Volatile organic compounds in breath can serve as a non‐invasive diagnostic biomarker for the detection of advanced adenomas and colorectal cancer
Summary Background Colorectal cancer (CRC) is the third most common cancer diagnosis in the Western world. Aim To evaluate exhaled volatile organic compounds (VOCs) as a non‐invasive biomarker for the detection of CRC and precursor lesions using an electronic nose. Methods In this multicentre study...
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| Veröffentlicht in: | Alimentary pharmacology & therapeutics Jg. 51; H. 3; S. 334 - 346 |
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England
Wiley Subscription Services, Inc
01.02.2020
John Wiley and Sons Inc |
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| Abstract | Summary
Background
Colorectal cancer (CRC) is the third most common cancer diagnosis in the Western world.
Aim
To evaluate exhaled volatile organic compounds (VOCs) as a non‐invasive biomarker for the detection of CRC and precursor lesions using an electronic nose.
Methods
In this multicentre study adult colonoscopy patients, without inflammatory bowel disease or (previous) malignancy, were invited for breath analysis. Two‐thirds of the breath tests were randomly assigned to develop training models which were used to predict the diagnosis of the remaining patients (external validation). In the end, all data were used to develop final‐disease models to further improve the discriminatory power of the algorithms.
Results
Five hundred and eleven breath samples were collected. Sixty‐four patients were excluded due to an inadequate breath test (n = 51), incomplete colonoscopy (n = 8) or colitis (n = 5). Classification was based on the most advanced lesion found; CRC (n = 70), advanced adenomas (AAs) (n = 117), non‐advanced adenoma (n = 117), hyperplastic polyp (n = 15), normal colonoscopy (n = 125). Training models for CRC and AAs had an area under the curve (AUC) of 0.76 and 0.71 and blind validation resulted in an AUC of 0.74 and 0.61 respectively. Final models for CRC and AAs yielded an AUC of 0.84 (sensitivity 95% and specificity 64%) and 0.73 (sensitivity and specificity 79% and 59%) respectively.
Conclusions
This study suggests that exhaled VOCs could potentially serve as a non‐invasive biomarker for the detection of CRC and AAs. Future studies including more patients could further improve the discriminatory potential of VOC analysis for the detection of (pre‐)malignant colorectal lesions. (https://clinicaltrials.gov Identifier NCT03488537) |
|---|---|
| AbstractList | Colorectal cancer (CRC) is the third most common cancer diagnosis in the Western world.
To evaluate exhaled volatile organic compounds (VOCs) as a non-invasive biomarker for the detection of CRC and precursor lesions using an electronic nose.
In this multicentre study adult colonoscopy patients, without inflammatory bowel disease or (previous) malignancy, were invited for breath analysis. Two-thirds of the breath tests were randomly assigned to develop training models which were used to predict the diagnosis of the remaining patients (external validation). In the end, all data were used to develop final-disease models to further improve the discriminatory power of the algorithms.
Five hundred and eleven breath samples were collected. Sixty-four patients were excluded due to an inadequate breath test (n = 51), incomplete colonoscopy (n = 8) or colitis (n = 5). Classification was based on the most advanced lesion found; CRC (n = 70), advanced adenomas (AAs) (n = 117), non-advanced adenoma (n = 117), hyperplastic polyp (n = 15), normal colonoscopy (n = 125). Training models for CRC and AAs had an area under the curve (AUC) of 0.76 and 0.71 and blind validation resulted in an AUC of 0.74 and 0.61 respectively. Final models for CRC and AAs yielded an AUC of 0.84 (sensitivity 95% and specificity 64%) and 0.73 (sensitivity and specificity 79% and 59%) respectively.
This study suggests that exhaled VOCs could potentially serve as a non-invasive biomarker for the detection of CRC and AAs. Future studies including more patients could further improve the discriminatory potential of VOC analysis for the detection of (pre-)malignant colorectal lesions. (https://clinicaltrials.gov Identifier NCT03488537). Colorectal cancer (CRC) is the third most common cancer diagnosis in the Western world.BACKGROUNDColorectal cancer (CRC) is the third most common cancer diagnosis in the Western world.To evaluate exhaled volatile organic compounds (VOCs) as a non-invasive biomarker for the detection of CRC and precursor lesions using an electronic nose.AIMTo evaluate exhaled volatile organic compounds (VOCs) as a non-invasive biomarker for the detection of CRC and precursor lesions using an electronic nose.In this multicentre study adult colonoscopy patients, without inflammatory bowel disease or (previous) malignancy, were invited for breath analysis. Two-thirds of the breath tests were randomly assigned to develop training models which were used to predict the diagnosis of the remaining patients (external validation). In the end, all data were used to develop final-disease models to further improve the discriminatory power of the algorithms.METHODSIn this multicentre study adult colonoscopy patients, without inflammatory bowel disease or (previous) malignancy, were invited for breath analysis. Two-thirds of the breath tests were randomly assigned to develop training models which were used to predict the diagnosis of the remaining patients (external validation). In the end, all data were used to develop final-disease models to further improve the discriminatory power of the algorithms.Five hundred and eleven breath samples were collected. Sixty-four patients were excluded due to an inadequate breath test (n = 51), incomplete colonoscopy (n = 8) or colitis (n = 5). Classification was based on the most advanced lesion found; CRC (n = 70), advanced adenomas (AAs) (n = 117), non-advanced adenoma (n = 117), hyperplastic polyp (n = 15), normal colonoscopy (n = 125). Training models for CRC and AAs had an area under the curve (AUC) of 0.76 and 0.71 and blind validation resulted in an AUC of 0.74 and 0.61 respectively. Final models for CRC and AAs yielded an AUC of 0.84 (sensitivity 95% and specificity 64%) and 0.73 (sensitivity and specificity 79% and 59%) respectively.RESULTSFive hundred and eleven breath samples were collected. Sixty-four patients were excluded due to an inadequate breath test (n = 51), incomplete colonoscopy (n = 8) or colitis (n = 5). Classification was based on the most advanced lesion found; CRC (n = 70), advanced adenomas (AAs) (n = 117), non-advanced adenoma (n = 117), hyperplastic polyp (n = 15), normal colonoscopy (n = 125). Training models for CRC and AAs had an area under the curve (AUC) of 0.76 and 0.71 and blind validation resulted in an AUC of 0.74 and 0.61 respectively. Final models for CRC and AAs yielded an AUC of 0.84 (sensitivity 95% and specificity 64%) and 0.73 (sensitivity and specificity 79% and 59%) respectively.This study suggests that exhaled VOCs could potentially serve as a non-invasive biomarker for the detection of CRC and AAs. Future studies including more patients could further improve the discriminatory potential of VOC analysis for the detection of (pre-)malignant colorectal lesions. (https://clinicaltrials.gov Identifier NCT03488537).CONCLUSIONSThis study suggests that exhaled VOCs could potentially serve as a non-invasive biomarker for the detection of CRC and AAs. Future studies including more patients could further improve the discriminatory potential of VOC analysis for the detection of (pre-)malignant colorectal lesions. (https://clinicaltrials.gov Identifier NCT03488537). Summary Background Colorectal cancer (CRC) is the third most common cancer diagnosis in the Western world. Aim To evaluate exhaled volatile organic compounds (VOCs) as a non‐invasive biomarker for the detection of CRC and precursor lesions using an electronic nose. Methods In this multicentre study adult colonoscopy patients, without inflammatory bowel disease or (previous) malignancy, were invited for breath analysis. Two‐thirds of the breath tests were randomly assigned to develop training models which were used to predict the diagnosis of the remaining patients (external validation). In the end, all data were used to develop final‐disease models to further improve the discriminatory power of the algorithms. Results Five hundred and eleven breath samples were collected. Sixty‐four patients were excluded due to an inadequate breath test (n = 51), incomplete colonoscopy (n = 8) or colitis (n = 5). Classification was based on the most advanced lesion found; CRC (n = 70), advanced adenomas (AAs) (n = 117), non‐advanced adenoma (n = 117), hyperplastic polyp (n = 15), normal colonoscopy (n = 125). Training models for CRC and AAs had an area under the curve (AUC) of 0.76 and 0.71 and blind validation resulted in an AUC of 0.74 and 0.61 respectively. Final models for CRC and AAs yielded an AUC of 0.84 (sensitivity 95% and specificity 64%) and 0.73 (sensitivity and specificity 79% and 59%) respectively. Conclusions This study suggests that exhaled VOCs could potentially serve as a non‐invasive biomarker for the detection of CRC and AAs. Future studies including more patients could further improve the discriminatory potential of VOC analysis for the detection of (pre‐)malignant colorectal lesions. (https://clinicaltrials.gov Identifier NCT03488537) BackgroundColorectal cancer (CRC) is the third most common cancer diagnosis in the Western world.AimTo evaluate exhaled volatile organic compounds (VOCs) as a non‐invasive biomarker for the detection of CRC and precursor lesions using an electronic nose.MethodsIn this multicentre study adult colonoscopy patients, without inflammatory bowel disease or (previous) malignancy, were invited for breath analysis. Two‐thirds of the breath tests were randomly assigned to develop training models which were used to predict the diagnosis of the remaining patients (external validation). In the end, all data were used to develop final‐disease models to further improve the discriminatory power of the algorithms.ResultsFive hundred and eleven breath samples were collected. Sixty‐four patients were excluded due to an inadequate breath test (n = 51), incomplete colonoscopy (n = 8) or colitis (n = 5). Classification was based on the most advanced lesion found; CRC (n = 70), advanced adenomas (AAs) (n = 117), non‐advanced adenoma (n = 117), hyperplastic polyp (n = 15), normal colonoscopy (n = 125). Training models for CRC and AAs had an area under the curve (AUC) of 0.76 and 0.71 and blind validation resulted in an AUC of 0.74 and 0.61 respectively. Final models for CRC and AAs yielded an AUC of 0.84 (sensitivity 95% and specificity 64%) and 0.73 (sensitivity and specificity 79% and 59%) respectively.ConclusionsThis study suggests that exhaled VOCs could potentially serve as a non‐invasive biomarker for the detection of CRC and AAs. Future studies including more patients could further improve the discriminatory potential of VOC analysis for the detection of (pre‐)malignant colorectal lesions. (https://clinicaltrials.gov Identifier NCT03488537) |
| Author | Kolkman, Jeroen J. Keulen, Kelly E. Jansen, Maud E. Schrauwen, Ruud W. M. Siersema, Peter D. |
| AuthorAffiliation | 1 Department of Gastroenterology and Hepatology Radboud University Medical Center Nijmegen The Netherlands 4 Department of Gastroenterology and Hepatology Bernhoven Uden The Netherlands 3 University Medical Center Groningen Groningen The Netherlands 2 Department of Gastroenterology and Hepatology Medisch Spectrum Twente Enschede The Netherlands |
| AuthorAffiliation_xml | – name: 4 Department of Gastroenterology and Hepatology Bernhoven Uden The Netherlands – name: 3 University Medical Center Groningen Groningen The Netherlands – name: 2 Department of Gastroenterology and Hepatology Medisch Spectrum Twente Enschede The Netherlands – name: 1 Department of Gastroenterology and Hepatology Radboud University Medical Center Nijmegen The Netherlands |
| Author_xml | – sequence: 1 givenname: Kelly E. orcidid: 0000-0001-7219-2775 surname: Keulen fullname: Keulen, Kelly E. email: kelly.vankeulen@radboudumc.nl organization: Radboud University Medical Center – sequence: 2 givenname: Maud E. surname: Jansen fullname: Jansen, Maud E. organization: University Medical Center Groningen – sequence: 3 givenname: Ruud W. M. surname: Schrauwen fullname: Schrauwen, Ruud W. M. organization: Bernhoven – sequence: 4 givenname: Jeroen J. orcidid: 0000-0002-0442-827X surname: Kolkman fullname: Kolkman, Jeroen J. organization: University Medical Center Groningen – sequence: 5 givenname: Peter D. orcidid: 0000-0002-6940-8499 surname: Siersema fullname: Siersema, Peter D. organization: Radboud University Medical Center |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/31858615$$D View this record in MEDLINE/PubMed |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 ObjectType-Article-2 ObjectType-Undefined-1 ObjectType-Feature-3 content type line 23 The Handling Editor for this article was Professor Jonathan Rhodes, and it was accepted for publication after full peer‐review. |
| ORCID | 0000-0002-6940-8499 0000-0002-0442-827X 0000-0001-7219-2775 |
| OpenAccessLink | https://onlinelibrary.wiley.com/doi/abs/10.1111%2Fapt.15622 |
| PMID | 31858615 |
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| PublicationCentury | 2000 |
| PublicationDate | February 2020 |
| PublicationDateYYYYMMDD | 2020-02-01 |
| PublicationDate_xml | – month: 02 year: 2020 text: February 2020 |
| PublicationDecade | 2020 |
| PublicationPlace | England |
| PublicationPlace_xml | – name: England – name: Chichester – name: Hoboken |
| PublicationTitle | Alimentary pharmacology & therapeutics |
| PublicationTitleAlternate | Aliment Pharmacol Ther |
| PublicationYear | 2020 |
| Publisher | Wiley Subscription Services, Inc John Wiley and Sons Inc |
| Publisher_xml | – name: Wiley Subscription Services, Inc – name: John Wiley and Sons Inc |
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Background
Colorectal cancer (CRC) is the third most common cancer diagnosis in the Western world.
Aim
To evaluate exhaled volatile organic compounds... Colorectal cancer (CRC) is the third most common cancer diagnosis in the Western world. To evaluate exhaled volatile organic compounds (VOCs) as a non-invasive... BackgroundColorectal cancer (CRC) is the third most common cancer diagnosis in the Western world.AimTo evaluate exhaled volatile organic compounds (VOCs) as a... Colorectal cancer (CRC) is the third most common cancer diagnosis in the Western world.BACKGROUNDColorectal cancer (CRC) is the third most common cancer... |
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| SubjectTerms | Adenoma Adenoma - diagnosis Adenoma - metabolism Adenoma - pathology Aged Biomarkers Biomarkers, Tumor - analysis Biomarkers, Tumor - metabolism Breath Analysis for Diagnosis of Colorectal Adenomas and Cancer Breath tests Breath Tests - instrumentation Breath Tests - methods Case-Control Studies Colitis Colonoscopy Colorectal cancer Colorectal carcinoma Colorectal Neoplasms - diagnosis Colorectal Neoplasms - metabolism Colorectal Neoplasms - pathology Cross-Sectional Studies Diagnosis Disease Progression Early Detection of Cancer - instrumentation Early Detection of Cancer - methods Electronic Nose - standards Electronic noses Exhalation - physiology Female Humans Inflammatory bowel diseases Intestine Lesions Male Malignancy Middle Aged Models, Biological Neoplasm Staging Netherlands Organic compounds Original Precancerous Conditions - diagnosis Precancerous Conditions - metabolism Precancerous Conditions - pathology Sensitivity and Specificity Tumors VOCs Volatile organic compounds Volatile Organic Compounds - analysis Volatile Organic Compounds - metabolism |
| Title | Volatile organic compounds in breath can serve as a non‐invasive diagnostic biomarker for the detection of advanced adenomas and colorectal cancer |
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