Abstract
The aim of this pilot study is to investigate the ability of an electronic nose (e-nose) to distinguish malignant gastric histology from healthy controls in exhaled breath. In a period of 3 weeks, all preoperative gastric carcinoma (GC) patients (n = 16) in the Beijing Oncology Hospital were asked to participate in the study. The control group (n = 28) consisted of family members screened by endoscopy and healthy volunteers. The e-nose consists of 3 sensors with which volatile organic compounds in the exhaled air react. Real-time analysis takes place within the e-nose, and binary data are exported and interpreted by an artificial neuronal network. This is a self-learning computational system. The inclusion rate of the study was 100%. Baseline characteristics differed significantly only for age: the average age of the patient group was 57 years and that of the healthy control group 37 years (P value = .000). Weight loss was the only significant different symptom (P value = .040). A total of 16 patients and 28 controls were included; 13 proved to be true positive and 20 proved to be true negative. The receiver operating characteristic curve showed a sensitivity of 81% and a specificity of 71%, with an accuracy of 75%. These results give a positive predictive value of 62% and a negative predictive value of 87%. This pilot study shows that the e-nose has the capability of diagnosing GC based on exhaled air, with promising predictive values for a screening purpose.
Highlights
Gastric carcinoma (GC) is the fourth most common cancer worldwide.[1,2] It is most prevalent in Eastern Asia, Eastern Europe, and South America
Advanced GC results in significantly decreased survival when compared with early-stage GC, which may yield 5-year survival rates of 90% after surgical resection, endoscopic submucosal dissection (ESD) or endoscopic mucosal resection (EMR).[6,7]
All gastric cancer patients underwent a resection after which the gastric cancer was proven by histopathology
Summary
Gastric carcinoma (GC) is the fourth most common cancer worldwide.[1,2] It is most prevalent in Eastern Asia, Eastern Europe, and South America. Up to 42% of the cases are in Eastern Asia (mainly in China), where the majority of the annual GC-related deaths occur.[2,3] The high mortality rates in China are linked to late detection, which is partly explained by the lack of signs and symptoms in GC patients.[4] In addition to that, the lack of efficient screening tools remains an unsolved issue in China, where the majority of the gastric cancer cases are already locally advanced or worse at time of diagnosis. Advanced GC results in significantly decreased survival when compared with early-stage GC, which may yield 5-year survival rates of 90% after surgical resection, endoscopic submucosal dissection (ESD) or endoscopic mucosal resection (EMR).[6,7] early detection and treatment seems to be the only way to reduce mortality, complications, and costs associated with the disease.[8]
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