The use of electronic nose technology for the detection of Lung Cancer (LC): analysis of exhaled volatile compounds by Aeonose®

Abstract

Background: The survival in LC strictly depends on the stage and the timepoint of diagnosis; thus an early detection of disease is crucial. The Aeonose® as a non-invasive test is of longstanding interest for detection of LC. Methods: In total, signatures of exhaled volatile compounds (VOCs) of 30 incident and untreated prevalent LC patients, who did not smoke in the last 2hrs prior to measurement, were captured via Aeonose® vs. 25 healthy subjects (HC). Area under Curve (AUC) and Matthews coefficient (MC) were used to interpret the data. Results: The Aeonose® differed in direct comparison between patients with LC and HC (n=25), showing an AUC of 0.95 and MC of 0.85. By validating the ability of Aeonose® to recognize a sustained LC remission or to predict relapse, we put the group LC complete remission (CR) into data statistics as blind samples. Interestingly, the device recognized all 25 CR patients as LC-positive. Indeed, 3/25 patients developed a cancer over the time after a measurement. To confirm these results further, we put 24 COPD patients as blind data, which were recognized by Aeonose® as LC positive as well. Conclusions: The Aeonose® shows some potential in identifying different LC cases. In our study, however, the device did not identify LC CR patients as cancer-negative. Our data suggest that – based on the current approach of comparing always only two conditions - relevant VOC signals originating from comorbidities such as COPD may have erroneously led to separation between LC and control. To overcome this, a multivariate approach or strategies following the concept of principal compound analysis, should be applied in future, cross-sectional studies.