Abstract
Background: Head and neck squamous cell carcinoma (HNSCC) is the sixth most common form of cancer worldwide, with approximately 630,000 new cases diagnosed each year. The development of low-cost and non-invasive tools for the detection of HNSCC using volatile organic compounds (VOCs) in the breath could potentially improve patient care. The aim of this study was to investigate the feasibility of selected ion flow tube mass spectrometry (SIFT-MS) technology to identify breath VOCs for the detection of HNSCC. Materials and Methods: Breath samples were obtained from HNSCC patients (N = 23) and healthy volunteers (N = 21). Exhaled alveolar breath samples were collected into FlexFoil® PLUS (SKC Limited, Dorset, UK) sampling bags from newly diagnosed, histologically confirmed, untreated patients with HNSCC and from non-cancer participants. Breath samples were analyzed by Selected Ion Flow Tube-Mass Spectrometry (SIFT-MS) (Syft Technologies, Christchurch, New Zealand) using Selective Ion Mode (SIM) scans that probed for 91 specific VOCs that had been previously reported as breath biomarkers of HNSCC and other malignancies. Results: Of the 91 compounds analyzed, the median concentration of hydrogen cyanide (HCN) was significantly higher in the HNSCC group (2.5 ppb, 1.6–4.4) compared to the non-cancer group (1.1 ppb, 0.9–1.3; Benjamini–Hochberg adjusted p < 0.05). A receiver operating curve (ROC) analysis showed an area under the curve (AUC) of 0.801 (95% CI, 0.65952–0.94296), suggesting moderate accuracy of HCN in distinguishing HNSCC from non-cancer individuals. There were no statistically significant differences in the concentrations of the other compounds of interest that were analyzed. Conclusions: This pilot study demonstrated the feasibility of SIFT-MS technology to identify VOCs for the detection of HNSCC.
Highlights
Head and neck squamous cell carcinoma (HNSCC) accounts for more than 630,000 cases and330,000 deaths worldwide each year [1]
Selective Ion Mode (SIM) scans were used to probe for 91 specific volatile organic compounds (VOCs) that had been previously reported as breath biomarkers of HNSCC
Breath samples were collected from patients with HNSCC (N = 23) and non-cancer volunteers (N = 21)
Summary
Head and neck squamous cell carcinoma (HNSCC) accounts for more than 630,000 cases and330,000 deaths worldwide each year [1]. Breath analysis represents a non-invasive, rapid, and painless technique that has been investigated for the early detection of cancers [3,4] and infection [5]. A breath analysis tool could help in the surveillance of patients after treatment of their head and neck cancer. The concept of non-invasive monitoring is demonstrated by the urea carbon-14 breath test to detect the presence of Helicobacter pylori and to check that the bacteria has been eradicated in patients after treatment. Head and neck squamous cell carcinoma (HNSCC) is the sixth most common form of cancer worldwide, with approximately 630,000 new cases diagnosed each year. The development of low-cost and non-invasive tools for the detection of HNSCC using volatile organic compounds (VOCs) in the breath could potentially improve patient care. Breath samples were analyzed by Selected Ion Flow Tube-Mass Spectrometry (SIFT-MS)
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