Chemical characterization of exhaled breath to differentiate between patients with malignant plueral mesothelioma from subjects with similar professional asbestos exposure

Abstract

Malignant pleural mesothelioma (MPM) is an aggressive tumour whose main aetiology is the long-term exposure to asbestos fibres. The diagnostic procedure of MPM is difficult and often requires invasive approaches; therefore, it is clinically important to find accurate markers for MPM by new noninvasive methods that may facilitate the diagnostic process and identify patients at an earlier stage. In the present study, the exhaled breath of 13 patients with histology-established diagnosis of MPM, 13 subjects with long-term certified professional exposure to asbestos (EXP) and 13 healthy subjects without exposure to asbestos (healthy controls, HC) were analysed. An analytical procedure to determine volatile organic compounds by sampling of air on a bed of solid sorbent and thermal desorption GC-MS analysis was developed in order to identify the compounds capable of discriminating among the three groups. The application of univariate (ANOVA) and multivariate statistical treatments (PCA, DFA and CP-ANN) showed that cyclopentane and cyclohexane were the dominant variables able to discriminate among the three groups. In particular, it was found that cyclohexane is the only compound able to differentiate the MPM group from the other two; therefore, it can be a possible marker of MPM. Cyclopentane is the dominant compound in the discrimination between EXP and the other groups (MPM and HC); then, it can be considered a good indicator for long-term asbestos exposure. This result suggests the need to perform frequent and thorough investigations on people exposed to asbestos in order to constantly monitor their state of health or possibly to study the evolution of disease over time.

A breath test for malignant mesothelioma using an electronic nose

“…However, studies are underway to identify individual breath components and it is likely that these will be characterised in the near future. For example, cyclopentane and cyclohexane are likely to prove important molecules which distinguish between MM patients and subjects with asbestos exposure [37].…”

An electronic nose distinguishes exhaled breath of patients with Malignant Pleural Mesothelioma from controls

“…Recently, we showed by explorative GC-MS analysis that levels of cyclohexane, toluene, xylene, benzaldehyde, trimethylbenzene, limonene, 2-ethyl-1-hexanol, and acetophenone, were altered in the exhaled breath of subjects with long-term exposure to asbestos, with and without MPM [8]. Furthermore, cyclohexane, cyclopenthane, dodecanoic, xylene, toluene, decane, methylcyclohexane, dimethyl-nonanoic, benzylaldehyde, limonene and b-pinene were most discriminative between MPM and exposed or non-exposed controls [8].…”

“…The patients in this study have been described previously [8]. In short, 39 adult subjects were divided into 3 groups.…”

“…This has been established by gas chromatography and mass spectrometry (GC-MS). Indeed, when using GC-MS, we have recently shown that exhaled air from MPM patients can be discriminated from controls based on pattern recognition of VOCs [8]. Even though cyclohexane was the predominant discriminative compound in MPM, it required multiple VOCs to obtain complete separation MPM patients and controls [8].…”

Exhalation pattern changes during fasting and low dose glucose treatment in rats

“…Not surprisingly, the bulk of medical research is associated with pulmonary disorders-for example, chronic obstructive pulmonary disease, asthma, cystic fibrosis, and lung cancer [8][9][10]. Furthermore, MCC-IMS has been used for detection of sepsis, inflammation, and various bacterial species [11,12].…”