« Previous Abstract[The reaction of taiga ticks to an attractant. II. The rates of removing ticks from a population]    Next AbstractVolatile organic compounds in bile for early diagnosis of cholangiocarcinoma in patients with primary sclerosing cholangitis: a pilot study »

Gastrointest Endosc

Title:		Volatile organic compounds in bile can diagnose malignant biliary strictures in the setting of pancreatic cancer: a preliminary observation
Author(s):		Navaneethan U; Parsi MA; Gutierrez NG; Bhatt A; Venkatesh PG; Lourdusamy D; Grove D; Hammel JP; Jang S; Sanaka MR; Stevens T; Vargo JJ; Dweik RA;
Address:		"Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland, Ohio, USA. Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland Clinic, Cleveland, Ohio, USA"
Journal Title:		Gastrointest Endosc
Year:		2014
Volume:		20140611
Issue:		6
Page Number:		1038 - 1045
DOI:		10.1016/j.gie.2014.04.016
ISSN/ISBN:		1097-6779 (Electronic) 0016-5107 (Linking)
Abstract:		"BACKGROUND: Ascertaining the nature of biliary strictures is challenging. The role of volatile organic compounds (VOCs) in bile in determining the cause of biliary strictures is not known. OBJECTIVE: To identify potential VOCs in the headspaces (gas above the sample) of bile in patients with malignant biliary strictures from pancreatic cancer. DESIGN: Prospective cross-sectional study. SETTING: Referral center. PATIENTS: Prospective study in which bile was aspirated in 96 patients undergoing ERCP for benign and malignant conditions. MAIN OUTCOME MEASUREMENTS: Selected ion flow tube mass spectrometry (VOICE200R SIFT-MS instrument; Syft Technologies Ltd, Christchurch, New Zealand) was used to analyze the headspace and to build a predictive model for pancreatic cancer. RESULTS: The headspaces from 96 bile samples were analyzed, including 24 from patients with pancreatic cancer and 72 from patients with benign biliary conditions. The concentrations of 6 compounds (acetaldehyde, acetone, benzene, carbon disulfide, pentane, and trimethylamine [TMA]) were increased in patients with pancreatic cancer compared with controls (P < .05). By using receiver-operating characteristic curve analysis, we developed a model for the diagnosis of pancreatic cancer based on the levels of TMA, acetone, isoprene, dimethyl sulfide, and acetaldehyde. The model [10.94 + 1.8229* log (acetaldehyde) + 0.7600* log (acetone) - 1.1746* log (dimethyl sulfide) + 1.0901* log (isoprene) - 2.1401 * log (trimethylamine) >/= 10] identified the patients with pancreatic cancer (area under the curve = 0.85), with 83.3% sensitivity and 81.9% specificity. LIMITATIONS: Sample size. CONCLUSIONS: The measurement of biliary fluid VOCs may help to distinguish malignant from benign biliary strictures. Further studies are warranted to validate these observations. (Clinical Trial Registration Number NCT01565460.)"
Keywords:		"Acetaldehyde/analysis Acetone/analysis Benzene/analysis Bile/*chemistry Biliary Tract Diseases/diagnosis Carbon Disulfide/analysis Case-Control Studies Choledocholithiasis/*diagnosis Constriction, Pathologic/diagnosis Cross-Sectional Studies Female Humans;"
Notes:		"MedlineNavaneethan, Udayakumar Parsi, Mansour A Gutierrez, Norma G Bhatt, Amit Venkatesh, Preethi G K Lourdusamy, Dennisdhilak Grove, David Hammel, Jeffrey P Jang, Sunguk Sanaka, Madhusudhan R Stevens, Tyler Vargo, John J Dweik, Raed A eng HL081064/HL/NHLBI NIH HHS/ HL103453/HL/NHLBI NIH HHS/ HL107147/HL/NHLBI NIH HHS/ HL109250/HL/NHLBI NIH HHS/ RR026231/RR/NCRR NIH HHS/ UL1TR 000439-06/TR/NCATS NIH HHS/ Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't 2014/06/16 Gastrointest Endosc. 2014 Dec; 80(6):1038-45. doi: 10.1016/j.gie.2014.04.016. Epub 2014 Jun 11"