Abstract
Exhaled breath compounds can non-invasively detect head and neck squamous cell carcinoma (HNSCC). Here we investigated exhaled compounds related to intestinal bacterial carbohydrate fermentation. Fasting breath samples were collected into 3 litre FlexFoil PLUS bags from patients awaiting a biopsy procedure for suspected HNSCC. Samples were analysed using a Syft selected ion flow-tube mass spectrometer and a Quintron BreathTracker. Two tailed non-parametric significance testing was conducted with corrections for multiple imputations. 74 patients were diagnosed (histological) with HNSCC and 61 patients were benign (controls). The methane to hydrogen ratio was significantly different between cancer and non-cancer controls (p = 0.0440). This ratio increased with tumour stage with a significant difference between T1 and T4 tumours (p = 0.0259). Hydrogen levels were significantly higher in controls who were smokers (p = 0.0129), with no smoking dependent methane changes. There were no differences in short chain fatty acids between groups. Exhaled compounds of intestinal carbohydrate fermentation can detect HNSCC patients. These findings suggest a modified carbohydrate fermentation profile in HNSCC patients that is tumour stage and smoking status dependent.
Highlights
Exhaled breath compounds can non-invasively detect head and neck squamous cell carcinoma (HNSCC)
The methane to hydrogen ratio was significantly different between patients with (n = 74) and without (n = 61) cancer (Table 2), with a lower ratio found in the control group compared to cancer (p = 0.0440) (Fig. 1A)
Four volatile SCFAs were detected in exhaled breath using selected ion flow tube – mass spectrometry (SIFT-MS) (Table 2)
Summary
Exhaled breath compounds can non-invasively detect head and neck squamous cell carcinoma (HNSCC). Exhaled compounds of intestinal carbohydrate fermentation can detect HNSCC patients. The major by-products of microbial carbohydrate fermentation in the large bowel include water, hydrogen, methane and short chain fatty acids (SCFAs) amongst various other gases. Measurement of microbial fermentation products in the large bowel have principally focussed on faecal SCFAs as static markers of microbial function and composition[8] This approach only provides static ‘moment in time’ information on changes to microbial activity. Exhaled breath hydrogen and methane have been previously investigated as non-invasive, real-time surrogate markers of the fermentation status of the large b owel[9], Scientific Reports | (2020) 10:15010
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