TY - JOUR
T1 - Detecting Colorectal Adenomas and Cancer Using Volatile Organic Compounds in Exhaled Breath
T2 - A Proof-of-Principle Study to Improve Screening
AU - Cheng, Hao Ran
AU - van Vorstenbosch, Robert W R
AU - Pachen, Daniëlle M
AU - Meulen, Lonne W T
AU - Straathof, Jan Willem A
AU - Dallinga, Jan W
AU - Jonkers, Daisy M A E
AU - Masclee, Ad A M
AU - Schooten, Frederik-Jan van
AU - Mujagic, Zlatan
AU - Smolinska, Agnieszka
N1 - Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology.
PY - 2022/11
Y1 - 2022/11
N2 - BACKGROUND: Early detection of colorectal cancer (CRC) via screening programs is crucial as survival rates worsen at advanced stages. However, the currently used screening method such as the fecal immunochemical test (FIT) suffers from a high number of false positives and is insensitive for detecting advanced adenomas resulting false negatives for these premalignant lesions. Therefore, more accurate, non-invasive screening tools are needed. Here, the utility of analyzing volatile organic compounds (VOCs) in exhaled breath in a FIT positive population to detect the presence of colorectal neoplasia was studied.METHODS: In this multicenter prospective study breath samples were collected from 382 FIT-positive patients with subsequent colonoscopy participating in the national Dutch bowel screening program (n = 84 negative controls, n = 130 non-advanced adenomas, n = 138 advanced adenomas, and n = 30 CRC). Pre-colonoscopy exhaled VOCs were analyzed using Thermal Desorption - Gas Chromatography - Mass Spectrometry and the data was pre-processed and analyzed using machine-learning techniques.RESULTS: Using 10 discriminatory VOCs advanced adenomas could be distinguished from negative controls with a sensitivity and specificity of 79% and 70%, respectively. Based on this biomarker profile, CRC and AA combined could be discriminated from controls with a sensitivity and specificity of 77% and 70%, respectively, and CRC alone could be discriminated from controls with a sensitivity and specificity of 80% and 70%, respectively. Moreover, the feasibility to discriminate non-advanced adenomas from controls as well as advanced adenomas was shown.CONCLUSION: VOCs in exhaled breath can detect the presence of advanced adenomas and CRC in a CRC screening population and may improve CRC screening in the future.
AB - BACKGROUND: Early detection of colorectal cancer (CRC) via screening programs is crucial as survival rates worsen at advanced stages. However, the currently used screening method such as the fecal immunochemical test (FIT) suffers from a high number of false positives and is insensitive for detecting advanced adenomas resulting false negatives for these premalignant lesions. Therefore, more accurate, non-invasive screening tools are needed. Here, the utility of analyzing volatile organic compounds (VOCs) in exhaled breath in a FIT positive population to detect the presence of colorectal neoplasia was studied.METHODS: In this multicenter prospective study breath samples were collected from 382 FIT-positive patients with subsequent colonoscopy participating in the national Dutch bowel screening program (n = 84 negative controls, n = 130 non-advanced adenomas, n = 138 advanced adenomas, and n = 30 CRC). Pre-colonoscopy exhaled VOCs were analyzed using Thermal Desorption - Gas Chromatography - Mass Spectrometry and the data was pre-processed and analyzed using machine-learning techniques.RESULTS: Using 10 discriminatory VOCs advanced adenomas could be distinguished from negative controls with a sensitivity and specificity of 79% and 70%, respectively. Based on this biomarker profile, CRC and AA combined could be discriminated from controls with a sensitivity and specificity of 77% and 70%, respectively, and CRC alone could be discriminated from controls with a sensitivity and specificity of 80% and 70%, respectively. Moreover, the feasibility to discriminate non-advanced adenomas from controls as well as advanced adenomas was shown.CONCLUSION: VOCs in exhaled breath can detect the presence of advanced adenomas and CRC in a CRC screening population and may improve CRC screening in the future.
KW - Gut microbiota
KW - Expression
KW - Prevention
U2 - 10.14309/ctg.0000000000000518
DO - 10.14309/ctg.0000000000000518
M3 - Article
C2 - 35981245
SN - 2155-384X
VL - 13
JO - Clinical and Translational Gastroenterology
JF - Clinical and Translational Gastroenterology
IS - 11
M1 - e00518
ER -