Abstract
This meta-analysis was aimed to estimate the diagnostic performance of volatile organic compounds (VOCs) as a potential novel tool to screen for the neoplasm of the digestive system. An integrated literature search was performed by two independent investigators to identify all relevant studies investigating VOCs in diagnosing neoplasm of the digestive system from inception to 7th December 2020. STATA and Revman software were used for data analysis. The methodological quality of each study was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. A bivariate mixed model was used and meta-regression and subgroup analysis were performed to identify possible sources of heterogeneity. A total of 36 studies comprised of 1712 cases of neoplasm and 3215 controls were included in our meta-analysis. Bivariate analysis showed a pooled sensitivity of 0.87 (95% confidence interval (CI) 0.83–0.90), specificity of 0.86 (95% CI 0.82–0.89), a positive likelihood ratio of 6.18 (95% CI 4.68–8.17), and a negative likelihood ratio of 0.15 (95% CI 0.12–0.20). The diagnostic odds ratio and the area under the summary ROC curve for diagnosing neoplasm of the digestive system were 40.61 (95% CI 24.77–66.57) and 0.93 (95% CI 0.90–0.95), respectively. Our analyses revealed that VOCs analysis could be considered as a potential novel tool to screen for malignant diseases of the digestive system.
Highlights
This meta-analysis was aimed to estimate the diagnostic performance of volatile organic compounds (VOCs) as a potential novel tool to screen for the neoplasm of the digestive system
Endoscopic examination with biopsy remains the gold standard for the diagnosis of gastric, esophageal, and colorectal cancers, while endoscopic ultrasonography and other imaging examinations can be used for the diagnosis of liver and pancreatic cancer
168 were excluded due to repetitive publications, and 350 articles were excluded based on the inclusion/ exclusion criteria after reading the titles and abstracts: 263 did not associate VOCs as tools for the diagnosis of neoplasm of the digestive system; 46 were review articles; 28 were conference abstracts; 2 were letters; 10 were not based on human studies; 1 was non-English literature
Summary
This meta-analysis was aimed to estimate the diagnostic performance of volatile organic compounds (VOCs) as a potential novel tool to screen for the neoplasm of the digestive system. There are circulating tumor DNA and methylated genes from blood, urine or feces that are still being evaluated These have shown good performance in the diagnosis of tumors of the digestive system, they have not been widely used in clinical practice due to immaturity in technology and high cost. Cancer-originated VOCs have been frequently detected in feces, urine, blood, skin, sweat, and gases exhaled from cancer patients. These have been produced by tumor cells, which can reflect the d isease[9,10,11]. The study by Kumar et al.[12] has shown significantly lower concentrations of several specific volatile compounds in non-tumor individuals than those with tumors
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