Abstract
BackgroundNon-invasive diagnostic strategies aimed at identifying biomarkers of lung cancer are of great interest for early cancer detection. The aim of this study was to set up a new method for identifying and quantifying volatile organic compounds (VOCs) in exhaled air of patients with non-small cells lung cancer (NSCLC), by comparing the levels with those obtained from healthy smokers and non-smokers, and patients with chronic obstructive pulmonary disease. The VOC collection and analyses were repeated three weeks after the NSCLC patients underwent lung surgery.MethodsThe subjects' breath was collected in a Teflon® bulb that traps the last portion of single slow vital capacity. The 13 VOCs selected for this study were concentrated using a solid phase microextraction technique and subsequently analysed by means of gas cromatography/mass spectrometry.ResultsThe levels of the selected VOCs ranged from 10-12 M for styrene to 10-9 M for isoprene. None of VOCs alone discriminated the study groups, and so it was not possible to identify one single chemical compound as a specific lung cancer biomarker. However, multinomial logistic regression analysis showed that VOC profile can correctly classify about 80 % of cases. Only isoprene and decane levels significantly decreased after surgery.ConclusionAs the combination of the 13 VOCs allowed the correct classification of the cases into groups, together with conventional diagnostic approaches, VOC analysis could be used as a complementary test for the early diagnosis of lung cancer. Its possible use in the follow-up of operated patients cannot be recommended on the basis of the results of our short-term nested study.
Highlights
Non-invasive diagnostic strategies aimed at identifying biomarkers of lung cancer are of great interest for early cancer detection
Multinomial logistic regression analysis showed that volatile organic compounds (VOCs) profile can correctly classify about 80 % of cases
As the combination of the 13 VOCs allowed the correct classification of the cases into groups, together with conventional diagnostic approaches, VOC analysis could be used as a complementary test for the early diagnosis of lung cancer
Summary
Non-invasive diagnostic strategies aimed at identifying biomarkers of lung cancer are of great interest for early cancer detection. The aim of this study was to set up a new method for identifying and quantifying volatile organic compounds (VOCs) in exhaled air of patients with non-small cells lung cancer (NSCLC), by comparing the levels with those obtained from healthy smokers and non-smokers, and patients with chronic obstructive pulmonary disease. In 1985, Gordon et al identified several alkanes and monomethylated alkanes in the exhaled air of lung cancer patients [4], an observation that aroused interest because of the possible use of exhaled biomarkers for early detection of the disease Classical screening procedures, such as chest radiography and sputum cytology, have not decreased the number of deaths due to lung cancer [5], but promising results have recently been obtained using novel imaging techniques such as low-dose helicoidal computed tomography [6], cost effectiveness and possible over-diagnosis seem to be serious issues. The aim of this study was to set up a new method for identifying and quantifying selected VOCs in exhaled air, and apply it to a cross-sectional study of NSCLC and COPD patients, and healthy control smokers and non-smokers, and a short-term follow-up study of patients undergoing surgery for NSCLC
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