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Identification of breath volatile organic compounds to distinguish pancreatic adenocarcinoma,pancreatic cystic neoplasm,and patients without pancreatic lesions

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World Journal of Gastrointestinal Oncology 2024年第3期16卷 894-906页

作者： Kasenee Tiankanon Nuttanit Pungpipattrakul thanikan sukaram Roongruedee Chaiteerakij Rungsun Rerknimitr Division of Gastroenterology Faculty of MedicineChulalongkorn UniversityBangkok 10330Thailand Center of Excellence for Innovation and Endoscopy in Gastrointestinal Oncology King Chulalongkorn Memorial HospitalThai Red Cross SocietyBangkok 10330Thailand

BACKGROUND Volatile organic compounds(VOCs)are a promising potential biomarker that may be able to identify the presence of cancers.AIM To identify exhaled breath VOCs that distinguish pancreatic ductal adenocar-cinoma(PDAC)from intraductal papillary mucinous neoplasm(IPMN)and healthy volunteers.METHODS We collected exhaled breath from histologically proven PDAC patients,radiological diagnosis IPMN,and healthy volunteers using the ReCIVA®device between 10/2021-11/2022.VOCs were identified by thermal desorption-gas chromatography/field-asymmetric ion mobility spectrometry and compared between groups.RESULTS A total of 156 participants(44%male,mean age 62.6±10.6)were enrolled(54 PDAC,42 IPMN,and 60 controls).Among the nine VOCs identified,two VOCs that showed differences between groups were dimethyl sulfide[0.73 vs 0.74 vs 0.94 arbitrary units(AU),respectively;P=0.008]and acetone dimers(3.95 vs 4.49 vs 5.19 AU,respectively;P<0.001).After adjusting for the imbalance parameters,PDAC showed higher dimethyl sulfide levels than the control and IPMN groups,with adjusted odds ratio(aOR)of 6.98(95%CI:1.15-42.17)and 4.56(1.03-20.20),respectively(P<0.05 both).Acetone dimer levels were also higher in PDAC compared to controls and IPMN(aOR:5.12(1.80-14.57)and aOR:3.35(1.47-7.63),respectively(P<0.05 both).Acetone dimer,but not dimethyl sulfide,performed better than CA19-9 in PDAC diagnosis(AUROC 0.910 vs 0.796).The AUROC of acetone dimer increased to 0.936 when combined with CA19-9,which was better than CA19-9 alone(P<0.05).CONCLUSION Dimethyl sulfide and acetone dimer are VOCs that potentially distinguish PDAC from IPMN and healthy participants.Additional prospective studies are required to validate these findings.

关键词： Volatile organic compound Pancreas Adenocarcinoma Pancreatic intraductal neoplasms Breathing

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Exhaled volatile organic compounds for cholangiocarcinoma diagnosis

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Liver Research 2022年第3期6卷 191-197页

作者： Nanicha Siriwong thanikan sukaram Rossarin Tansawat Terapap Apiparakoon Thodsawit Tiyarattanachai Sanparith Marukatat Rungsun Rerknimitr Roongruedee Chaiteerakij Department of Medicine Faculty of MedicineChulalongkorn UniversityBangkokThailand Division of Gastroenterology Department of MedicineFaculty of MedicineChulalongkorn Universityand King Chulalongkorn Memorial HospitalThai Red Cross SocietyBangkokThailand Department of Food and Pharmaceutical Chemistry Faculty of Pharmaceutical SciencesChulalongkorn UniversityBangkokThailand Department of Computer Engineering Faculty of EngineeringChulalongkorn UniversityBangkokThailand Clinical Sciences PhD International Program Faculty of MedicineChulalongkorn UniversityThailand Image Processing and Understanding Team Artificial Intelligence Research GroupNational Electronics and Computer Technology Center(NECTEC)Thailand Center of Excellence for Innovation and Endoscopy in Gastrointestinal Oncology Chulalongkorn UniversityBangkokThailand

Objectives:The difficulties in the early detection consequent to the lack of sensitive biomarkers render patients with cholangiocarcinoma(CCA)to have poor outcomes.Recently,sensitive and specific volatile organic compounds(VOCs)were identified in several cancers.However,the VOC profiles in CCA are not well-studied.Thus,we investigated the VOC profiles in exhaled breath of CCA patients and controls.Methods:We prospectively collected exhaled breath samples from 30 consecutive patients newly diagnosed with CCA and 30 controls who did not have CCA(seven had benign biliary strictures and 23 had other medical conditions).Exhaled VOCs were identified using gas chromatography mass spectrometry Triple Quadrupoles system.Analysis of the significant differences in VOCs between cases and controls was conducted using supervised multivariate regression analysis.Further validation was performed for these VOCs in another cohort of 18 CCA patients and 22 controls.Results:Levels of six compounds were significantly different between CCA patients and controls,namely,acetone,isopropyl alcohol,dimethyl sulfide,1,4-pentadiene,allyl methyl sulfide,and N,N-dimethylacetamide.Acetone and dimethyl sulfide were independently associated with CCA as demonstrated in the multivariate analysis.Using the cut-off value of 8.59107 arbitrary unit(AU),acetone had a sensitivity and specificity of 82.1%and 75.8%,respectively,with an area under the receiving operator curve(AUROC)of 0.85 for the CCA diagnosis.Acetone level was also significantly different between cases and controls in the validation cohort.Using the same cut-off value,the sensitivity,specificity,and AUROC was 59.1%,66.7%,and 0.85,respectively.Conclusion:Breath analysis may potentially be useful for CCA diagnosis.A cohort of patients with earlystage CCA in further studies is needed to confirm the ability of exhaled VOCs for the early detection of CCA.

关键词： Cholangiocarcinoma(CCA) Bile duct cancer Volatile organic compounds(VOCs) Biomarker Cancer screening Diagnostic model

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