Volatolomics analysis of exhaled breath and gastric-endoluminal gas for distinguishing early upper gastrointestinal cancer from benign

Abstract

Exhaled breath and gastric-endoluminal gas (volatile products of diseased tissues) contain a large number of volatile organic compounds (VOCs), which are valuable for early diagnosis of upper gastrointestinal (UGI) cancer. In this study, exhaled breath and gastric-endoluminal gas of patients with UGI cancer and benign disease were analyzed by gas chromatography-mass spectrometry (GC-MS) and ultraviolet photoionization time-of-flight mass spectrometry (UVP-TOFMS) to construct UGI cancer diagnostic models. Breath samples of 116 UGI cancer and 77 benign disease subjects and gastric-endoluminal gas samples of 114 UGI cancer and 76 benign disease subjects were collected. Machine learning (ML) algorithms were used to construct UGI cancer diagnostic models. Classification models based on exhaled breath for distinguishing UGI cancer from the benign group have area under the curve (AUC) of receiver operating characteristic (ROC) curve values of 0.959 and 0.994 corresponding to GC-MS and UVP-TOFMS analysis, respectively. The AUC values of models based on gastric-endoluminal gas for UGI cancer and benign group classification are 0.935 and 0.929 corresponding to GC-MS and UVP-TOFMS analysis, respectively. This work indicates that volatolomics analysis of exhaled breath and gastric-endoluminal diseased tissues have great potential in early screening of UGI cancer. Moreover, gastric-endoluminal gas can be a means of gas biopsy to provide auxiliary information for the examination of tissue lesions during gastroscopy.

Selectivity of Exhaled Breath Biomarkers of Lung Cancer in Relation to Cancer of Other Localizations

“…Various scientists published the results of studies where cancer diagnostic methods based on exhaled breath analysis using different analytical tools were developed [6][7][8][9]. Gas chromatography coupled with mass spectrometry (GC-MS) has taken a dominant position in the field of exhaled breath analysis since it is able to provide the most complete information regarding the sample composition [10][11][12]. Additionally, other analytical methods, including ion mobility spectrometry (IMS) [13], selected ion flow tube mass spectrometry (SIFT-MS) [14,15], proton-transfer-reaction mass spectrometry (PTR-MS) [16][17][18], are widely applied for exhaled breath analysis.…”