Abstract
Malignant mesothelioma (MM) is an incurable cancer. MM is often misdiagnosed, with a poor 5-year survival and limited treatment options. The discovery of endogenous volatile organic compounds (VOCs) is required in order to accelerate the development of a breath test as an alternative to conventional MM diagnosis. For the first time, this study used solid-phase microextraction and gas chromatography-mass spectrometry to identify VOCs released directly from the biphasic MM cell line MSTO-211H and the epithelioid MM cell line NCI-H28 as well as the non-malignant mesothelial cell line MET-5A. Multivariate statistical analysis showed separation between MSTO-211H, NCI-H28 and MET-5A results. 2-ethyl-1-hexanol was significantly increased in both MSTO-211H and NCI-H28 cells compared to MET-5A controls. In addition, ethyl propionate and cyclohexanol were significantly increased in MSTO-211H cells and dodecane was significantly increased in NCI-H28 cells. This is the first study reporting headspace analysis of these MM cell lines and the first to consider the effects of mesothelioma sub-type on VOC profile. Current results further highlight the potential for a diagnostic mesothelioma breath test as well as providing proof of concept for the differentiation between biphasic and epithelioid mesothelioma based on VOC profiles.
Highlights
Malignant mesothelioma (MM) is an extremely aggressive and incurable malignancy most commonly affecting the mesothelial cell lining of the pleura as well as other internal organs [1]
Chromatograms produced from Solid-phase microextraction (SPME) gas chromatography-mass spectrometry (GC-MS) of MSTO-211H, NCI-H28 and MET-5A groups appeared very similar, making it difficult to identify any observable differences in volatile organic compounds (VOCs)
MM breath analysis is still in its early stages— previous studies have provided a proof of concept for the identification of MM patients based on VOCs in exhaled breath
Summary
Malignant mesothelioma (MM) is an extremely aggressive and incurable malignancy most commonly affecting the mesothelial cell lining of the pleura as well as other internal organs [1]. Despite the regulation of asbestos which was introduced in the mid-1980s, UK MM incidence has risen in that time due to a prolonged latency period of up to 60 years since initial exposure [4]. It is difficult to identify patients at an early stage due to the prolonged latency period and non-specific signs and symptoms such as chest pains and pleural effusions, which present only in the late stages of the disease [7]. Definitive MM diagnosis must be confirmed through a chest CT scan and invasive biopsies [8] These issues highlight the requirement of a novel diagnostic method within MM; one capable of identifying patients at an earlier disease stage, differentiating between MM sub-types and avoiding invasive biopsy procedures
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