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Ann Surg

Title:		Mass Spectrometric Analysis of Exhaled Breath for the Identification of Volatile Organic Compound Biomarkers in Esophageal and Gastric Adenocarcinoma
Author(s):		Kumar S; Huang J; Abbassi-Ghadi N; Mackenzie HA; Veselkov KA; Hoare JM; Lovat LB; Spanel P; Smith D; Hanna GB;
Address:		"*Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, London, UK daggerDepartment of Medicine, Imperial College London, St Mary's Hospital, London, UK double daggerDepartment of Surgery and Interventional Science, National Medical Laser Centre, University College London, London, UK section signJ. Heyrovsky Institute of Physical Chemistry, Academy of Sciences of the Czech Republic, Prague, Czech Republic paragraph signInstitute for Science and Technology in Medicine, Keele University, Guy Hilton Research Centre, Hartshill, UK"
Journal Title:		Ann Surg
Year:		2015
Volume:		262
Issue:		6
Page Number:		981 - 990
DOI:		10.1097/SLA.0000000000001101
ISSN/ISBN:		1528-1140 (Electronic) 0003-4932 (Linking)
Abstract:		"OBJECTIVE: The present study assessed whether exhaled breath analysis using Selected Ion Flow Tube Mass Spectrometry could distinguish esophageal and gastric adenocarcinoma from noncancer controls. BACKGROUND: The majority of patients with upper gastrointestinal cancer present with advanced disease, resulting in poor long-term survival rates. Novel methods are needed to diagnose potentially curable upper gastrointestinal malignancies. METHODS: A Profile-3 Selected Ion Flow Tube Mass Spectrometry instrument was used for analysis of volatile organic compounds (VOCs) within exhaled breath samples. All study participants had undergone upper gastrointestinal endoscopy on the day of breath sampling. Receiver operating characteristic analysis and a diagnostic risk prediction model were used to assess the discriminatory accuracy of the identified VOCs. RESULTS: Exhaled breath samples were analyzed from 81 patients with esophageal (N = 48) or gastric adenocarcinoma (N = 33) and 129 controls including Barrett's metaplasia (N = 16), benign upper gastrointestinal diseases (N = 62), or a normal upper gastrointestinal tract (N = 51). Twelve VOCs-pentanoic acid, hexanoic acid, phenol, methyl phenol, ethyl phenol, butanal, pentanal, hexanal, heptanal, octanal, nonanal, and decanal-were present at significantly higher concentrations (P < 0.05) in the cancer groups than in the noncancer controls. The area under the ROC curve using these significant VOCs to discriminate esophageal and gastric adenocarcinoma from those with normal upper gastrointestinal tracts was 0.97 and 0.98, respectively. The area under the ROC curve for the model and validation subsets of the diagnostic prediction model was 0.92 +/- 0.01 and 0.87 +/- 0.03, respectively. CONCLUSIONS: Distinct exhaled breath VOC profiles can distinguish patients with esophageal and gastric adenocarcinoma from noncancer controls"
Keywords:		"Adenocarcinoma/*diagnosis/metabolism Aged Biomarkers, Tumor/*metabolism Breath Tests Case-Control Studies Decision Support Techniques Esophageal Neoplasms/*diagnosis/metabolism Exhalation Female Humans Male *Mass Spectrometry Middle Aged ROC Curve Risk As;"
Notes:		"MedlineKumar, Sacheen Huang, Juzheng Abbassi-Ghadi, Nima Mackenzie, Hugh A Veselkov, Kirill A Hoare, Jonathan M Lovat, Laurence B Spanel, Patrik Smith, David Hanna, George B eng Clinical Trial Research Support, Non-U.S. Gov't 2015/01/13 Ann Surg. 2015 Dec; 262(6):981-90. doi: 10.1097/SLA.0000000000001101"