 10.1177/11795549221105027] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 05/16/2022] [Indexed: 02/05/2023] Open
Abstract
Background: Volatile organic compounds (VOCs) have been involved in cancer diagnosis via breath, urine, and feces. We aimed to assess the diagnostic ability of VOCs on digestive cancers. Methods: We systematically reviewed prospective clinical trials evaluating VOCs’ diagnostic ability on esophageal, gastric, colorectal, hepatic, and pancreatic cancer (PC). Databases including PubMed and Ovid-Medline were searched. Results: A total of 35 trials with 5314 patient-times qualified for inclusion. The pooled sensitivity of VOCs diagnosing gastroesophageal cancer from healthy controls is 0.89 (95% confidence interval [CI]: 0.82-0.94), the pooled specificity is 0.890 (95% CI: 0.84-0.93), and area under the curve (AUC) of the summary receiver operating characteristic curve is 0.95 (95% CI: 0.93-0.95). The pooled sensitivity of VOCs diagnosing colorectal cancer from heathy controls is 0.92 (95% CI: 0.85-0.96), the pooled specificity is 0.88 (95% CI: 0.77-0.94), and the AUC is 0.96 (95% CI: 0.94-0.97). The pooled sensitivity of VOCs distinguishing gastrointestinal (GI) cancer from precancerous lesions is 0.84 (95% CI: 0.67-0.92), the pooled specificity is 0.74 (95% CI: 0.43-0.91), and the AUC is 0.87 (95% CI: 0.84-0.89). The pooled sensitivity of VOCs diagnosing hepatocellular carcinoma is 0.68 (95% CI: 0.52-0.81), the pooled specificity is 0.81 (95% CI: 0.47-0.96), and the AUC is 0.78 (95% CI: 0.74-0.81). The pooled sensitivity of VOCs diagnosing PC is 0.88 (95% CI: 0.80-0.93), the pooled specificity is 0.82 (95% CI: 0.62-0.93), and the AUC is 0.92 (95% CI: 0.89-0.94). Conclusions: Volatile organic compounds have potential role in diagnosing GI cancer with comparatively high sensitivity, specificity, and AUC (PROSPERO registration number: CRD42021260039).
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Affiliation(s)
- Hang Yang
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Yi Mou
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Bing Hu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
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Scheepers MHMC, Al-Difaie Z, Brandts L, Peeters A, van Grinsven B, Bouvy ND. Diagnostic Performance of Electronic Noses in Cancer Diagnoses Using Exhaled Breath: A Systematic Review and Meta-analysis. JAMA Netw Open 2022; 5:e2219372. [PMID: 35767259 PMCID: PMC9244610 DOI: 10.1001/jamanetworkopen.2022.19372] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
IMPORTANCE There has been a growing interest in the use of electronic noses (e-noses) in detecting volatile organic compounds in exhaled breath for the diagnosis of cancer. However, no systematic evaluation has been performed of the overall diagnostic accuracy and methodologic challenges of using e-noses for cancer detection in exhaled breath. OBJECTIVE To provide an overview of the diagnostic accuracy and methodologic challenges of using e-noses for the detection of cancer. DATA SOURCES An electronic search was performed in the PubMed and Embase databases (January 1, 2000, to July 1, 2021). STUDY SELECTION Inclusion criteria were the following: (1) use of e-nose technology, (2) detection of cancer, and (3) analysis of exhaled breath. Exclusion criteria were (1) studies published before 2000; (2) studies not performed in humans; (3) studies not performed in adults; (4) studies that only analyzed biofluids; and (5) studies that exclusively used gas chromatography-mass spectrometry to analyze exhaled breath samples. DATA EXTRACTION AND SYNTHESIS PRISMA guidelines were used for the identification, screening, eligibility, and selection process. Quality assessment was performed using Quality Assessment of Diagnostic Accuracy Studies 2. Generalized mixed-effects bivariate meta-analysis was performed. MAIN OUTCOMES AND MEASURES Main outcomes were sensitivity, specificity, and mean area under the receiver operating characteristic curve. RESULTS This review identified 52 articles with a total of 3677 patients with cancer. All studies were feasibility studies. The sensitivity of e-noses ranged from 48.3% to 95.8% and the specificity from 10.0% to 100.0%. Pooled analysis resulted in a mean (SE) area under the receiver operating characteristic curve of 94% (95% CI, 92%-96%), a sensitivity of 90% (95% CI, 88%-92%), and a specificity of 87% (95% CI, 81%-92%). Considerable heterogeneity existed among the studies because of differences in the selection of patients, endogenous and exogenous factors, and collection of exhaled breath. CONCLUSIONS AND RELEVANCE Results of this review indicate that e-noses have a high diagnostic accuracy for the detection of cancer in exhaled breath. However, most studies were feasibility studies with small sample sizes, a lack of standardization, and a high risk of bias. The lack of standardization and reproducibility of e-nose research should be addressed in future research.
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Affiliation(s)
- Max H. M. C. Scheepers
- GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands
| | - Zaid Al-Difaie
- GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands
| | - Lloyd Brandts
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, the Netherlands
| | - Andrea Peeters
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, the Netherlands
| | - Bart van Grinsven
- Sensor Engineering, Faculty of Science and Engineering, Maastricht University, Maastricht, the Netherlands
| | - Nicole D. Bouvy
- Department of Surgery, Maastricht University Medical Center, Maastricht, the Netherlands
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Kabir KM, Baker MJ, Donald WA. Micro- and nanoscale sensing of volatile organic compounds for early-stage cancer diagnosis. Trends Analyt Chem 2022. [DOI: 10.1016/j.trac.2022.116655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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29
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Biomarkers to Detect Early-Stage Colorectal Cancer. Biomedicines 2022; 10:biomedicines10020255. [PMID: 35203465 PMCID: PMC8869393 DOI: 10.3390/biomedicines10020255] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 01/17/2022] [Accepted: 01/20/2022] [Indexed: 02/06/2023] Open
Abstract
Colorectal cancer is a leading cause of mortality worldwide. The high incidence and the acceleration of incidence in younger people reinforces the need for better techniques of early detection. The use of noninvasive biomarkers has potential to more accurately inform how patients are prioritised for clinical investigation, which, in turn, may ultimately translate into improved survival for those subsequently found to have curable-stage CRC. This review surveys a wide range of CRC biomarkers that may (alone or in combination) identify symptomatic patients presenting in primary care who should be progressed for clinical investigation.
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Novel Diagnostic Biomarkers in Colorectal Cancer. Int J Mol Sci 2022; 23:ijms23020852. [PMID: 35055034 PMCID: PMC8776048 DOI: 10.3390/ijms23020852] [Citation(s) in RCA: 60] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 12/27/2021] [Accepted: 01/03/2022] [Indexed: 02/06/2023] Open
Abstract
Colorectal cancer (CRC) is still a leading cause of cancer death worldwide. Less than half of cases are diagnosed when the cancer is locally advanced. CRC is a heterogenous disease associated with a number of genetic or somatic mutations. Diagnostic markers are used for risk stratification and early detection, which might prolong overall survival. Nowadays, the widespread use of semi-invasive endoscopic methods and feacal blood tests characterised by suboptimal accuracy of diagnostic results has led to the detection of cases at later stages. New molecular noninvasive tests based on the detection of CRC alterations seem to be more sensitive and specific then the current methods. Therefore, research aiming at identifying molecular markers, such as DNA, RNA and proteins, would improve survival rates and contribute to the development of personalized medicine. The identification of “ideal” diagnostic biomarkers, having high sensitivity and specificity, being safe, cheap and easy to measure, remains a challenge. The purpose of this review is to discuss recent advances in novel diagnostic biomarkers for tumor tissue, blood and stool samples in CRC patients.
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MATSUMORI SEI, HASHIMOTO TAKASHI, NASU MOTOMI, KAGA NAOKO, TAKA HIKARI, FUJIMURA TSUTOMU, UENO TAKASHI, MIURA YOSHIKI, KAJIYAMA YOSHIAKI. Development of a Non-invasive Diagnostic Method for Esophageal Squamous Cell Carcinoma by Gas Chromatographic Analysis of Exhaled Breath. JUNTENDO MEDICAL JOURNAL 2022. [DOI: 10.14789/jmj.jmj22-0023-oa] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- SEI MATSUMORI
- Department of Esophageal and Gastroenterological Surgery, Juntendo University Graduate School of Medicine
| | - TAKASHI HASHIMOTO
- Department of Esophageal and Gastroenterological Surgery, Juntendo University Graduate School of Medicine
| | - MOTOMI NASU
- Department of Esophageal and Gastroenterological Surgery, Juntendo University Graduate School of Medicine
| | - NAOKO KAGA
- Laboratory of Proteomics and Biomolecular Science, Biomedical Research Core Facilities, Juntendo University Graduate School of Medicine
| | - HIKARI TAKA
- Laboratory of Proteomics and Biomolecular Science, Biomedical Research Core Facilities, Juntendo University Graduate School of Medicine
| | - TSUTOMU FUJIMURA
- Laboratory of Proteomics and Biomolecular Science, Biomedical Research Core Facilities, Juntendo University Graduate School of Medicine
| | - TAKASHI UENO
- Laboratory of Proteomics and Biomolecular Science, Biomedical Research Core Facilities, Juntendo University Graduate School of Medicine
| | - YOSHIKI MIURA
- Laboratory of Proteomics and Biomolecular Science, Biomedical Research Core Facilities, Juntendo University Graduate School of Medicine
| | - YOSHIAKI KAJIYAMA
- Department of Esophageal and Gastroenterological Surgery, Juntendo University Graduate School of Medicine
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Volatile organic compounds as a potential screening tool for neoplasm of the digestive system: a meta-analysis. Sci Rep 2021; 11:23716. [PMID: 34887450 PMCID: PMC8660806 DOI: 10.1038/s41598-021-02906-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 11/24/2021] [Indexed: 02/02/2023] Open
Abstract
This meta-analysis was aimed to estimate the diagnostic performance of volatile organic compounds (VOCs) as a potential novel tool to screen for the neoplasm of the digestive system. An integrated literature search was performed by two independent investigators to identify all relevant studies investigating VOCs in diagnosing neoplasm of the digestive system from inception to 7th December 2020. STATA and Revman software were used for data analysis. The methodological quality of each study was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. A bivariate mixed model was used and meta-regression and subgroup analysis were performed to identify possible sources of heterogeneity. A total of 36 studies comprised of 1712 cases of neoplasm and 3215 controls were included in our meta-analysis. Bivariate analysis showed a pooled sensitivity of 0.87 (95% confidence interval (CI) 0.83–0.90), specificity of 0.86 (95% CI 0.82–0.89), a positive likelihood ratio of 6.18 (95% CI 4.68–8.17), and a negative likelihood ratio of 0.15 (95% CI 0.12–0.20). The diagnostic odds ratio and the area under the summary ROC curve for diagnosing neoplasm of the digestive system were 40.61 (95% CI 24.77–66.57) and 0.93 (95% CI 0.90–0.95), respectively. Our analyses revealed that VOCs analysis could be considered as a potential novel tool to screen for malignant diseases of the digestive system.
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Zheng Y, Tang N, Omar R, Hu Z, Duong T, Wang J, Wu W, Haick H. Smart Materials Enabled with Artificial Intelligence for Healthcare Wearables. ADVANCED FUNCTIONAL MATERIALS 2021; 31. [DOI: 10.1002/adfm.202105482] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Indexed: 08/30/2023]
Abstract
AbstractContemporary medicine suffers from many shortcomings in terms of successful disease diagnosis and treatment, both of which rely on detection capacity and timing. The lack of effective, reliable, and affordable detection and real‐time monitoring limits the affordability of timely diagnosis and treatment. A new frontier that overcomes these challenges relies on smart health monitoring systems that combine wearable sensors and an analytical modulus. This review presents the latest advances in smart materials for the development of multifunctional wearable sensors while providing a bird's eye‐view of their characteristics, functions, and applications. The review also presents the state‐of‐the‐art on wearables fitted with artificial intelligence (AI) and support systems for clinical decision in early detection and accurate diagnosis of disorders. The ongoing challenges and future prospects for providing personal healthcare with AI‐assisted support systems relating to clinical decisions are presented and discussed.
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Affiliation(s)
- Youbin Zheng
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute Technion‐Israel Institute of Technology Haifa 3200003 Israel
| | - Ning Tang
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute Technion‐Israel Institute of Technology Haifa 3200003 Israel
| | - Rawan Omar
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute Technion‐Israel Institute of Technology Haifa 3200003 Israel
| | - Zhipeng Hu
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute Technion‐Israel Institute of Technology Haifa 3200003 Israel
- School of Chemistry Xi'an Jiaotong University Xi'an 710126 P. R. China
| | - Tuan Duong
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute Technion‐Israel Institute of Technology Haifa 3200003 Israel
| | - Jing Wang
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute Technion‐Israel Institute of Technology Haifa 3200003 Israel
| | - Weiwei Wu
- School of Advanced Materials and Nanotechnology Interdisciplinary Research Center of Smart Sensors Xidian University Xi'an 710126 P. R. China
| | - Hossam Haick
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute Technion‐Israel Institute of Technology Haifa 3200003 Israel
- School of Advanced Materials and Nanotechnology Interdisciplinary Research Center of Smart Sensors Xidian University Xi'an 710126 P. R. China
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Gould O, Drabińska N, Ratcliffe N, de Lacy Costello B. Hyphenated Mass Spectrometry versus Real-Time Mass Spectrometry Techniques for the Detection of Volatile Compounds from the Human Body. Molecules 2021; 26:molecules26237185. [PMID: 34885767 PMCID: PMC8659178 DOI: 10.3390/molecules26237185] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/22/2021] [Accepted: 11/23/2021] [Indexed: 01/16/2023] Open
Abstract
Mass spectrometry (MS) is an analytical technique that can be used for various applications in a number of scientific areas including environmental, security, forensic science, space exploration, agri-food, and numerous others. MS is also continuing to offer new insights into the proteomic and metabolomic fields. MS techniques are frequently used for the analysis of volatile compounds (VCs). The detection of VCs from human samples has the potential to aid in the diagnosis of diseases, in monitoring drug metabolites, and in providing insight into metabolic processes. The broad usage of MS has resulted in numerous variations of the technique being developed over the years, which can be divided into hyphenated and real-time MS techniques. Hyphenated chromatographic techniques coupled with MS offer unparalleled qualitative analysis and high accuracy and sensitivity, even when analysing complex matrices (breath, urine, stool, etc.). However, these benefits are traded for a significantly longer analysis time and a greater need for sample preparation and method development. On the other hand, real-time MS techniques offer highly sensitive quantitative data. Additionally, real-time techniques can provide results in a matter of minutes or even seconds, without altering the sample in any way. However, real-time MS can only offer tentative qualitative data and suffers from molecular weight overlap in complex matrices. This review compares hyphenated and real-time MS methods and provides examples of applications for each technique for the detection of VCs from humans.
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Affiliation(s)
- Oliver Gould
- Centre for Research in Biosciences, Frenchay Campus, University of the West of England, Coldharbour Lane, Bristol BS16 1QY, UK; (N.R.); (B.d.L.C.)
- Correspondence: (O.G.); (N.D.)
| | - Natalia Drabińska
- Department of Chemistry and Biodynamics of Food, Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, 10-748 Olsztyn, Poland
- Food Volatilomics and Sensomics Group, Faculty of Food Science and Nutrition, Poznan University of Life Sciences, 60-637 Poznan, Poland
- Correspondence: (O.G.); (N.D.)
| | - Norman Ratcliffe
- Centre for Research in Biosciences, Frenchay Campus, University of the West of England, Coldharbour Lane, Bristol BS16 1QY, UK; (N.R.); (B.d.L.C.)
| | - Ben de Lacy Costello
- Centre for Research in Biosciences, Frenchay Campus, University of the West of England, Coldharbour Lane, Bristol BS16 1QY, UK; (N.R.); (B.d.L.C.)
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Yang HY, Chen WC, Tsai RC. Accuracy of the Electronic Nose Breath Tests in Clinical Application: A Systematic Review and Meta-Analysis. BIOSENSORS 2021; 11:bios11110469. [PMID: 34821685 PMCID: PMC8615633 DOI: 10.3390/bios11110469] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 11/20/2021] [Accepted: 11/20/2021] [Indexed: 05/25/2023]
Abstract
(1) Background: An electronic nose applies a sensor array to detect volatile biomarkers in exhaled breath to diagnose diseases. The overall diagnostic accuracy remains unknown. The objective of this review was to provide an estimate of the diagnostic accuracy of sensor-based breath tests for the diagnosis of diseases. (2) Methods: We searched the PubMed and Web of Science databases for studies published between 1 January 2010 and 14 October 2021. The search was limited to human studies published in the English language. Clinical trials were not included in this review. (3) Results: Of the 2418 records identified, 44 publications were eligible, and 5728 patients were included in the final analyses. The pooled sensitivity was 90.0% (95% CI, 86.3-92.8%, I2 = 47.7%), the specificity was 88.4% (95% CI, 87.1-89.5%, I2 = 81.4%), and the pooled area under the curve was 0.93 (95% CI 0.91-0.95). (4) Conclusion: The findings of our review suggest that a standardized report of diagnostic accuracy and a report of the accuracy in a test set are needed. Sensor array systems of electronic noses have the potential for noninvasiveness at the point-of-care in hospitals. Nevertheless, the procedure for reporting the accuracy of a diagnostic test must be standardized.
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Affiliation(s)
- Hsiao-Yu Yang
- Institute of Environmental and Occupational Health Sciences, National Taiwan University, Taipei 10055, Taiwan; (W.-C.C.); (R.-C.T.)
- Department of Public Health, National Taiwan University College of Public Health, Taipei 10055, Taiwan
- Department of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei 10002, Taiwan
| | - Wan-Chin Chen
- Institute of Environmental and Occupational Health Sciences, National Taiwan University, Taipei 10055, Taiwan; (W.-C.C.); (R.-C.T.)
- Department of Family Medicine, Changhua Christian Hospital, Changhua 50006, Taiwan
| | - Rodger-Chen Tsai
- Institute of Environmental and Occupational Health Sciences, National Taiwan University, Taipei 10055, Taiwan; (W.-C.C.); (R.-C.T.)
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Gouzerh F, Bessière JM, Ujvari B, Thomas F, Dujon AM, Dormont L. Odors and cancer: Current status and future directions. Biochim Biophys Acta Rev Cancer 2021; 1877:188644. [PMID: 34737023 DOI: 10.1016/j.bbcan.2021.188644] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 10/22/2021] [Accepted: 10/23/2021] [Indexed: 02/07/2023]
Abstract
Cancer is the second leading cause of death in the world. Because tumors detected at early stages are easier to treat, the search for biomarkers-especially non-invasive ones-that allow early detection of malignancies remains a central goal to reduce cancer mortality. Cancer, like other pathologies, often alters body odors, and much has been done by scientists over the last few decades to assess the value of volatile organic compounds (VOCs) as signatures of cancers. We present here a quantitative review of 208 studies carried out between 1984 and 2020 that explore VOCs as potential biomarkers of cancers. We analyzed the main findings of these studies, listing and classifying VOCs related to different cancer types while considering both sampling methods and analysis techniques. Considering this synthesis, we discuss several of the challenges and the most promising prospects of this research direction in the war against cancer.
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Affiliation(s)
- Flora Gouzerh
- CREEC/CANECEV (CREES), Montpellier, France; MIVEGEC, Université de Montpellier, CNRS, IRD, Montpellier, France; CEFE, Univ Montpellier, CNRS, EPHE, IRD, Univ Paul Valéry Montpellier 3, Montpellier, France.
| | - Jean-Marie Bessière
- Ecole Nationale de Chimie de Montpellier, Laboratoire de Chimie Appliquée, Montpellier, France
| | - Beata Ujvari
- Deakin University, School of Life and Environmental Sciences, Centre for Integrative Ecology, Waurn Ponds, Vic 3216, Australia
| | - Frédéric Thomas
- CREEC/CANECEV (CREES), Montpellier, France; MIVEGEC, Université de Montpellier, CNRS, IRD, Montpellier, France
| | - Antoine M Dujon
- CREEC/CANECEV (CREES), Montpellier, France; MIVEGEC, Université de Montpellier, CNRS, IRD, Montpellier, France; Deakin University, School of Life and Environmental Sciences, Centre for Integrative Ecology, Waurn Ponds, Vic 3216, Australia
| | - Laurent Dormont
- CEFE, Univ Montpellier, CNRS, EPHE, IRD, Univ Paul Valéry Montpellier 3, Montpellier, France
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Zhang J, Tian Y, Luo Z, Qian C, Li W, Duan Y. Breath volatile organic compound analysis: an emerging method for gastric cancer detection. J Breath Res 2021; 15. [PMID: 34610588 DOI: 10.1088/1752-7163/ac2cde] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 10/05/2021] [Indexed: 12/14/2022]
Abstract
Gastric cancer is a common malignancy, being the fifth most frequently diagnosed cancer and the fourth leading cause of cancer-related deaths worldwide. Diagnosis of gastric cancer at the early stage is critical to effectively improve the survival rate. However, a substantial proportion of patients with gastric cancer in the early stages lack specific symptoms or are asymptomatic. Moreover, the imaging techniques currently used for gastric cancer screening, such as computed tomography and barium examination, are usually radioactive and have low sensitivity and specificity. Even though endoscopy has high accuracy for gastric cancer screening, its application is limited by the invasiveness of the technique. Breath analysis is an economic, effective, easy to perform, non-invasive detection method, and has no undesirable side effects on subjects. Extensive worldwide research has been conducted on breath volatile organic compounds (VOCs), which reveals its prospect as a potential method for gastric cancer detection. Many interesting results have been obtained and innovative methods have been introduced in this subject; hence, an extensive review would be beneficial. By providing a comprehensive list of breath VOCs identified by gastric cancer would promote further research in this field. This review summarizes the commonly used technologies for exhaled breath analysis, focusing on the application of analytical instruments in the detection of breath VOCs in gastric cancers, and the alterations in the profile of breath biomarkers in gastric cancer patients are discussed as well.
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Affiliation(s)
- Jing Zhang
- Research Center of Analytical Instrumentation, Key Laboratory of Synthetic and Natural Functional Molecule Chemistry of Ministry of Education, College of Chemistry & Materials Science, Northwest University, Xi'an 710069, People's Republic of China
| | - Yonghui Tian
- Research Center of Analytical Instrumentation, Key Laboratory of Synthetic and Natural Functional Molecule Chemistry of Ministry of Education, College of Chemistry & Materials Science, Northwest University, Xi'an 710069, People's Republic of China
| | - Zewei Luo
- Research Center of Analytical Instrumentation, Key Laboratory of Synthetic and Natural Functional Molecule Chemistry of Ministry of Education, College of Chemistry & Materials Science, Northwest University, Xi'an 710069, People's Republic of China
| | - Cheng Qian
- Shaanxi Key Laboratory of Earth Surface System and Environmental Carrying Capacity, College of Urban and Environmental Sciences, Northwest University, Xi'an 710127, People's Republic of China
| | - Wenwen Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - Yixiang Duan
- Research Center of Analytical Instrumentation, Key Laboratory of Synthetic and Natural Functional Molecule Chemistry of Ministry of Education, College of Chemistry & Materials Science, Northwest University, Xi'an 710069, People's Republic of China
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Wang T, Tsang T, Turshudzhyan A, Dacus H, Tadros M. Updates, Controversies, and Emerging Approaches in Colorectal Screening. Cureus 2021; 13:e17844. [PMID: 34660050 PMCID: PMC8501747 DOI: 10.7759/cureus.17844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2021] [Indexed: 12/24/2022] Open
Abstract
Colorectal cancer (CRC) is the third most common cancer worldwide and the second leading cause of cancer-related deaths. Despite the threatening statistics, the US burden for CRC has been decreasing, which is likely multifactorial and has partial contribution from widespread timely screening, more advanced CRC treatment, and daily aspirin use in some patients. While overall death rate from CRC decreased by approximately a half between 1975 and 2012, epidemiologic studies demonstrate that CRC incidence is increasing in the younger population. This pattern has prompted the American Cancer Society (ACS) to revise their guidelines. In this review, we plan to discuss the most recent changes in guidelines, data to support them, controversies concerning CRC screening methods, age to start and to stop screening, and post-colonoscopy/polypectomy surveillance guidelines.
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Affiliation(s)
- Tiffany Wang
- Internal Medicine, Albany Medical College, Albany, USA
| | - Tyler Tsang
- Internal Medicine, Albany Medical College, Albany, USA
| | | | - Heather Dacus
- Internal Medicine, New York State Department of Health, New York, USA
| | - Micheal Tadros
- Gastroenterology and Hepatology, Albany Medical Center, Albany, USA
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Kim C, Raja IS, Lee JM, Lee JH, Kang MS, Lee SH, Oh JW, Han DW. Recent Trends in Exhaled Breath Diagnosis Using an Artificial Olfactory System. BIOSENSORS 2021; 11:337. [PMID: 34562928 PMCID: PMC8467588 DOI: 10.3390/bios11090337] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/06/2021] [Accepted: 09/10/2021] [Indexed: 12/26/2022]
Abstract
Artificial olfactory systems are needed in various fields that require real-time monitoring, such as healthcare. This review introduces cases of detection of specific volatile organic compounds (VOCs) in a patient's exhaled breath and discusses trends in disease diagnosis technology development using artificial olfactory technology that analyzes exhaled human breath. We briefly introduce algorithms that classify patterns of odors (VOC profiles) and describe artificial olfactory systems based on nanosensors. On the basis of recently published research results, we describe the development trend of artificial olfactory systems based on the pattern-recognition gas sensor array technology and the prospects of application of this technology to disease diagnostic devices. Medical technologies that enable early monitoring of health conditions and early diagnosis of diseases are crucial in modern healthcare. By regularly monitoring health status, diseases can be prevented or treated at an early stage, thus increasing the human survival rate and reducing the overall treatment costs. This review introduces several promising technical fields with the aim of developing technologies that can monitor health conditions and diagnose diseases early by analyzing exhaled human breath in real time.
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Affiliation(s)
- Chuntae Kim
- BIO-IT Foundry Technology Institute, Pusan National University, Busan 46241, Korea
| | | | - Jong-Min Lee
- School of Nano Convergence Technology, Hallym University, Chuncheon 24252, Korea
| | | | - Moon Sung Kang
- Department of Cogno-Mechatronics Engineering, Pusan National University, Busan 46241, Korea
| | - Seok Hyun Lee
- Department of Cogno-Mechatronics Engineering, Pusan National University, Busan 46241, Korea
| | - Jin-Woo Oh
- BIO-IT Foundry Technology Institute, Pusan National University, Busan 46241, Korea
- Department of Nanoenergy Engineering, Pusan National University, Busan 46241, Korea
| | - Dong-Wook Han
- BIO-IT Foundry Technology Institute, Pusan National University, Busan 46241, Korea
- Department of Cogno-Mechatronics Engineering, Pusan National University, Busan 46241, Korea
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Yuan ZC, Hu B. Mass Spectrometry-Based Human Breath Analysis: Towards COVID-19 Diagnosis and Research. JOURNAL OF ANALYSIS AND TESTING 2021; 5:287-297. [PMID: 34422436 PMCID: PMC8364943 DOI: 10.1007/s41664-021-00194-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/25/2021] [Indexed: 12/12/2022]
Abstract
COVID-19 is a highly contagious respiratory disease that can be infected through human exhaled breath. Human breath analysis is an attractive strategy for rapid diagnosis of COVID-19 in a non-invasive way by monitoring breath biomarkers. Mass spectrometry (MS)-based approaches offer a promising analytical platform for human breath analysis due to their high speed, specificity, sensitivity, reproducibility, and broad coverage, as well as its versatile coupling methods with different chromatographic separation, and thus can lead to a better understanding of the clinical and biochemical processes of COVID-19. Herein, we try to review the developments and applications of MS-based approaches for multidimensional analysis of COVID-19 breath samples, including metabolites, proteins, microorganisms, and elements. New features of breath sampling and analysis are highlighted. Prospects and challenges on MS-based breath analysis related to COVID-19 diagnosis and study are discussed.
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Affiliation(s)
- Zi-Cheng Yuan
- Guangdong Provincial Engineering Research Center for On-line Source Apportionment System of Air Pollution, Institute of Mass Spectrometry and Atmospheric Environment, Jinan University, Guangzhou, 510632 China
| | - Bin Hu
- Guangdong Provincial Engineering Research Center for On-line Source Apportionment System of Air Pollution, Institute of Mass Spectrometry and Atmospheric Environment, Jinan University, Guangzhou, 510632 China
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Tyagi H, Daulton E, Bannaga AS, Arasaradnam RP, Covington JA. Non-Invasive Detection and Staging of Colorectal Cancer Using a Portable Electronic Nose. SENSORS (BASEL, SWITZERLAND) 2021; 21:5440. [PMID: 34450881 PMCID: PMC8398649 DOI: 10.3390/s21165440] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 07/30/2021] [Accepted: 07/30/2021] [Indexed: 12/24/2022]
Abstract
Electronic noses (e-nose) offer potential for the detection of cancer in its early stages. The ability to analyse samples in real time, at a low cost, applying easy-to-use and portable equipment, gives e-noses advantages over other technologies, such as Gas Chromatography-Mass Spectrometry (GC-MS). For diseases such as cancer with a high mortality, a technology that can provide fast results for use in routine clinical applications is important. Colorectal cancer (CRC) is among the highest occurring cancers and has high mortality rates, if diagnosed late. In our study, we investigated the use of portable electronic nose (PEN3), with further analysis using GC-TOF-MS, for the analysis of gases and volatile organic compounds (VOCs) to profile the urinary metabolome of colorectal cancer. We also compared the different cancer stages with non-cancers using the PEN3 and GC-TOF-MS. Results obtained from PEN3, and GC-TOF-MS demonstrated high accuracy for the separation of CRC and non-cancer. PEN3 separated CRC from non-cancerous group with 0.81 AUC (Area Under the Curve). We used data from GC-TOF-MS to obtain a VOC profile for CRC, which identified 23 potential biomarker VOCs for CRC. Thus, the PEN3 and GC-TOF-MS were found to successfully separate the cancer group from the non-cancer group.
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Affiliation(s)
- Heena Tyagi
- School of Engineering, University of Warwick, Coventry CV4 7AL, UK; (H.T.); (E.D.)
| | - Emma Daulton
- School of Engineering, University of Warwick, Coventry CV4 7AL, UK; (H.T.); (E.D.)
| | - Ayman S. Bannaga
- Department of Gastroenterology, University Hospital Coventry & Warwickshire, Coventry CV2 2DX, UK; (A.S.B.); (R.P.A.)
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
| | - Ramesh P. Arasaradnam
- Department of Gastroenterology, University Hospital Coventry & Warwickshire, Coventry CV2 2DX, UK; (A.S.B.); (R.P.A.)
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
- School of Health Sciences, Coventry University, Coventry CV1 5FB, UK
- Leicester Cancer Centre, University of Leicester, Leicester LE1 7RH, UK
| | - James A. Covington
- School of Engineering, University of Warwick, Coventry CV4 7AL, UK; (H.T.); (E.D.)
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Stott K, Phillips B, Parry L, May S. Recent advancements in the exploitation of the gut microbiome in the diagnosis and treatment of colorectal cancer. Biosci Rep 2021; 41:BSR20204113. [PMID: 34236075 PMCID: PMC8314433 DOI: 10.1042/bsr20204113] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/05/2021] [Accepted: 07/07/2021] [Indexed: 02/06/2023] Open
Abstract
Over the last few decades it has been established that the complex interaction between the host and the multitude of organisms that compose the intestinal microbiota plays an important role in human metabolic health and disease. Whilst there is no defined consensus on the composition of a healthy microbiome due to confounding factors such as ethnicity, geographical locations, age and sex, there are undoubtably populations of microbes that are consistently dysregulated in gut diseases including colorectal cancer (CRC). In this review, we discuss the most recent advances in the application of the gut microbiota, not just bacteria, and derived microbial compounds in the diagnosis of CRC and the potential to exploit microbes as novel agents in the management and treatment of CRC. We highlight examples of the microbiota, and their derivatives, that have the potential to become standalone diagnostic tools or be used in combination with current screening techniques to improve sensitivity and specificity for earlier CRC diagnoses and provide a perspective on their potential as biotherapeutics with translatability to clinical trials.
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Affiliation(s)
- Katie J. Stott
- European Cancer Stem Cell Research Institute, School of Biosciences, Cardiff University, Cardiff CF24 4HQ, U.K
| | - Bethan Phillips
- European Cancer Stem Cell Research Institute, School of Biosciences, Cardiff University, Cardiff CF24 4HQ, U.K
| | - Lee Parry
- European Cancer Stem Cell Research Institute, School of Biosciences, Cardiff University, Cardiff CF24 4HQ, U.K
| | - Stephanie May
- CRUK Beatson Institute, Garscube Estate, Switchback Road, Bearsden, Glasgow G61 1BD, U.K
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Chandrapalan S, Bosch S, Cubiella J, Guardiola J, Kimani P, Mulder C, Persaud K, de Meij TGJ, Altomare DF, Brenner H, de Boer NKH, Ricciardiello L, Arasaradnam RP. Systematic review with meta-analysis: volatile organic compound analysis to improve faecal immunochemical testing in the detection of colorectal cancer. Aliment Pharmacol Ther 2021; 54:14-23. [PMID: 34004036 DOI: 10.1111/apt.16405] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 03/20/2021] [Accepted: 04/24/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Faecal immunochemical test (FIT) is emerging as a valid test to rule-out the presence of colorectal cancer (CRC). However, the accuracy of FIT is dependent on the cut-off applied. An additional low-cost test could improve further detection of CRC. AIMS To evaluate the efficacy of combined FIT and volatile organic compounds (VOC) in the detection of CRC within symptomatic populations. METHODS Systematic reviews on the diagnostic accuracy of FIT and VOC, for the detection of CRC, were updated. Meta-analyses were performed adopting a bivariate model for sensitivity and specificity. Clinical utility of combined FIT and VOC was estimated using Fagan's nomogram. Post-test probability of FIT negatives was used as a pre-test probability for VOC. RESULTS The pooled sensitivity and specificity of FIT at 10 µg/g faeces, for the detection of CRC, were 0.914 (95% confidence interval [CI] = 0.894-0.936) and 0.783 (CI = 0.850-0.696), respectively. For VOC, the sensitivity was 0.837 (CI = 0.781-0.881) and the specificity was 0.803 (CI = 0.870-0.712). The area under the curve for FIT and VOC were 0.926 and 0.885, respectively. In a population with 5% CRC prevalence, the estimated probability of having CRC following a negative FIT was 0.5% and following both negative FIT and VOC was 0.1%. CONCLUSIONS In a FIT-negative symptomatic population, VOC can be a good test to rule-out the presence of CRC. The estimated probability reduction by 0.4% when both tests being negative offers adequate safety netting in primary care for the exclusion of CRC. The number needed to colonoscope to identify one CRC is eight if either FIT or VOC positive. Cost-effectiveness and clinical accuracy of this approach will need further evaluation.
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Milyutin Y, Abud-Hawa M, Kloper-Weidenfeld V, Mansour E, Broza YY, Shani G, Haick H. Fabricating and printing chemiresistors based on monolayer-capped metal nanoparticles. Nat Protoc 2021; 16:2968-2990. [PMID: 34012107 DOI: 10.1038/s41596-021-00528-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 02/23/2021] [Indexed: 02/03/2023]
Abstract
Chemiresistors that are based on monolayer-capped metal nanoparticles (MCNPs) have been used in a wide variety of innovative sensing applications, including detection and monitoring of diagnostic markers in body fluids, explosive materials, environmental contaminations and food quality control. The sensing mechanism is based on reversible swelling or aggregation and/or changes in dielectric constant of the MCNPs. In this protocol, we describe a procedure for producing MCNP-based chemiresistive sensors that is reproducible from device to device and from batch to batch. The approach relies on three main steps: (i) controlled synthesis of gold MCNPs, (ii) fabrication of electrodes that are surrounded with a microbarrier ring to confine the deposited MCNP solution and (iii) a tailor-made drying process to enable evaporation of solvent residues from the MCNP sensing layer to prevent a coffee-ring effect. Application of this approach has been shown to produce devices with ±1.5% variance-a value consistent with the criterion for commercial sensors-as well as long shelf life and stability. Fabrication of chemical sensors based on dodecanethiol- or 2-ethylhexanethiol-capped MCNPs with this approach provides high sensitivity and accuracy in the detection of volatile organic compounds (e.g., octane and decane), toxic gaseous species (e.g., HCl and NH3) in air and simulated mixtures of lung and gastric cancer from exhaled breath.
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Affiliation(s)
- Yana Milyutin
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa, Israel
| | - Manal Abud-Hawa
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa, Israel
| | - Viki Kloper-Weidenfeld
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa, Israel
| | - Elias Mansour
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa, Israel
| | - Yoav Y Broza
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa, Israel
| | - Gidi Shani
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa, Israel
| | - Hossam Haick
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa, Israel.
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The New Approach to a Pattern Recognition of Volatile Compounds: The Inflammation Markers in Nasal Mucus Swabs from Calves Using the Gas Sensor Array. CHEMOSENSORS 2021. [DOI: 10.3390/chemosensors9060116] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This paper discusses the application of two approaches (direct and inverse) to the identification of volatile substances by means of a gas sensor array in a headspace over nasal mucus swab samples taken from calves with differing degrees of respiratory damage. We propose a unique method to visualize sensor array data for quality analysis, based on the spectra of cross mass sensitivity parameters. The traditional method, which requires an initial sensor array trained on the vapors of the individual substances (database accumulation)—with their further identification in the analyzed bio-samples through the comparison of the analysis results to the database—has shown unsatisfactory performance. The proposed inverse approach is more informative for the pattern recognition of volatile substances in the headspace of mucus samples. The projection of the calculated parameters of the sensor array for individual substances in the principal component space, acquired while processing the sensor array output from nasal swab samples, has allowed us to divide animals into groups according to the clinical diagnosis of their lung condition (healthy respiratory system, bronchitis, or bronchopneumonia). The substances detected in the gas phase of the nasal swab samples (cyclohexanone, butanone-2,4-methyl-2-pentanone) were correlated with the clinical state of the animals, and were consistent with the reference data on disease markers in exhaled air established for destructive organism processes.
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Are Volatile Organic Compounds Accurate Markers in the Assessment of Colorectal Cancer and Inflammatory Bowel Diseases? A Review. Cancers (Basel) 2021; 13:cancers13102361. [PMID: 34068419 PMCID: PMC8153598 DOI: 10.3390/cancers13102361] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/05/2021] [Accepted: 05/10/2021] [Indexed: 02/06/2023] Open
Abstract
Simple Summary Early diagnosis is crucial for reducing colorectal cancer-related mortality in both the general population and inflammatory bowel disease. Volatile organic compound (VOC) analysis is a promising alternative to the gold standard procedure, endoscopy, for early detection and surveillance of colorectal diseases. This review aimed to provide a general overview of the most recent evidence in this area on VOC testing in breath, stool, and urine samples. Abstract Colorectal cancer (CRC) is one of the leading causes of cancer-related death in the Western world. Early detection decreases incidence and mortality. Screening programs based on fecal occult blood testing help identify patients requiring endoscopic examination, but accuracy is far from optimal. Among the alternative strategies, volatile organic compounds (VOCs) represent novel potentially useful biomarkers of colorectal cancer. They also represent a promising tool for the screening of both intestinal inflammation and related CRC. The review is focused on the diagnostic potential of VOCs in sporadic CRC and in inflammatory bowel diseases (IBD), which increase the risk of CRC, analyzing future clinical applications. Despite limitations related to inadequate strength of evidence, differing analytical platforms identify different VOCs, and this unconventional approach for diagnosing colorectal cancer is promising. Some VOC profiles, besides identifying inflammation, seem disease-specific in inflammatory bowel diseases. Thus, breath, urine, and fecal VOCs provide a new and promising clinical approach to differential diagnosis, evaluation of the inflammatory status, and possibly the assessment of treatment efficacy in IBD. Conversely, specific VOC patterns correlating inflammatory bowel disease and cancer risk are still lacking, and studies focused on this issue are strongly encouraged. No prospective studies have assessed the risk of CRC development by using VOCs in samples collected before the onset of disease, both in the general population and in patients with IBD.
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Drabińska N, Flynn C, Ratcliffe N, Belluomo I, Myridakis A, Gould O, Fois M, Smart A, Devine T, Costello BDL. A literature survey of all volatiles from healthy human breath and bodily fluids: the human volatilome. J Breath Res 2021; 15. [PMID: 33761469 DOI: 10.1088/1752-7163/abf1d0] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 03/24/2021] [Indexed: 02/06/2023]
Abstract
This paper comprises an updated version of the 2014 review which reported 1846 volatile organic compounds (VOCs) identified from healthy humans. In total over 900 additional VOCs have been reported since the 2014 review and the VOCs from semen have been added. The numbers of VOCs found in breath and the other bodily fluids are: blood 379, breath 1488, faeces 443, milk 290, saliva 549, semen 196, skin 623 and urine 444. Compounds were assigned CAS registry numbers and named according to a common convention where possible. The compounds have been included in a single table with the source reference(s) for each VOC, an update on our 2014 paper. VOCs have also been grouped into tables according to their chemical class or functionality to permit easy comparison. Careful use of the database is needed, as a number of the identified VOCs only have level 2-putative assignment, and only a small fraction of the reported VOCs have been validated by standards. Some clear differences are observed, for instance, a lack of esters in urine with a high number in faeces and breath. However, the lack of compounds from matrices such a semen and milk compared to breath for example could be due to the techniques used or reflect the intensity of effort e.g. there are few publications on VOCs from milk and semen compared to a large number for breath. The large number of volatiles reported from skin is partly due to the methodologies used, e.g. by collecting skin sebum (with dissolved VOCs and semi VOCs) onto glass beads or cotton pads and then heating to a high temperature to desorb VOCs. All compounds have been included as reported (unless there was a clear discrepancy between name and chemical structure), but there may be some mistaken assignations arising from the original publications, particularly for isomers. It is the authors' intention that this work will not only be a useful database of VOCs listed in the literature but will stimulate further study of VOCs from healthy individuals; for example more work is required to confirm the identification of these VOCs adhering to the principles outlined in the metabolomics standards initiative. Establishing a list of volatiles emanating from healthy individuals and increased understanding of VOC metabolic pathways is an important step for differentiating between diseases using VOCs.
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Affiliation(s)
- Natalia Drabińska
- Division of Food Sciences, Institute of Animal Reproduction and Food Research of Polish Academy of Sciences, Tuwima 10, 10-747 Olsztyn, Poland
| | - Cheryl Flynn
- Centre of Research in Biosciences, University of the West of England, Frenchay Campus, Coldharbour Lane, Bristol BS16 1QY, United Kingdom
| | - Norman Ratcliffe
- Centre of Research in Biosciences, University of the West of England, Frenchay Campus, Coldharbour Lane, Bristol BS16 1QY, United Kingdom
| | - Ilaria Belluomo
- Department of Surgery and Cancer, Imperial College London, St. Mary's Campus, QEQM Building, London W2 1NY, United Kingdom
| | - Antonis Myridakis
- Department of Surgery and Cancer, Imperial College London, St. Mary's Campus, QEQM Building, London W2 1NY, United Kingdom
| | - Oliver Gould
- Centre of Research in Biosciences, University of the West of England, Frenchay Campus, Coldharbour Lane, Bristol BS16 1QY, United Kingdom
| | - Matteo Fois
- Centre of Research in Biosciences, University of the West of England, Frenchay Campus, Coldharbour Lane, Bristol BS16 1QY, United Kingdom
| | - Amy Smart
- Centre of Research in Biosciences, University of the West of England, Frenchay Campus, Coldharbour Lane, Bristol BS16 1QY, United Kingdom
| | - Terry Devine
- Centre of Research in Biosciences, University of the West of England, Frenchay Campus, Coldharbour Lane, Bristol BS16 1QY, United Kingdom
| | - Ben De Lacy Costello
- Centre of Research in Biosciences, University of the West of England, Frenchay Campus, Coldharbour Lane, Bristol BS16 1QY, United Kingdom
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Hintzen KFH, Grote J, Wintjens AGWE, Lubbers T, Eussen MMM, van Schooten FJ, Bouvy ND, Peeters A. Breath analysis for the detection of digestive tract malignancies: systematic review. BJS Open 2021; 5:6226007. [PMID: 33855362 PMCID: PMC8047095 DOI: 10.1093/bjsopen/zrab013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 11/27/2020] [Accepted: 02/03/2021] [Indexed: 01/01/2023] Open
Abstract
Background In recent decades there has been growing interest in the use of volatile organic compounds (VOCs) in exhaled breath as biomarkers for the diagnosis of multiple variants of cancer. This review aimed to evaluate the diagnostic accuracy and current status of VOC analysis in exhaled breath for the detection of cancer in the digestive tract. Methods PubMed and the Cochrane Library database were searched for VOC analysis studies, in which exhaled air was used to detect gastro-oesophageal, liver, pancreatic, and intestinal cancer in humans, Quality assessment was performed using the QUADAS-2 criteria. Data on diagnostic performance, VOCs with discriminative power, and methodological information were extracted from the included articles. Results Twenty-three articles were included (gastro-oesophageal cancer n = 14, liver cancer n = 1, pancreatic cancer n = 2, colorectal cancer n = 6). Methodological issues included different modalities of patient preparation and sampling and platform used. The sensitivity and specificity of VOC analysis ranged from 66.7 to 100 per cent and from 48.1 to 97.9 per cent respectively. Owing to heterogeneity of the studies, no pooling of the results could be performed. Of the VOCs found, 32 were identified in more than one study. Nineteen were reported as cancer type-specific, whereas 13 were found in different cancer types. Overall, decanal, nonanal, and acetone were the most frequently identified. Conclusion The literature on VOC analysis has documented a lack of standardization in study designs. Heterogeneity between the studies and insufficient validation of the results make interpretation of the outcomes challenging. To reach clinical applicability, future studies on breath analysis should provide an accurate description of the methodology and validate their findings.
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Affiliation(s)
- K F H Hintzen
- Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands.,Department of Pharmacology and Toxicology, Maastricht University, Maastricht, the Netherlands
| | - J Grote
- Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - A G W E Wintjens
- Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - T Lubbers
- Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - M M M Eussen
- Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - F J van Schooten
- Department of Pharmacology and Toxicology, Maastricht University, Maastricht, the Netherlands
| | - N D Bouvy
- Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - A Peeters
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, the Netherlands
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49
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Khoubnasabjafari M, Mogaddam MRA, Rahimpour E, Soleymani J, Saei AA, Jouyban A. Breathomics: Review of Sample Collection and Analysis, Data Modeling and Clinical Applications. Crit Rev Anal Chem 2021; 52:1461-1487. [PMID: 33691552 DOI: 10.1080/10408347.2021.1889961] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Metabolomics research is rapidly gaining momentum in disease diagnosis, on top of other Omics technologies. Breathomics, as a branch of metabolomics is developing in various frontiers, for early and noninvasive monitoring of disease. This review starts with a brief introduction to metabolomics and breathomics. A number of important technical issues in exhaled breath collection and factors affecting the sampling procedures are presented. We review the recent progress in metabolomics approaches and a summary of their applications on the respiratory and non-respiratory diseases investigated by breath analysis. Recent reports on breathomics studies retrieved from Scopus and Pubmed were reviewed in this work. We conclude that analyzing breath metabolites (both volatile and nonvolatile) is valuable in disease diagnoses, and therefore believe that breathomics will turn into a promising noninvasive discipline in biomarker discovery and early disease detection in personalized medicine. The problem of wide variations in the reported metabolite concentrations from breathomics studies should be tackled by developing more accurate analytical methods and sophisticated numerical analytical alogorithms.
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Affiliation(s)
- Maryam Khoubnasabjafari
- Tuberculosis and Lung Diseases Research Center and Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.,Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohamad Reza Afshar Mogaddam
- Food and Drug Safety Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Pharmaceutical Analysis Research Center and Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Elaheh Rahimpour
- Pharmaceutical Analysis Research Center and Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran.,Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Jafar Soleymani
- Pharmaceutical Analysis Research Center and Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran.,Liver and Gastrointestinal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir Ata Saei
- Department of Medical Biochemistry and Biophysics, Division of Physiological Chemistry I, Karolinska Institutet, Stockholm, Sweden
| | - Abolghasem Jouyban
- Food and Drug Safety Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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50
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Xiang L, Wu S, Hua Q, Bao C, Liu H. Volatile Organic Compounds in Human Exhaled Breath to Diagnose Gastrointestinal Cancer: A Meta-Analysis. Front Oncol 2021; 11:606915. [PMID: 33747921 PMCID: PMC7970758 DOI: 10.3389/fonc.2021.606915] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 01/21/2021] [Indexed: 12/11/2022] Open
Abstract
Introduction Human exhaled volatile organic compounds (VOCs) are being extensively studied for the purposes of noninvasive cancer diagnoses. This article was primarily to assess the feasibility of utilizing exhaled VOCs analysis for gastrointestinal cancer (GIC) diagnosis. Methods PRISMA-based system searches were conducted for related studies of exhaled VOCs in GIC diagnosis based on predetermined criteria. Relevant articles on colorectal cancer and gastroesophageal cancer were summarized, and meta analysis was performed on articles providing sensitivity and specificity data. Results From 2,227 articles, 14 were found to meet inclusion criteria, six of which were on colorectal cancer (CRC) and eight on Gastroesophageal cancer(GEC). Five articles could provide specific data of sensitivity and specificity in GEC, which were used for meta-analysis. The pooled sensitivity, specificity, diagnostic odds ratio (DOR), and area under the curve (AUC) were calculated based on the combination of these data, and were 85.0% [95% confidence interval (CI): 79.0%-90.0%], 89.0% (95%CI: 86.0%-91.0%), 41.30 (21.56-79.10), and 0.93, respectively. Conclusion VOCs can distinguish gastrointestinal cancers from other gastrointestinal diseases, opening up a new avenue for the diagnosis and identification of gastrointestinal cancers, and the analysis of VOCs in exhaled breath has potential clinical application in screening. VOCs are promising tumor biomarkers for GIC diagnosis. Furthermore, limitations like the heterogeneity of diagnostic VOCs between studies should be minded.
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Affiliation(s)
- Lijuan Xiang
- Department of Tumor Biotherapy (5th Ward of the Department of Oncology), Anhui Provincial Cancer Hospital, West District of The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.,Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Sihan Wu
- Department of Tumor Biotherapy (5th Ward of the Department of Oncology), Anhui Provincial Cancer Hospital, West District of The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.,Department of Oncology, Affiliated Provincial Hospital of Anhui Medical University, Hefei, China
| | - Qingling Hua
- Department of Oncology, Yijishan Hospital, Wannan Medical College, Wuhu, China
| | - Chuyang Bao
- Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Hu Liu
- Department of Tumor Biotherapy (5th Ward of the Department of Oncology), Anhui Provincial Cancer Hospital, West District of The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
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