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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Bibliographic Details
Published in:Alimentary pharmacology & therapeutics Vol. 51; no. 3; pp. 334 - 346
Main Authors: Keulen, Kelly E., Jansen, Maud E., Schrauwen, Ruud W. M., Kolkman, Jeroen J., Siersema, Peter D.
Format: Journal Article
Language:English
Published: England Wiley Subscription Services, Inc 01.02.2020
John Wiley and Sons Inc
Subjects:
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
Netherlands
ISSN:0269-2813, 1365-2036, 1365-2036
Online Access:Get full text
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Summary: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)
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The Handling Editor for this article was Professor Jonathan Rhodes, and it was accepted for publication after full peer‐review.
ISSN:0269-2813
1365-2036
1365-2036
DOI:10.1111/apt.15622