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Cancers (Basel)

Title:		Urinary Volatile Organic Compound Testing in Fast-Track Patients with Suspected Colorectal Cancer
Author(s):		Boulind CE; Gould O; de Lacy Costello B; Allison J; White P; Ewings P; Wicaksono AN; Curtis NJ; Pullyblank A; Jayne D; Covington JA; Ratcliffe N; Turner C; Francis NK;
Address:		"Department of General Surgery, Yeovil District Hospital NHS Foundation Trust, Higher Kingston, Yeovil BA21 4AT, UK. Institute of Bio-Sensing Technology, Frenchay Campus, University of the West of England, Coldharbour Lane, Bristol BS16 1QY, UK. Southwest NIHR Research Design Service, Somerset NHS Foundation Trust, Parkfield Drive, Taunton TA1 5DA, UK. School of Engineering, University of Warwick, Coventry CV4 7AL, UK. Department of Surgery, North Bristol NHS Foundation Trust, Southmead Road, Bristol BS10 5NB, UK. The John Goligher Colorectal Surgery Unit, St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds LS9 7TF, UK. St James's University Hospital, University of Leeds, 7 Clinical Sciences Building, Leeds LS9 7TF, UK. College of Health, Medicine and Life Scienes, Brunel University, Kingston Lane, Uxbridge, Middlesex UB8 3PH, UK. Division of Surgery and Interventional Science, University College London, London NW3 2PF, UK"
Journal Title:		Cancers (Basel)
Year:		2022
Volume:		20220424
Issue:		9
Page Number:		-
DOI:		10.3390/cancers14092127
ISSN/ISBN:		2072-6694 (Print) 2072-6694 (Electronic) 2072-6694 (Linking)
Abstract:		"Colorectal symptoms are common but only infrequently represent serious pathology, including colorectal cancer (CRC). A large number of invasive tests are presently performed for reassurance. We investigated the feasibility of urinary volatile organic compound (VOC) testing as a potential triage tool in patients fast-tracked for assessment for possible CRC. A prospective, multi-center, observational feasibility study was performed across three sites. Patients referred to NHS fast-track pathways for potential CRC provided a urine sample that underwent Gas Chromatography-Mass Spectrometry (GC-MS), Field Asymmetric Ion Mobility Spectrometry (FAIMS), and Selected Ion Flow Tube Mass Spectrometry (SIFT-MS) analysis. Patients underwent colonoscopy and/or CT colonography and were grouped as either CRC, adenomatous polyp(s), or controls to explore the diagnostic accuracy of VOC output data supported by an artificial neural network (ANN) model. 558 patients participated with 23 (4%) CRC diagnosed. 59% of colonoscopies and 86% of CT colonographies showed no abnormalities. Urinary VOC testing was feasible, acceptable to patients, and applicable within the clinical fast track pathway. GC-MS showed the highest clinical utility for CRC and polyp detection vs. controls (sensitivity = 0.878, specificity = 0.882, AUROC = 0.896) but it is labour intensive. Urinary VOC testing and analysis are feasible within NHS fast-track CRC pathways. Clinically meaningful differences between patients with cancer, polyps, or no pathology were identified suggesting VOC analysis may have future utility as a triage tool"
Keywords:		colorectal cancer fast track volatile organic compounds;
Notes:		"PubMed-not-MEDLINEBoulind, Caroline E Gould, Oliver de Lacy Costello, Ben Allison, Joanna White, Paul Ewings, Paul Wicaksono, Alfian N Curtis, Nathan J Pullyblank, Anne Jayne, David Covington, James A Ratcliffe, Norman Turner, Claire Francis, Nader K eng PB-PG-0416-20022/National Institute for Health Research/ Switzerland 2022/05/15 Cancers (Basel). 2022 Apr 24; 14(9):2127. doi: 10.3390/cancers14092127"