Abstract

Bladder cancer (BCa) and prostate cancer (PCa) are some of the most common cancers in the world. In both BCa and PCa, the diagnosis is often confirmed with an invasive technique that carries a risk to the patient. Consequently, a non-invasive diagnostic approach would be medically desirable and beneficial to the patient. The use of volatile organic compounds (VOCs) for disease diagnosis, including cancer, is a promising research area that could support the diagnosis process. In this study, we investigated the urinary VOC profiles in BCa, PCa patients and non-cancerous controls by using gas chromatography-ion mobility spectrometry (GC-IMS) and gas chromatography time-of-flight mass spectrometry (GC-TOF-MS) to analyse patient samples. GC-IMS separated BCa from PCa (area under the curve: AUC: 0.97 (0.93–1.00)), BCa vs. non-cancerous (AUC: 0.95 (0.90–0.99)) and PCa vs. non-cancerous (AUC: 0.89 (0.83–0.94)) whereas GC-TOF-MS differentiated BCa from PCa (AUC: 0.84 (0.73–0.93)), BCa vs. non-cancerous (AUC: 0.81 (0.70–0.90)) and PCa vs. non-cancerous (AUC: 0.94 (0.90–0.97)). According to our study, a total of 34 biomarkers were found using GC-TOF-MS data, of which 13 VOCs were associated with BCa, seven were associated with PCa, and 14 VOCs were found in the comparison of BCa and PCa.

Highlights

  • A study published in 2016 provided significant evidence for the use of urinary volatile organic compounds (VOCs) for distinguishing Bladder cancer (BCa), from a total of 72 urine samples the results showed an accuracy of 89%, 90% sensitivity, and 88% specificity using PLS-DA on GC-MS data [29]

  • Once all the samples had been within a test set, statistical results were generated from the probabilities, including a receiver operator characteristic (ROC) curve, area under the curve (AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV)

  • It was found that both gas chromatography-ion mobility spectrometry (GC-IMS) and GC-TOF-MS have the potential to differentiate between different cancer groups with respective AUC for different diagnostic groups: For GC-IMS, BCa and prostate cancer (PCa) (0.97 (0.93–1)), BCa and non-cancerous (0.95 (0.90–0.99)), PCa and non-cancerous (0.89 (0.83–0.94)) and for GC-TOF-MS, BCa and PCa (0.84 (0.73–0.93)), BCa and non-cancerous (0.81(0.70–0.90)), PCa and non-cancerous (0.94 (0.90–0.97))

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Summary

Introduction

Detection and diagnosis of cancer remains a key goal to improve the prognosis and life expectancy of patients [1–4]. Cancer results in some of the highest mortality rates for any disease. In 2020 alone there were more than 19 million new cancer diagnoses and almost 10 million deaths [5]. The UK is a major contributor to this, with some of the highest cancer rates in the world. It is amongst the top 10% of countries, with the highest number of new cases of cancer [6]. These figures emphasize the importance of using screening methods to improve disease diagnosis and to reduce cancer morbidity [7]

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