Abstract
IntroductionHuman exhaled volatile organic compounds (VOCs) are being extensively studied for the purposes of noninvasive cancer diagnoses. This article was primarily to assess the feasibility of utilizing exhaled VOCs analysis for gastrointestinal cancer (GIC) diagnosis.MethodsPRISMA-based system searches were conducted for related studies of exhaled VOCs in GIC diagnosis based on predetermined criteria. Relevant articles on colorectal cancer and gastroesophageal cancer were summarized, and meta analysis was performed on articles providing sensitivity and specificity data.ResultsFrom 2,227 articles, 14 were found to meet inclusion criteria, six of which were on colorectal cancer (CRC) and eight on Gastroesophageal cancer(GEC). Five articles could provide specific data of sensitivity and specificity in GEC, which were used for meta-analysis. The pooled sensitivity, specificity, diagnostic odds ratio (DOR), and area under the curve (AUC) were calculated based on the combination of these data, and were 85.0% [95% confidence interval (CI): 79.0%–90.0%], 89.0% (95%CI: 86.0%–91.0%), 41.30 (21.56–79.10), and 0.93, respectively.ConclusionVOCs can distinguish gastrointestinal cancers from other gastrointestinal diseases, opening up a new avenue for the diagnosis and identification of gastrointestinal cancers, and the analysis of VOCs in exhaled breath has potential clinical application in screening. VOCs are promising tumor biomarkers for GIC diagnosis. Furthermore, limitations like the heterogeneity of diagnostic VOCs between studies should be minded.
Highlights
Human exhaled volatile organic compounds (VOCs) are being extensively studied for the purposes of noninvasive cancer diagnoses
It is worth noting that 10 VOCs appeared in two or more Gastroesophageal cancer studies, as shown in Figure 2, which partly reveals the repeatability of exhaled VOCs in the Gastroesophageal cancer field
The first reported attempt to identify CRC with exhaled VOCs was Peng et al [30], the results showed that six VOCs could be used to distinguish colon cancer from healthy controls (HC)
Summary
Human exhaled volatile organic compounds (VOCs) are being extensively studied for the purposes of noninvasive cancer diagnoses. Since the early symptoms of gastrointestinal cancer are not specific, endoscopy yields unsatisfactory diagnostic rates, which have shortages of being costly, painful and unsuitable for gastrointestinal cancer screening. Convenient, non-invasive and low-cost diagnostic methods are urgently needed for early cancer diagnoses and screening. Serum biomarkers and gastrointestinal barium angiography are commonly used in gastrointestinal cancer diagnosis, and fecal occult blood test is the most widely used and evaluable tests for current colorectal cancer screening. Serum biomarkers for gastrointestinal cancer, such as carcinoembryonic antigen (CEA) and Cancer antigen 19-9 (CA199) cannot play the expected diagnostic roles due to their poor accuracies. Noninvasive biomarkers are especially needed to be found for the purpose of diagnoses of gastrointestinal cancer
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