Abstract
BackgroundScreening endoscopy is considered to be the most accurate tool for early detection of gastric cancer, but it is both invasive and costly. It is therefore essential to develop cost-effective and non-invasive diagnostic tools for gastric cancer. The aim of this study is to investigate the presence of certain volatile organic compounds (VOCs) associated with gastric cancer and to survey the usefulness of VOCs as screening tools of gastric cancer.MethodsThe present study was conducted prospectively to identify the relationship between gastric cancer and specific VOCs quantified by mass spectrometry. Exhaled breath samples from a total of 43 participants were analysed. This study was approved by the Institutional Review Board of the College of Medicine, Catholic University of Korea (KC16TISI0598), and registered to clinical research information service (KCT0004356).ResultsNine VOCs differed significantly between the control and cancer patient groups. When participants were divided into control, early gastric cancer (EGC), and advanced gastric cancer (AGC) groups, seven VOCs remained significantly different. Of these, four (propanal, aceticamide, isoprene and 1,3 propanediol) showed gradual increases as cancer advanced, from normal control to EGC to AGC. In receiver operating characteristic curves for these four VOCs, the area under the curve for gastric cancer prediction was highest (0.842) when more than two VOCs were present.ConclusionsThe present study offers potential directions for non-invasive gastric cancer screening, and may inspire advanced diagnostic technologies in the era of smart home healthcare. However, despite the high accuracy, cancer-specific VOCs from several studies on different populations, and analytic methods show inconsistency, it is necessary to establish standards for each analytical method, and to validate on each population.
Highlights
Gastric cancer produces no symptoms until it is well-advanced; early diagnosis and a good prognosis are difficult to achieve without screening by endoscopy
As the rate of early detection via endoscopy has increased in East Asian countries such as Japan and Korea, more than 60% of gastric cancers diagnosed in the past 10 years have been early stage [1]
Based on the concept that volatile organic compounds (VOCs) are not derived directly from the lung or gastrointestinal organs but from the metabolic origin through the blood circulating system, VOCs associated with solid tumours such as lung, bladder, pancreas, breast or gastric cancers have been proposed in a number of studies (Figure 1) [6, 8,9,10]
Summary
Gastric cancer produces no symptoms until it is well-advanced; early diagnosis and a good prognosis are difficult to achieve without screening by endoscopy. In which diseases were diagnosed after exposing dogs to human breath, and on cancer diagnosis using electronic nose detection systems, followed [6]. With these developments, VOCs have become a topic of interest in a wide range of medical fields, and have been examined in the context of cardiovascular disease, oncology, neurodegenerative disease, respiratory disease, gastrointestinal disease and diabetes [7]. Screening endoscopy is considered to be the most accurate tool for early detection of gastric cancer, but it is both invasive and costly. The aim of this study is to investigate the presence of certain volatile organic compounds (VOCs) associated with gastric cancer and to survey the usefulness of VOCs as screening tools of gastric cancer
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