| Title: | Volatile Organic Compounds in Urine for Noninvasive Diagnosis of Malignant Biliary Strictures: A Pilot Study |
| Author(s): | Navaneethan U; Parsi MA; Lourdusamy D; Grove D; Sanaka MR; Hammel JP; Vargo JJ; Dweik RA; |
| Address: | "Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland, OH, USA, udhaykumar81@gmail.com" |
| DOI: | 10.1007/s10620-015-3596-x |
| ISSN/ISBN: | 1573-2568 (Electronic) 0163-2116 (Linking) |
| Abstract: | "BACKGROUND: The use of volatile organic compounds (VOCs) in bile was recently studied and appeared promising for diagnosis of malignancy. Noninvasive diagnosis of malignant biliary strictures by using VOCs in urine has not been studied. AIM: To identify potential VOCs in urine to diagnose malignant biliary strictures. METHODS: In this prospective cross-sectional study, urine was obtained immediately prior to ERCP from consecutive patients with biliary strictures. Selected-ion flow-tube mass spectrometry was used to analyze the concentration of VOCs in urine samples. RESULTS: Fifty-four patients with biliary strictures were enrolled. Fifteen patients had malignant stricture [six cholangiocarcinoma (CCA) and nine pancreatic cancer], and 39 patients had benign strictures [10 primary sclerosing cholangitis (PSC) and 29 with benign biliary conditions including chronic pancreatitis and papillary stenosis]. The concentration of several compounds (ethanol and 2-propanol) was significantly different in patients with malignant compared with benign biliary strictures (p < 0.05). Using receiver operating characteristic curve analysis, we developed a model for the diagnosis of malignant biliary strictures adjusted for age and gender based on VOC levels of 2-propranol, carbon disulfide, and trimethyl amine (TMA). The model [-2.4191 * log(2-propanol) + 1.1617 * log(TMA) - 1.2172 * log(carbon disulfide)] >/= 7.73 identified the patients with malignant biliary stricture [area under the curve (AUC = 0.83)], with 93.3 % sensitivity and 61.5 % specificity (p = 0.009). Comparing patients with CCA and PSC, the model [38.864 * log(ethane) - 3.989 * log(1-octene)] |
| Keywords: | "Bile Duct Neoplasms/*diagnosis/urine Bile Ducts/*pathology Bile Ducts, Intrahepatic/pathology Cholangiocarcinoma/diagnosis/urine Cholangitis, Sclerosing/diagnosis/urine Constriction, Pathologic/*diagnosis/urine Cross-Sectional Studies Female Humans Male P;" |
| Notes: | "MedlineNavaneethan, Udayakumar Parsi, Mansour A Lourdusamy, Dennisdhilak Grove, David Sanaka, Madhusudhan R Hammel, Jeffrey P 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 2015/02/25 Dig Dis Sci. 2015 Jul; 60(7):2150-7. doi: 10.1007/s10620-015-3596-x. Epub 2015 Feb 24" |
