Exhaled breath online measurement for cervical cancer patients and healthy subjects by proton transfer reaction mass spectrometry

Cervical cancer is a common cancer among women and has a high morbidity and mortality. The traditional clinical methods for cervical cancer screening are invasive and limited in terms of cost and time. There is an unmet clinical need for new methods to aid clinicians in the rapid screening and auxiliary diagnosis of cervical precancer. Recently, breath analysis has become an attractive approach for investigation of cancer biomarkers and shows great potential in cancer screening owing to its high sensitivity, quickness, and non-invasive nature. In this pilot study, breath analysis by proton transfer reaction mass spectrometry (PTR-MS) was utilized for online analysis of the exhaled breath of 13 cervical cancer patients and 34 female healthy volunteers. The Mann-Whitney U test and stepwise forward linear discriminant analysis were performed for data statistics. On the basis of the statistical analysis, four characteristic ions at m/z 76, 87, 93, and 121 were found for discriminating cervical cancer. The sensitivity and specificity were calculated to be 92.3% and 88.2%, respectively, using the stepwise discriminant analysis. The possible identities of characteristic ions were also discussed in detail. Although there are some uncertainties in the identification of these characteristic ions and more participants (including cervical cancer patients and healthy volunteers) are needed to further confirm the results, the results in this study demonstrate that the online breath test using PTR-MS is a promising approach for cervical cancer screening.