期刊
ANNALS OF SURGERY
卷 262, 期 6, 页码 981-990出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/SLA.0000000000001101
关键词
breath analysis; esophageal cancer; gastric cancer; mass spectrometry; volatile organic compounds
类别
资金
- Imperial National Institute for Health Research Biomedical Research Centre
- Rosetrees Trust [M261CD1]
- Stoneygate Trust [M261CD1]
- Imperial College Junior Fellowship Research Program
- National Institute for Health Research [CL-2014-21-002] Funding Source: researchfish
- Rosetrees Trust [M261-CD1] Funding Source: researchfish
Objective:The present study assessed whether exhaled breath analysis using Selected Ion Flow Tube Mass Spectrometry could distinguish esophageal and gastric adenocarcinoma from noncancer controls.Background:The majority of patients with upper gastrointestinal cancer present with advanced disease, resulting in poor long-term survival rates. Novel methods are needed to diagnose potentially curable upper gastrointestinal malignancies.Methods:A Profile-3 Selected Ion Flow Tube Mass Spectrometry instrument was used for analysis of volatile organic compounds (VOCs) within exhaled breath samples. All study participants had undergone upper gastrointestinal endoscopy on the day of breath sampling. Receiver operating characteristic analysis and a diagnostic risk prediction model were used to assess the discriminatory accuracy of the identified VOCs.Results:Exhaled breath samples were analyzed from 81 patients with esophageal (N=48) or gastric adenocarcinoma (N=33) and 129 controls including Barrett's metaplasia (N=16), benign upper gastrointestinal diseases (N=62), or a normal upper gastrointestinal tract (N=51). Twelve VOCspentanoic acid, hexanoic acid, phenol, methyl phenol, ethyl phenol, butanal, pentanal, hexanal, heptanal, octanal, nonanal, and decanalwere present at significantly higher concentrations (P<0.05) in the cancer groups than in the noncancer controls. The area under the ROC curve using these significant VOCs to discriminate esophageal and gastric adenocarcinoma from those with normal upper gastrointestinal tracts was 0.97 and 0.98, respectively. The area under the ROC curve for the model and validation subsets of the diagnostic prediction model was 0.920.01 and 0.87 +/- 0.03, respectively.Conclusions:Distinct exhaled breath VOC profiles can distinguish patients with esophageal and gastric adenocarcinoma from noncancer controls.
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