Breath testing as potential colorectal cancer screening tool

Abstract

Although colorectal cancer (CRC) screening is included in organized programs of many countries worldwide, there is still a place for better screening tools. In this study, 418 breath samples were collected from 65 patients with CRC, 22 with advanced or nonadvanced adenomas, and 122 control cases. All patients, including the controls, had undergone colonoscopy. The samples were analysed with two different techniques. The first technique relied on gas chromatography coupled with mass spectrometry (GC-MS) for identification and quantification of volatile organic compounds (VOCs). The T-test was used to identify significant VOCs (p values < 0.017). The second technique relied on sensor analysis with a pattern recognition method for building a breath pattern to identify different groups. Blind analysis or leave-one-out cross validation was conducted for validation. The GC-MS analysis revealed four significant VOCs that identified the tested groups; these were acetone and ethyl acetate (higher in CRC), ethanol and 4-methyl octane (lower in CRC). The sensor-analysis distinguished CRC from the control group with 85% sensitivity, 94% specificity and 91% accuracy. The performance of the sensors in identifying the advanced adenoma group from the non-advanced adenomas was 88% sensitivity, 100% specificity, and 94% accuracy. The performance of the sensors in identifying the advanced adenoma group was distinguished from the control group was 100% sensitivity, 88% specificity, and 94% accuracy. For summary, volatile marker testing by using sensor analysis is a promising noninvasive approach for CRC screening.Globally colorectal cancer (CRC) is the third most prevalent cancer and the fourth leading cause of death from malignant diseases. 1 The 5-year survival rate for colorectal cancer when diagnosed at an early stage before it has spread is about 90%. But only about four out of 10 colorectal cancers are found at that early stage. In advanced stages, the survival rates are substantially lower. Therefore, regular CRC screening or testing are considered as some of the most powerful tools for preventing colorectal cancer caused mortality. 2 Not only does CRC screening save lives, but it also is cost effective. Studies have shown that the cost-effectiveness of CRC screening is consistent with many other kinds of preventive services and is lower than some common interventions. 3 The laboratory-based faecal immunochemical test (FIT) is the test-of-choice currently in the EU. 4 Alternatively, several recent studies have demonstrated the ability of flexiblesigmoidoscopy to decrease the disease-specific mortality when used as a screening tool. 5-7 However, colonoscopy is considered better than sigmoidoscopy in preventing mortality. 8 Poland, Germany and Czech Republic are using colonoscopy as their primary screening tool. Nevertheless, the major problem with endoscopic methods for CRC screening is low compliance. 9 A systemic review of participation in CRC screening within trial settings after the first-time invitation has reported only...

Volatile organic compounds as new biomarkers for colorectal cancer: a review

“…This is the gold standard hybrid analytical platform employed successfully for the chemical characterization of VOC biomarkers. This method was used in seven of the 10 studies. GC‐MS allows the physical separation of the volatile molecules in samples and the subsequent identification of their nature and quantification, permitting identification of the exact composition of the sample analysed.…”

“…Recently Amal et al . published the results of an analysis of exhaled breath from 65 patients with CRC, 22 with adenoma and 122 healthy controls. GC‐MS and an e‐nose made from cross‐reactive nanoarrays in combination were used for the analysis.…”

Self-Healable Sensors Based Nanoparticles for Detecting Physiological Markers via Skin and Breath: Toward Disease Prevention via Wearable Devices

“…A promising approach for monitoring the physiological parameters of healthy people is based on the continuous (or frequent) detection of volatile organic compounds (VOCs) [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] and/or pressure pulses that are derived from human breath/skin, along with monitoring of heart-beat and breath rate, inter alia. 21,22 This approach has the potential to be painless, easy-to-perform, inexpensive and give results that can be available immediately for therapeutic assessment/diagnosis.…”

Diagnosis and Classification of 17 Diseases from 1404 Subjects via Pattern Analysis of Exhaled Molecules

“…32,43,44,47,48 Artificially intelligent nanoarrays of different composition were assessed in a series of separate laboratory (preclinical) and clinical studies for the detection of a wide range of cancerous and noncancerous diseases. 8,14,23−32,43,45,47,49−57 In these studies, disease detection was mostly carried out with reference to healthy control groups, without examining correlated and uncorrelated clinical confounding factors. Clinical classification itself was beyond the focus of these studies.…”