It has been reported that dogs are capable of identifying cancer in humans by detecting a specific odor: bladder cancer by detecting urine odor and other cancers by detecting exhaled breath odor. However, no odor recognized by dogs that indicates cancer has been identified. In this study, we examined whether bladder cancer could be detected by gas chromatography-mass spectrometry (GC-MS)-based metabolomics analysis of urine odor. Nine patients with bladder cancer and 7 healthy controls were recruited as participants. Patients collected urine 3 d before and for 3-7 d after surgery. The concentrated urine odor was analyzed by GC-MS and principal component analysis (PCA). Results indicated 12 metabolites of urine odor. Score plots of 7 of the preoperative bladder cancer patients were clearly different from those of controls on the PCA map. The distribution of controls was in the negative domain of principal component (PC) 1, whereas the distribution of preoperative patients was in the positive domain of PC1. Bladder cancer was diagnosed in 5 of the 9 patients on the basis of urinary cytology. The findings indicate the potential to screen bladder cancer by analyzing urine odor. Moreover, diagnosis of bladder cancer on the basis of urine odor might have higher sensitivity than screening by urinary cytology.
Key words metabolomics; urine odor; bladder cancer; GC-MSThe annual incidence of bladder cancer in men and women is showing a gradual tendency to increase. 1) Urinary tract epithelial cancer is the main bladder cancer and is conventionally detected by hematuria. Screening examinations include urinary cytology, and imaging by cystoscopy, and definitive pathological diagnosis is made by transurethral bladder biopsy. But they have high invasiveness. The bladder cancer is classified roughly into a permeative cancer of the intramural muscular layer and a superficial (muscular layer non-permeation) bladder cancer. When permeative cancer of bladder was discovered, a patient needs all bladder enucleation which is normal treatment that causes urinary passage change. Decline of the quality of life (QOL) is an important problem for patients. On the other hand, when superficial bladder cancer was discovered, a transurethral resection of bladder tumor (TURBT) is considered first-choice treatment. By receiving TURBT, the patient can still keep the bladder. Survival rates for five years of the patient become more than 95%. The life convalescence of the patient is good, too.2) However, many patients have a relapse of a cancer intravesically after a surgery early. It becomes necessary to perform the enforcement of the bladder cancer screening examinations including a purpose to detect a recurrence frequently. For such a reason, the physical, mental and financial burden for the patient is big, and development of the noninvasive screening is urgent business. Therefore, we decided to develop a new screening system for indentifying urinary tract epithelial cancer by metabolomics analysis of urinary odor.The identification of bladder c...