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Ma TT, Chang Z, Zhang N, Xu H. Application of electronic nose technology in the diagnosis of gastrointestinal diseases: a review. J Cancer Res Clin Oncol 2024; 150:401. [PMID: 39192027 PMCID: PMC11349790 DOI: 10.1007/s00432-024-05925-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 08/14/2024] [Indexed: 08/29/2024]
Abstract
Electronic noses (eNoses) are electronic bionic olfactory systems that use sensor arrays to produce response patterns to different odors, thereby enabling the identification of various scents. Gastrointestinal diseases have a high incidence rate and occur in 9 out of 10 people in China. Gastrointestinal diseases are characterized by a long course of symptoms and are associated with treatment difficulties and recurrence. This review offers a comprehensive overview of volatile organic compounds, with a specific emphasis on those detected via the eNose system. Furthermore, this review describes the application of bionic eNose technology in the diagnosis and screening of gastrointestinal diseases based on recent local and international research progress and advancements. Moreover, the prospects of bionic eNose technology in the field of gastrointestinal disease diagnostics are discussed.
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Affiliation(s)
- Tan-Tan Ma
- Department of Gastroenterology, The First Hospital of Jilin University, 71 Xinmin Street, Changchun, 130021, China
| | - Zhiyong Chang
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun, 130022, China
| | - Nan Zhang
- Department of Gastroenterology, The First Hospital of Jilin University, 71 Xinmin Street, Changchun, 130021, China.
| | - Hong Xu
- Department of Gastroenterology, The First Hospital of Jilin University, 71 Xinmin Street, Changchun, 130021, China.
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Capuano R, Ciotti M, Catini A, Bernardini S, Di Natale C. Clinical applications of volatilomic assays. Crit Rev Clin Lab Sci 2024:1-20. [PMID: 39129534 DOI: 10.1080/10408363.2024.2387038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/23/2024] [Accepted: 07/29/2024] [Indexed: 08/13/2024]
Abstract
The study of metabolomics is revealing immense potential for diagnosis, therapy monitoring, and understanding of pathogenesis processes. Volatilomics is a subcategory of metabolomics interested in the detection of molecules that are small enough to be released in the gas phase. Volatile compounds produced by cellular processes are released into the blood and lymph, and can reach the external environment through different pathways, such as the blood-air interface in the lung that are detected in breath, or the blood-water interface in the kidney that leads to volatile compounds detected in urine. Besides breath and urine, additional sources of volatile compounds such as saliva, blood, feces, and skin are available. Volatilomics traces its roots back over fifty years to the pioneering investigations in the 1970s. Despite extensive research, the field remains in its infancy, hindered by a lack of standardization despite ample experimental evidence. The proliferation of analytical instrumentations, sample preparations and methods of volatilome sampling still make it difficult to compare results from different studies and to establish a common standard approach to volatilomics. This review aims to provide an overview of volatilomics' diagnostic potential, focusing on two key technical aspects: sampling and analysis. Sampling poses a challenge due to the susceptibility of human samples to contamination and confounding factors from various sources like the environment and lifestyle. The discussion then delves into targeted and untargeted approaches in volatilomics. Some case studies are presented to exemplify the results obtained so far. Finally, the review concludes with a discussion on the necessary steps to fully integrate volatilomics into clinical practice.
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Affiliation(s)
- Rosamaria Capuano
- Department of Electronic Engineering, University of Rome Tor Vergata, Roma, Italy
- Interdepartmental Center for Volatilomics, "A. D'Amico", University of Rome Tor Vergata, Rome, Italy
| | - Marco Ciotti
- Department of Laboratory Medicine, University Hospital Tor Vergata, Rome, Italy
| | - Alexandro Catini
- Department of Electronic Engineering, University of Rome Tor Vergata, Roma, Italy
- Interdepartmental Center for Volatilomics, "A. D'Amico", University of Rome Tor Vergata, Rome, Italy
| | - Sergio Bernardini
- Interdepartmental Center for Volatilomics, "A. D'Amico", University of Rome Tor Vergata, Rome, Italy
- Department of Laboratory Medicine, University Hospital Tor Vergata, Rome, Italy
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Corrado Di Natale
- Department of Electronic Engineering, University of Rome Tor Vergata, Roma, Italy
- Interdepartmental Center for Volatilomics, "A. D'Amico", University of Rome Tor Vergata, Rome, Italy
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Zhai Z, Liu Y, Li C, Wang D, Wu H. Electronic Noses: From Gas-Sensitive Components and Practical Applications to Data Processing. SENSORS (BASEL, SWITZERLAND) 2024; 24:4806. [PMID: 39123852 PMCID: PMC11314697 DOI: 10.3390/s24154806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 06/14/2024] [Accepted: 06/16/2024] [Indexed: 08/12/2024]
Abstract
Artificial olfaction, also known as an electronic nose, is a gas identification device that replicates the human olfactory organ. This system integrates sensor arrays to detect gases, data acquisition for signal processing, and data analysis for precise identification, enabling it to assess gases both qualitatively and quantitatively in complex settings. This article provides a brief overview of the research progress in electronic nose technology, which is divided into three main elements, focusing on gas-sensitive materials, electronic nose applications, and data analysis methods. Furthermore, the review explores both traditional MOS materials and the newer porous materials like MOFs for gas sensors, summarizing the applications of electronic noses across diverse fields including disease diagnosis, environmental monitoring, food safety, and agricultural production. Additionally, it covers electronic nose pattern recognition and signal drift suppression algorithms. Ultimately, the summary identifies challenges faced by current systems and offers innovative solutions for future advancements. Overall, this endeavor forges a solid foundation and establishes a conceptual framework for ongoing research in the field.
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Affiliation(s)
- Zhenyu Zhai
- National Institute of Metrology of China, Beijing 100029, China; (Z.Z.); (D.W.)
| | - Yaqian Liu
- Inner Mongolia Institute of Metrology Testing and Research, Hohhot 010020, China
| | - Congju Li
- College of Textiles, Donghua University, Shanghai 201620, China;
| | - Defa Wang
- National Institute of Metrology of China, Beijing 100029, China; (Z.Z.); (D.W.)
| | - Hai Wu
- National Institute of Metrology of China, Beijing 100029, China; (Z.Z.); (D.W.)
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Zheng W, Min Y, Pang K, Wu D. Sample Collection and Processing in Volatile Organic Compound Analysis for Gastrointestinal Cancers. Diagnostics (Basel) 2024; 14:1563. [PMID: 39061700 PMCID: PMC11276357 DOI: 10.3390/diagnostics14141563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Revised: 07/17/2024] [Accepted: 07/18/2024] [Indexed: 07/28/2024] Open
Abstract
Volatile organic compounds have drawn significant attention in recent years as a novel tool for non-invasive detection of a wide range of diseases, including gastrointestinal cancers, for which the need for effective, affordable, and non-invasive screening methods is substantial. Sample preparation is a fundamental step that greatly influences the quality of results and the feasibility of wide-range applications. This review summarizes sampling methods used in studies aiming at testing the diagnostic value of volatile organic compounds in gastrointestinal cancers, discussing in detail some of the recent advancements in automated sampling techniques. Finally, we propose some directions in which sample collection and processing can improve for VOC analysis to be popularized in clinical settings.
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Affiliation(s)
- Weiyang Zheng
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Yiyang Min
- 8-yr M.D. Program, Peking Union Medical College, Beijing 100730, China
| | - Ke Pang
- 8-yr M.D. Program, Peking Union Medical College, Beijing 100730, China
| | - Dong Wu
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
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Wang Q, Fang Y, Tan S, Li Z, Zheng R, Ren Y, Jiang Y, Huang X. Diagnostic performance of volatile organic compounds analysis and electronic noses for detecting colorectal cancer: a systematic review and meta-analysis. Front Oncol 2024; 14:1397259. [PMID: 38817891 PMCID: PMC11138104 DOI: 10.3389/fonc.2024.1397259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 04/24/2024] [Indexed: 06/01/2024] Open
Abstract
Introduction The detection of Volatile Organic Compounds (VOCs) could provide a potential diagnostic modality for the early detection and surveillance of colorectal cancers. However, the overall diagnostic accuracy of the proposed tests remains uncertain. Objective This systematic review is to ascertain the diagnostic accuracy of using VOC analysis techniques and electronic noses (e-noses) as noninvasive diagnostic methods for colorectal cancer within the realm of clinical practice. Methods A systematic search was undertaken on PubMed, EMBASE, Web of Science, and the Cochrane Library to scrutinize pertinent studies published from their inception to September 1, 2023. Only studies conducted on human subjects were included. Meta-analysis was performed using a bivariate model to obtain summary estimates of sensitivity, specificity, and positive and negative likelihood ratios. The Quality Assessment of Diagnostic Accuracy Studies 2 tool was deployed for quality assessment. The protocol for this systematic review was registered in PROSPERO, and PRISMA guidelines were used for the identification, screening, eligibility, and selection process. Results This review encompassed 32 studies, 22 studies for VOC analysis and 9 studies for e-nose, one for both, with a total of 4688 subjects in the analysis. The pooled sensitivity and specificity of VOC analysis for CRC detection were 0.88 (95% CI, 0.83-0.92) and 0.85 (95% CI, 0.78-0.90), respectively. In the case of e-nose, the pooled sensitivity was 0.87 (95% CI, 0.83-0.90), and the pooled specificity was 0.78 (95% CI, 0.62-0.88). The area under the receiver operating characteristic analysis (ROC) curve for VOC analysis and e-noses were 0.93 (95% CI, 0.90-0.95) and 0.90 (95% CI, 0.87-0.92), respectively. Conclusion The outcomes of this review substantiate the commendable accuracy of VOC analysis and e-nose technology in detecting CRC. VOC analysis has a higher specificity than e-nose for the diagnosis of CRC and a sensitivity comparable to that of e-nose. However, numerous limitations, including a modest sample size, absence of standardized collection methods, lack of external validation, and a notable risk of bias, were identified. Consequently, there exists an imperative need for expansive, multi-center clinical studies to elucidate the applicability and reproducibility of VOC analysis or e-nose in the noninvasive diagnosis of colorectal cancer. Systematic review registration https://www.crd.york.ac.uk/prospero/#recordDetails, identifier CRD42023398465.
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Affiliation(s)
- Qiaoling Wang
- TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yu Fang
- Second Department of Oncology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Shiyan Tan
- Second Department of Oncology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Zhuohong Li
- Second Department of Oncology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Ruyi Zheng
- Second Department of Oncology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yifeng Ren
- TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yifang Jiang
- TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Xiaopeng Huang
- TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
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Tibaduiza D, Anaya M, Gómez J, Sarmiento J, Perez M, Lara C, Ruiz J, Osorio N, Rodriguez K, Hernandez I, Sanchez C. Electronic Tongues and Noses: A General Overview. BIOSENSORS 2024; 14:190. [PMID: 38667183 PMCID: PMC11048215 DOI: 10.3390/bios14040190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 04/06/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024]
Abstract
As technology advances, electronic tongues and noses are becoming increasingly important in various industries. These devices can accurately detect and identify different substances and gases based on their chemical composition. This can be incredibly useful in fields such as environmental monitoring and industrial food applications, where the quality and safety of products or ecosystems should be ensured through a precise analysis. Traditionally, this task is performed by an expert panel or by using laboratory tests but sometimes becomes a bottleneck because of time and other human factors that can be solved with technologies such as the provided by electronic tongue and nose devices. Additionally, these devices can be used in medical diagnosis, quality monitoring, and even in the automotive industry to detect gas leaks. The possibilities are endless, and as these technologies continue to improve, they will undoubtedly play an increasingly important role in improving our lives and ensuring our safety. Because of the multiple applications and developments in this field in the last years, this work will present an overview of the electronic tongues and noses from the point of view of the approaches developed and the methodologies used in the data analysis and steps to this aim. In the same manner, this work shows some of the applications that can be found in the use of these devices and ends with some conclusions about the current state of these technologies.
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Affiliation(s)
- Diego Tibaduiza
- Departamento de Ingeniería Eléctrica y Electrónica, Universidad Nacional de Colombia, Bogotá 111321, Colombia; (M.A.); (J.G.); (J.S.); (M.P.); (C.L.); (J.R.); (N.O.); (I.H.); (C.S.)
| | - Maribel Anaya
- Departamento de Ingeniería Eléctrica y Electrónica, Universidad Nacional de Colombia, Bogotá 111321, Colombia; (M.A.); (J.G.); (J.S.); (M.P.); (C.L.); (J.R.); (N.O.); (I.H.); (C.S.)
| | - Johan Gómez
- Departamento de Ingeniería Eléctrica y Electrónica, Universidad Nacional de Colombia, Bogotá 111321, Colombia; (M.A.); (J.G.); (J.S.); (M.P.); (C.L.); (J.R.); (N.O.); (I.H.); (C.S.)
| | - Juan Sarmiento
- Departamento de Ingeniería Eléctrica y Electrónica, Universidad Nacional de Colombia, Bogotá 111321, Colombia; (M.A.); (J.G.); (J.S.); (M.P.); (C.L.); (J.R.); (N.O.); (I.H.); (C.S.)
| | - Maria Perez
- Departamento de Ingeniería Eléctrica y Electrónica, Universidad Nacional de Colombia, Bogotá 111321, Colombia; (M.A.); (J.G.); (J.S.); (M.P.); (C.L.); (J.R.); (N.O.); (I.H.); (C.S.)
| | - Cristhian Lara
- Departamento de Ingeniería Eléctrica y Electrónica, Universidad Nacional de Colombia, Bogotá 111321, Colombia; (M.A.); (J.G.); (J.S.); (M.P.); (C.L.); (J.R.); (N.O.); (I.H.); (C.S.)
| | - Johan Ruiz
- Departamento de Ingeniería Eléctrica y Electrónica, Universidad Nacional de Colombia, Bogotá 111321, Colombia; (M.A.); (J.G.); (J.S.); (M.P.); (C.L.); (J.R.); (N.O.); (I.H.); (C.S.)
| | - Nicolas Osorio
- Departamento de Ingeniería Eléctrica y Electrónica, Universidad Nacional de Colombia, Bogotá 111321, Colombia; (M.A.); (J.G.); (J.S.); (M.P.); (C.L.); (J.R.); (N.O.); (I.H.); (C.S.)
| | - Katerin Rodriguez
- Departamento de Ingeniería Química y Ambiental, Universidad Nacional de Colombia, Bogotá 111321, Colombia;
| | - Isaac Hernandez
- Departamento de Ingeniería Eléctrica y Electrónica, Universidad Nacional de Colombia, Bogotá 111321, Colombia; (M.A.); (J.G.); (J.S.); (M.P.); (C.L.); (J.R.); (N.O.); (I.H.); (C.S.)
| | - Carlos Sanchez
- Departamento de Ingeniería Eléctrica y Electrónica, Universidad Nacional de Colombia, Bogotá 111321, Colombia; (M.A.); (J.G.); (J.S.); (M.P.); (C.L.); (J.R.); (N.O.); (I.H.); (C.S.)
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Angioli R, Santonico M, Pennazza G, Montera R, Luvero D, Gatti A, Zompanti A, Finamore P, Incalzi RA. Use of Sensor Array Analysis to Detect Ovarian Cancer through Breath, Urine, and Blood: A Case-Control Study. Diagnostics (Basel) 2024; 14:561. [PMID: 38473033 DOI: 10.3390/diagnostics14050561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 03/14/2024] Open
Abstract
Ovarian cancer (OC) is the eighth most common cancer in women. Since screening programs do not exist, it is often diagnosed in advanced stages. Today, the detection of OC is based on clinical examination, transvaginal ultrasound (US), and serum biomarker (Carbohydrate Antigen 125 (CA 125) and Human Epididymis Protein 4 (HE4)) dosage, with a sensitivity of 88% and 95%, respectively, and a specificity of 84% for US and 76% for biomarkers. These methods are clearly not enough, and OC in its early stages is often missed. Many scientists have recently focused their attention on volatile organic compounds (VOCs). These are gaseous molecules, found in the breath, that could provide interesting information on several diseases, including solid tumors. To detect VOCs, an electronic nose was invented by a group of researchers. A similar device, the e-tongue, was later created to detect specific molecules in liquids. For the first time in the literature, we investigated the potential use of the electronic nose and the electronic tongue to detect ovarian cancer not just from breath but also from urine, blood, and plasma samples.
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Affiliation(s)
- Roberto Angioli
- Unit of Gynecology, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - Marco Santonico
- Unit of Electronics for Sensor Systems, Department of Science and Technology for Sustainable Development and One Health, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 21, 00128 Rome, Italy
| | - Giorgio Pennazza
- Unit of Electronics for Sensor Systems, Department of Engineering, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 21, 00128 Rome, Italy
| | - Roberto Montera
- Unit of Gynecology, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - Daniela Luvero
- Unit of Gynecology, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - Alessandra Gatti
- Unit of Gynecology, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - Alessandro Zompanti
- Unit of Electronics for Sensor Systems, Department of Engineering, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 21, 00128 Rome, Italy
| | - Panaiotis Finamore
- Unit of Geriatrics, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - Raffaele Antonelli Incalzi
- Unit of Geriatrics, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 200, 00128 Rome, Italy
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Wang H, Cao X, Meng P, Zheng C, Liu J, Liu Y, Zhang T, Li X, Shi X, Sun X, Zhang T, Zuo H, Wang Z, Fu X, Li H, Zheng H. Machine learning-based identification of colorectal advanced adenoma using clinical and laboratory data: a phase I exploratory study in accordance with updated World Endoscopy Organization guidelines for noninvasive colorectal cancer screening tests. Front Oncol 2024; 14:1325514. [PMID: 38463224 PMCID: PMC10921227 DOI: 10.3389/fonc.2024.1325514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 02/05/2024] [Indexed: 03/12/2024] Open
Abstract
Objective The recent World Endoscopy Organization (WEO) guidelines now recognize precursor lesions of colorectal cancer (CRC) as legitimate screening targets. However, an optimal screening method for detecting advanced adenoma (AA), a significant precursor lesion, remains elusive. Methods We employed five machine learning methods, using clinical and laboratory data, to develop and validate a diagnostic model for identifying patients with AA (569 AAs vs. 3228 controls with normal colonoscopy). The best-performing model was selected based on sensitivity and specificity assessments. Its performance in recognizing adenoma-carcinoma sequence was evaluated in line with guidelines, and adjustable thresholds were established. For comparison, the Fecal Occult Blood Test (FOBT) was also selected. Results The XGBoost model demonstrated superior performance in identifying AA, with a sensitivity of 70.8% and a specificity of 83.4%. It successfully detected 42.7% of non-advanced adenoma (NAA) and 80.1% of CRC. The model-transformed risk assessment scale provided diagnostic performance at different positivity thresholds. Compared to FOBT, the XGBoost model better identified AA and NAA, however, was less effective in CRC. Conclusion The XGBoost model, compared to FOBT, offers improved accuracy in identifying AA patients. While it may not meet the recommendations of some organizations, it provides value for individuals who are unable to use FOBT for various reasons.
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Affiliation(s)
- Huijie Wang
- Department of Endoscopy, Shijiazhuang Traditional Chinese Medicine Hospital, Shijiazhuang, China
| | - Xu Cao
- Department of Endoscopy, Shijiazhuang Traditional Chinese Medicine Hospital, Shijiazhuang, China
| | - Ping Meng
- Department of Gastroenterology, Shijiazhuang Traditional Chinese Medicine Hospital, Shijiazhuang, China
| | - Caihua Zheng
- Department of Gastroenterology, Shijiazhuang Traditional Chinese Medicine Hospital, Shijiazhuang, China
| | - Jinli Liu
- Department of Gastroenterology, Shijiazhuang Traditional Chinese Medicine Hospital, Shijiazhuang, China
| | - Yong Liu
- Department of Endoscopy, Shijiazhuang Traditional Chinese Medicine Hospital, Shijiazhuang, China
| | - Tianpeng Zhang
- Department of Anus & Intestine Surgery, Shijiazhuang Traditional Chinese Medicine Hospital, Shijiazhuang, China
| | - Xiaofang Li
- Department of Endoscopy, Shijiazhuang Traditional Chinese Medicine Hospital, Shijiazhuang, China
| | - Xiaoyang Shi
- Department of Endoscopy, Shijiazhuang Traditional Chinese Medicine Hospital, Shijiazhuang, China
| | - Xiaoxing Sun
- Department of Endoscopy, Shijiazhuang Traditional Chinese Medicine Hospital, Shijiazhuang, China
| | - Teng Zhang
- Institute of Traditional Chinese Medicine, North China University of Science and Technology, Tangshan, China
| | - Haiying Zuo
- Graduate School, Hebei North University, Zhangjiakou, China
| | - Zhichao Wang
- Graduate School, Hebei North University, Zhangjiakou, China
| | - Xin Fu
- Research and Development Department, Wuhan Metware Biotechnology Co., Ltd, Wuhan, China
| | - Huan Li
- Research and Development Department, Wuhan Metware Biotechnology Co., Ltd, Wuhan, China
| | - Huanwei Zheng
- Department of Gastroenterology, Shijiazhuang Traditional Chinese Medicine Hospital, Shijiazhuang, China
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Zhang F, Yang L, Wei J, Tian X. Non-Invasive Blood Pressure Tracking of Spontaneous Hypertension Rats Using an Electronic Nose. SENSORS (BASEL, SWITZERLAND) 2023; 24:238. [PMID: 38203100 PMCID: PMC10781391 DOI: 10.3390/s24010238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/20/2023] [Accepted: 12/28/2023] [Indexed: 01/12/2024]
Abstract
Traditional noninvasive blood pressure measurement methods in experimental animals are time consuming and difficult to operate, particularly for large numbers of animals. In this study, the possibility of sensing fecal odor to estimate the blood pressure status of spontaneous hypertension rats (SHRs) was explored with the aim of establishing a new method for non-invasive monitoring of blood pressure. The body weight and blood pressure of SHRs kept increasing with growth, and the odor information monitored using an E-nose varied with the blood pressure status, particularly for sensors S6 and S7. The fecal information was analyzed using principal component analysis, canonical discriminant analysis and multilayer perception neural networks (MLP) to discriminate SHRs from normal ones, with a 100% correct classification rate. For better prediction of blood pressure, the model built using multiple linear regression analysis, partial least squares regression analysis and multilayer perceptron neural network analysis were used, with coefficients of determination (R2) ranging from 0.8036 to 0.9926. Moreover, the best prediction model for blood pressure was established using MLP analysis with an R2¬ higher than 0.91. Thus, changes in blood pressure levels can be tracked non-invasively, and normotension can be distinguished from hypertension or even at different hypertension levels based on the odor information of rat feces, providing a foundation for non-invasive health monitoring. This work might provide potential instructions for functional food research aimed at lowering blood pressure.
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Affiliation(s)
- Fumei Zhang
- China-Malaysia National Joint Laboratory, Biomedical Research Center, Northwest Minzu University, Lanzhou 730030, China; (F.Z.); (L.Y.); (J.W.)
- Department of Medicine, Northwest Minzu University, Lanzhou 730124, China
| | - Lijing Yang
- China-Malaysia National Joint Laboratory, Biomedical Research Center, Northwest Minzu University, Lanzhou 730030, China; (F.Z.); (L.Y.); (J.W.)
- School of Life Sciences and Engineering, Northwest Minzu University, Lanzhou 730124, China
| | - Jia Wei
- China-Malaysia National Joint Laboratory, Biomedical Research Center, Northwest Minzu University, Lanzhou 730030, China; (F.Z.); (L.Y.); (J.W.)
- School of Life Sciences and Engineering, Northwest Minzu University, Lanzhou 730124, China
| | - Xiaojing Tian
- China-Malaysia National Joint Laboratory, Biomedical Research Center, Northwest Minzu University, Lanzhou 730030, China; (F.Z.); (L.Y.); (J.W.)
- School of Life Sciences and Engineering, Northwest Minzu University, Lanzhou 730124, China
- Gannan Yak Milk Research Institute, Gannan 747000, China
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10
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Liu Q, Li S, Li Y, Yu L, Zhao Y, Wu Z, Fan Y, Li X, Wang Y, Zhang X, Zhang Y. Identification of urinary volatile organic compounds as a potential non-invasive biomarker for esophageal cancer. Sci Rep 2023; 13:18587. [PMID: 37903959 PMCID: PMC10616168 DOI: 10.1038/s41598-023-45989-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 10/26/2023] [Indexed: 11/01/2023] Open
Abstract
Early diagnosis of esophageal cancer (EC) is extremely challenging. The study presented herein aimed to assess whether urinary volatile organic compounds (VOCs) may be emerging diagnostic biomarkers for EC. Urine samples were collected from EC patients and healthy controls (HCs). Gas chromatography-ion mobility spectrometry (GC-IMS) was next utilised for volatile organic compound detection and predictive models were constructed using machine learning algorithms. ROC curve analysis indicated that an 8-VOCs based machine learning model could aid the diagnosis of EC, with the Random Forests having a maximum AUC of 0.874 and sensitivities and specificities of 84.2% and 90.6%, respectively. Urine VOC analysis aids in the diagnosis of EC.
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Affiliation(s)
- Qi Liu
- Department of Clinical Laboratory, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China
- Shandong Engineering Research Center of Biomarker and Artificial Intelligence Application, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China
| | - Shuhai Li
- Department of Thoracic Surgery, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China
| | - Yaping Li
- Department of Clinical Laboratory, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China
- Shandong Engineering Research Center of Biomarker and Artificial Intelligence Application, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China
| | - Longchen Yu
- Department of Clinical Laboratory, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China
- Shandong Engineering Research Center of Biomarker and Artificial Intelligence Application, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China
| | - Yuxiao Zhao
- Department of Clinical Laboratory, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China
- Shandong Engineering Research Center of Biomarker and Artificial Intelligence Application, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China
| | - Zhihong Wu
- Department of Traditional Chinese Medicine, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China.
| | - Yingjing Fan
- Department of Clinical Laboratory, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China
- Shandong Engineering Research Center of Biomarker and Artificial Intelligence Application, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China
| | - Xinyang Li
- Department of Clinical Laboratory, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China
- Shandong Engineering Research Center of Biomarker and Artificial Intelligence Application, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China
| | - Yifeng Wang
- Department of Clinical Laboratory, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China
- Shandong Engineering Research Center of Biomarker and Artificial Intelligence Application, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China
| | - Xin Zhang
- Department of Clinical Laboratory, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China
- Shandong Engineering Research Center of Biomarker and Artificial Intelligence Application, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China
| | - Yi Zhang
- Department of Clinical Laboratory, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China.
- Shandong Engineering Research Center of Biomarker and Artificial Intelligence Application, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China.
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11
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Ungkulpasvich U, Hatakeyama H, Hirotsu T, di Luccio E. Pancreatic Cancer and Detection Methods. Biomedicines 2023; 11:2557. [PMID: 37760999 PMCID: PMC10526344 DOI: 10.3390/biomedicines11092557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/05/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
The pancreas is a vital organ with exocrine and endocrine functions. Pancreatitis is an inflammation of the pancreas caused by alcohol consumption and gallstones. This condition can heighten the risk of pancreatic cancer (PC), a challenging disease with a high mortality rate. Genetic and epigenetic factors contribute significantly to PC development, along with other risk factors. Early detection is crucial for improving PC outcomes. Diagnostic methods, including imagining modalities and tissue biopsy, aid in the detection and analysis of PC. In contrast, liquid biopsy (LB) shows promise in early tumor detection by assessing biomarkers in bodily fluids. Understanding the function of the pancreas, associated diseases, risk factors, and available diagnostic methods is essential for effective management and early PC detection. The current clinical examination of PC is challenging due to its asymptomatic early stages and limitations of highly precise diagnostics. Screening is recommended for high-risk populations and individuals with potential benign tumors. Among various PC screening methods, the N-NOSE plus pancreas test stands out with its high AUC of 0.865. Compared to other commercial products, the N-NOSE plus pancreas test offers a cost-effective solution for early detection. However, additional diagnostic tests are required for confirmation. Further research, validation, and the development of non-invasive screening methods and standardized scoring systems are crucial to enhance PC detection and improve patient outcomes. This review outlines the context of pancreatic cancer and the challenges for early detection.
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Affiliation(s)
| | | | | | - Eric di Luccio
- Hirotsu Bioscience Inc., 22F The New Otani Garden Court, 4-1 Kioi-cho, Chiyoda-ku, Tokyo 102-0094, Japan; (U.U.); (H.H.); (T.H.)
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12
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Dalis C, Mesfin FM, Manohar K, Liu J, Shelley WC, Brokaw JP, Markel TA. Volatile Organic Compound Assessment as a Screening Tool for Early Detection of Gastrointestinal Diseases. Microorganisms 2023; 11:1822. [PMID: 37512994 PMCID: PMC10385474 DOI: 10.3390/microorganisms11071822] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/13/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023] Open
Abstract
Gastrointestinal (GI) diseases have a high prevalence throughout the United States. Screening and diagnostic modalities are often expensive and invasive, and therefore, people do not utilize them effectively. Lack of proper screening and diagnostic assessment may lead to delays in diagnosis, more advanced disease at the time of diagnosis, and higher morbidity and mortality rates. Research on the intestinal microbiome has demonstrated that dysbiosis, or unfavorable alteration of organismal composition, precedes the onset of clinical symptoms for various GI diseases. GI disease diagnostic research has led to a shift towards non-invasive methods for GI screening, including chemical-detection tests that measure changes in volatile organic compounds (VOCs), which are the byproducts of bacterial metabolism that result in the distinct smell of stool. Many of these tools are expensive, immobile benchtop instruments that require highly trained individuals to interpret the results. These attributes make them difficult to implement in clinical settings. Alternatively, electronic noses (E-noses) are relatively cheaper, handheld devices that utilize multi-sensor arrays and pattern recognition technology to analyze VOCs. The purpose of this review is to (1) highlight how dysbiosis impacts intestinal diseases and how VOC metabolites can be utilized to detect alterations in the microbiome, (2) summarize the available VOC analytical platforms that can be used to detect aberrancies in intestinal health, (3) define the current technological advancements and limitations of E-nose technology, and finally, (4) review the literature surrounding several intestinal diseases in which headspace VOCs can be used to detect or predict disease.
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Affiliation(s)
- Costa Dalis
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Fikir M Mesfin
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Krishna Manohar
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Jianyun Liu
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - W Christopher Shelley
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - John P Brokaw
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Troy A Markel
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN 46202, USA
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13
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Grizzi F, Bax C, Hegazi MAAA, Lotesoriere BJ, Zanoni M, Vota P, Hurle RF, Buffi NM, Lazzeri M, Tidu L, Capelli L, Taverna G. Early Detection of Prostate Cancer: The Role of Scent. CHEMOSENSORS 2023; 11:356. [DOI: 10.3390/chemosensors11070356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
Prostate cancer (PCa) represents the cause of the second highest number of cancer-related deaths worldwide, and its clinical presentation can range from slow-growing to rapidly spreading metastatic disease. As the characteristics of most cases of PCa remains incompletely understood, it is crucial to identify new biomarkers that can aid in early detection. Despite the prostate-specific antigen serum (PSA) levels, prostate biopsy, and imaging representing the actual gold-standard for diagnosing PCa, analyzing volatile organic compounds (VOCs) has emerged as a promising new frontier. We and other authors have reported that highly trained dogs can recognize specific VOCs associated with PCa with high accuracy. However, using dogs in clinical practice has several limitations. To exploit the potential of VOCs, an electronic nose (eNose) that mimics the dog olfactory system and can potentially be used in clinical practice was designed. To explore the eNose as an alternative to dogs in diagnosing PCa, we conducted a systematic literature review and meta-analysis of available studies. PRISMA guidelines were used for the identification, screening, eligibility, and selection process. We included six studies that employed trained dogs and found that the pooled diagnostic sensitivity was 0.87 (95% CI 0.86–0.89; I2, 98.6%), the diagnostic specificity was 0.83 (95% CI 0.80–0.85; I2, 98.1%), and the area under the summary receiver operating characteristic curve (sROC) was 0.64 (standard error, 0.25). We also analyzed five studies that used an eNose to diagnose PCa and found that the pooled diagnostic sensitivity was 0.84 (95% CI, 0.80–0.88; I2, 57.1%), the diagnostic specificity was 0.88 (95% CI, 0.84–0.91; I2, 66%), and the area under the sROC was 0.93 (standard error, 0.03). These pooled results suggest that while highly trained dogs have the potentiality to diagnose PCa, the ability is primarily related to olfactory physiology and training methodology. The adoption of advanced analytical techniques, such as eNose, poses a significant challenge in the field of clinical practice due to their growing effectiveness. Nevertheless, the presence of limitations and the requirement for meticulous study design continue to present challenges when employing eNoses for the diagnosis of PCa.
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Affiliation(s)
- Fabio Grizzi
- Department of Immunology and Inflammation, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
| | - Carmen Bax
- Politecnico di Milano, Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”, 20133 Milan, Italy
| | - Mohamed A. A. A. Hegazi
- Department of Immunology and Inflammation, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
| | - Beatrice Julia Lotesoriere
- Politecnico di Milano, Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”, 20133 Milan, Italy
| | - Matteo Zanoni
- Department of Urology, Humanitas Mater Domini, 21100 Castellanza, Italy
| | - Paolo Vota
- Department of Urology, Humanitas Mater Domini, 21100 Castellanza, Italy
| | - Rodolfo Fausto Hurle
- Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
| | - Nicolò Maria Buffi
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
| | - Massimo Lazzeri
- Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
| | - Lorenzo Tidu
- Italian Ministry of Defenses, “Vittorio Veneto” Division, 50136 Firenze, Italy
| | - Laura Capelli
- Politecnico di Milano, Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”, 20133 Milan, Italy
| | - Gianluigi Taverna
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
- Department of Urology, Humanitas Mater Domini, 21100 Castellanza, Italy
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14
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Kato M, Yamaguchi M, Ooka A, Takahashi R, Suzuki T, Onoda K, Yoshikawa Y, Tsunematsu Y, Sato M, Yoshioka Y, Igarashi M, Hayakawa S, Shoji K, Shoji Y, Ishikawa T, Watanabe K, Miyoshi N. Non-target GC-MS analyses of fecal VOCs in NASH-hepatocellular carcinoma model STAM mice. Sci Rep 2023; 13:8924. [PMID: 37264108 DOI: 10.1038/s41598-023-36091-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 05/29/2023] [Indexed: 06/03/2023] Open
Abstract
The increased incidence of obesity in the global population has increased the risk of several chronic inflammation-related diseases, including non-alcoholic steatohepatitis (NASH)-hepatocellular carcinoma (HCC). The progression from NASH to HCC involves a virus-independent liver carcinogenic mechanism; however, we currently lack effective treatment and prevention strategies. Several reports have suggested that fecal volatile organic compounds (VOCs) are strongly associated with NASH-HCC; therefore, we explored the biomarkers involved in its pathogenesis and progression. Fecal samples collected from control and NASH-HCC model STAM mice were subjected to headspace autosampler gas chromatography-electron ionization-mass spectrometry. Non-target profiling analysis identified diacetyl (2,3-butandione) as a fecal VOC that characterizes STAM mice. Although fecal diacetyl levels were correlated with the HCC in STAM mice, diacetyl is known as a cytotoxic/tissue-damaging compound rather than genotoxic or mutagenic; therefore, we examined the effect of bioactivity associated with NASH progression. We observed that diacetyl induced several pro-inflammatory molecules, including tumor necrosis factor-α, cyclooxygenase-2, monocyte chemoattractant protein-1, and transforming growth factor-β, in mouse macrophage RAW264.7 and Kupffer KPU5 cells. Additionally, we observed that diacetyl induced α-smooth muscle actin, one of the hallmarks of fibrosis, in an ex vivo cultured hepatic section, but not in in vitro hepatic stellate TWNT-1 cells. These results suggest that diacetyl would be a potential biomarker of fecal VOC in STAM mice, and its ability to trigger the macrophage-derived inflammation and fibrosis may partly contribute to NASH-HCC carcinogenesis.
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Affiliation(s)
- Mai Kato
- Graduate School of Integrated Pharmaceutical and Nutritional Sciences, University of Shizuoka, 52-1 Yada, Suruga, Shizuoka, 422-8526, Japan
| | - Momoka Yamaguchi
- Graduate School of Integrated Pharmaceutical and Nutritional Sciences, University of Shizuoka, 52-1 Yada, Suruga, Shizuoka, 422-8526, Japan
| | - Akira Ooka
- Graduate School of Integrated Pharmaceutical and Nutritional Sciences, University of Shizuoka, 52-1 Yada, Suruga, Shizuoka, 422-8526, Japan
| | - Ryota Takahashi
- Graduate School of Integrated Pharmaceutical and Nutritional Sciences, University of Shizuoka, 52-1 Yada, Suruga, Shizuoka, 422-8526, Japan
| | - Takuji Suzuki
- Department of Food Science and Nutrition, Faculty of Human Life and Science, Doshisha Women's College of Liberal Arts, Kyoto, Japan
| | - Keita Onoda
- Graduate School of Integrated Pharmaceutical and Nutritional Sciences, University of Shizuoka, 52-1 Yada, Suruga, Shizuoka, 422-8526, Japan
| | - Yuko Yoshikawa
- Graduate School of Integrated Pharmaceutical and Nutritional Sciences, University of Shizuoka, 52-1 Yada, Suruga, Shizuoka, 422-8526, Japan
- School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Yuta Tsunematsu
- Graduate School of Integrated Pharmaceutical and Nutritional Sciences, University of Shizuoka, 52-1 Yada, Suruga, Shizuoka, 422-8526, Japan
| | - Michio Sato
- Graduate School of Integrated Pharmaceutical and Nutritional Sciences, University of Shizuoka, 52-1 Yada, Suruga, Shizuoka, 422-8526, Japan
| | - Yasukiyo Yoshioka
- Graduate School of Integrated Pharmaceutical and Nutritional Sciences, University of Shizuoka, 52-1 Yada, Suruga, Shizuoka, 422-8526, Japan
| | - Miki Igarashi
- Advanced Clinical Research Center, Institute of Neurological Disorders, Kawasaki, Kanagawa, Japan
| | - Sumio Hayakawa
- Department of Biochemistry and Molecular Biology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Kumiko Shoji
- Basic Nutrition, Kagawa Nutrition University, Saitama, Japan
| | - Yutaka Shoji
- Department of Food Science and Nutrition, Shizuoka Eiwa Gakuin University Junior College, Shizuoka, Japan
| | - Tomohisa Ishikawa
- Graduate School of Integrated Pharmaceutical and Nutritional Sciences, University of Shizuoka, 52-1 Yada, Suruga, Shizuoka, 422-8526, Japan
| | - Kenji Watanabe
- Graduate School of Integrated Pharmaceutical and Nutritional Sciences, University of Shizuoka, 52-1 Yada, Suruga, Shizuoka, 422-8526, Japan
| | - Noriyuki Miyoshi
- Graduate School of Integrated Pharmaceutical and Nutritional Sciences, University of Shizuoka, 52-1 Yada, Suruga, Shizuoka, 422-8526, Japan.
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15
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Chemoresistive Nanosensors Employed to Detect Blood Tumor Markers in Patients Affected by Colorectal Cancer in a One-Year Follow Up. Cancers (Basel) 2023; 15:cancers15061797. [PMID: 36980683 PMCID: PMC10046137 DOI: 10.3390/cancers15061797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/07/2023] [Accepted: 03/14/2023] [Indexed: 03/18/2023] Open
Abstract
Colorectal cancer (CRC) represents 10% of the annual tumor diagnosis and deaths occurring worldwide. Given the lack of specific symptoms, which could determine a late diagnosis, the research for specific CRC biomarkers and for innovative low-invasive methods to detect them is crucial. Therefore, on the basis of previously published results, some volatile organic compounds (VOCs), detectable through gas sensors, resulted in particularly promising CRC biomarkers, making these sensors suitable candidates to be employed in CRC screening devices. A new device was employed here to analyze the exhalations of blood samples collected from CRC-affected patients at different stages of their pre- and post-surgery therapeutic path, in order to assess the sensor’s capability for discriminating among these samples. The stages considered were: the same day of the surgical treatment (T1); before the hospital discharge (T2); after one month and after 10–12 months from surgery (T3 and T4, respectively). This device, equipped with four different sensors based on different metal–oxide mixtures, enabled a distinction between T1 and T4 with a sensitivity and specificity of 93% and 82%, respectively, making it suitable for clinical follow-up protocols, patient health status monitoring and to detect possible post-treatment relapses.
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16
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Kiss H, Örlős Z, Gellért Á, Megyesfalvi Z, Mikáczó A, Sárközi A, Vaskó A, Miklós Z, Horváth I. Exhaled Biomarkers for Point-of-Care Diagnosis: Recent Advances and New Challenges in Breathomics. MICROMACHINES 2023; 14:391. [PMID: 36838091 PMCID: PMC9964519 DOI: 10.3390/mi14020391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 01/29/2023] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
Cancers, chronic diseases and respiratory infections are major causes of mortality and present diagnostic and therapeutic challenges for health care. There is an unmet medical need for non-invasive, easy-to-use biomarkers for the early diagnosis, phenotyping, predicting and monitoring of the therapeutic responses of these disorders. Exhaled breath sampling is an attractive choice that has gained attention in recent years. Exhaled nitric oxide measurement used as a predictive biomarker of the response to anti-eosinophil therapy in severe asthma has paved the way for other exhaled breath biomarkers. Advances in laser and nanosensor technologies and spectrometry together with widespread use of algorithms and artificial intelligence have facilitated research on volatile organic compounds and artificial olfaction systems to develop new exhaled biomarkers. We aim to provide an overview of the recent advances in and challenges of exhaled biomarker measurements with an emphasis on the applicability of their measurement as a non-invasive, point-of-care diagnostic and monitoring tool.
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Affiliation(s)
- Helga Kiss
- National Koranyi Institute for Pulmonology, Koranyi F Street 1, 1121 Budapest, Hungary
| | - Zoltán Örlős
- National Koranyi Institute for Pulmonology, Koranyi F Street 1, 1121 Budapest, Hungary
| | - Áron Gellért
- National Koranyi Institute for Pulmonology, Koranyi F Street 1, 1121 Budapest, Hungary
| | - Zsolt Megyesfalvi
- National Koranyi Institute for Pulmonology, Koranyi F Street 1, 1121 Budapest, Hungary
| | - Angéla Mikáczó
- Department of Pulmonology, University of Debrecen, Nagyerdei krt 98, 4032 Debrecen, Hungary
| | - Anna Sárközi
- Department of Pulmonology, University of Debrecen, Nagyerdei krt 98, 4032 Debrecen, Hungary
| | - Attila Vaskó
- Department of Pulmonology, University of Debrecen, Nagyerdei krt 98, 4032 Debrecen, Hungary
| | - Zsuzsanna Miklós
- National Koranyi Institute for Pulmonology, Koranyi F Street 1, 1121 Budapest, Hungary
| | - Ildikó Horváth
- National Koranyi Institute for Pulmonology, Koranyi F Street 1, 1121 Budapest, Hungary
- Department of Pulmonology, University of Debrecen, Nagyerdei krt 98, 4032 Debrecen, Hungary
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17
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Bosch S, de Menezes RX, Pees S, Wintjens DJ, Seinen M, Bouma G, Kuyvenhoven J, Stokkers PCF, de Meij TGJ, de Boer NKH. Electronic Nose Sensor Drift Affects Diagnostic Reliability and Accuracy of Disease-Specific Algorithms. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22239246. [PMID: 36501947 PMCID: PMC9740993 DOI: 10.3390/s22239246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 11/18/2022] [Accepted: 11/19/2022] [Indexed: 06/12/2023]
Abstract
Sensor drift is a well-known disadvantage of electronic nose (eNose) technology and may affect the accuracy of diagnostic algorithms. Correction for this phenomenon is not routinely performed. The aim of this study was to investigate the influence of eNose sensor drift on the development of a disease-specific algorithm in a real-life cohort of inflammatory bowel disease patients (IBD). In this multi-center cohort, patients undergoing colonoscopy collected a fecal sample prior to bowel lavage. Mucosal disease activity was assessed based on endoscopy. Controls underwent colonoscopy for various reasons and had no endoscopic abnormalities. Fecal eNose profiles were measured using Cyranose 320®. Fecal samples of 63 IBD patients and 63 controls were measured on four subsequent days. Sensor data displayed associations with date of measurement, which was reproducible across all samples irrespective of disease state, disease activity state, disease localization and diet of participants. Based on logistic regression, corrections for sensor drift improved accuracy to differentiate between IBD patients and controls based on the significant differences of six sensors (p = 0.004; p < 0.001; p = 0.001; p = 0.028; p < 0.001 and p = 0.005) with an accuracy of 0.68. In this clinical study, short-term sensor drift affected fecal eNose profiles more profoundly than clinical features. These outcomes emphasize the importance of sensor drift correction to improve reliability and repeatability, both within and across eNose studies.
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Affiliation(s)
- Sofie Bosch
- Department of Gastroenterology and Hepatology, AG&M Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 Amsterdam, The Netherlands
| | - Renée X. de Menezes
- Department of Epidemiology and Biostatistics, Vrije Universiteit Amsterdam, 1081 Amsterdam, The Netherlands
- Biostatistics Unit, Netherlands Cancer Institute, 1066 Amsterdam, The Netherlands
| | - Suzanne Pees
- Department of Gastroenterology and Hepatology, AG&M Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 Amsterdam, The Netherlands
| | - Dion J. Wintjens
- Department of Gastroenterology and Hepatology, Maastricht University Medical Centre (MUMC+), 6229 Maastricht, The Netherlands
| | - Margien Seinen
- Department of Gastroenterology and Hepatology, OLVG West, 1061 Amsterdam, The Netherlands
| | - Gerd Bouma
- Department of Gastroenterology and Hepatology, AG&M Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 Amsterdam, The Netherlands
| | - Johan Kuyvenhoven
- Department of Gastroenterology and Hepatology, Spaarne Gasthuis Hospital, 2134 Hoofddorp, The Netherlands
| | - Pieter C. F. Stokkers
- Department of Gastroenterology and Hepatology, OLVG West, 1061 Amsterdam, The Netherlands
| | - Tim G. J. de Meij
- Department of Pediatric Gastroenterology, UMC, Vrije Universiteit Amsterdam, 1081 Amsterdam, The Netherlands
| | - Nanne K. H. de Boer
- Department of Gastroenterology and Hepatology, AG&M Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 Amsterdam, The Netherlands
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18
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Yang H, Mou Y, Hu B. Diagnostic Ability of Volatile Organic Compounds in Digestive Cancer: A Systematic Review With Meta-Analysis. Clin Med Insights Oncol 2022; 16:11795549221105027. [PMID: 35754925 PMCID: PMC9218909 DOI: 10.1177/11795549221105027] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 05/16/2022] [Indexed: 02/05/2023] Open
Abstract
Background: Volatile organic compounds (VOCs) have been involved in cancer diagnosis via breath, urine, and feces. We aimed to assess the diagnostic ability of VOCs on digestive cancers. Methods: We systematically reviewed prospective clinical trials evaluating VOCs’ diagnostic ability on esophageal, gastric, colorectal, hepatic, and pancreatic cancer (PC). Databases including PubMed and Ovid-Medline were searched. Results: A total of 35 trials with 5314 patient-times qualified for inclusion. The pooled sensitivity of VOCs diagnosing gastroesophageal cancer from healthy controls is 0.89 (95% confidence interval [CI]: 0.82-0.94), the pooled specificity is 0.890 (95% CI: 0.84-0.93), and area under the curve (AUC) of the summary receiver operating characteristic curve is 0.95 (95% CI: 0.93-0.95). The pooled sensitivity of VOCs diagnosing colorectal cancer from heathy controls is 0.92 (95% CI: 0.85-0.96), the pooled specificity is 0.88 (95% CI: 0.77-0.94), and the AUC is 0.96 (95% CI: 0.94-0.97). The pooled sensitivity of VOCs distinguishing gastrointestinal (GI) cancer from precancerous lesions is 0.84 (95% CI: 0.67-0.92), the pooled specificity is 0.74 (95% CI: 0.43-0.91), and the AUC is 0.87 (95% CI: 0.84-0.89). The pooled sensitivity of VOCs diagnosing hepatocellular carcinoma is 0.68 (95% CI: 0.52-0.81), the pooled specificity is 0.81 (95% CI: 0.47-0.96), and the AUC is 0.78 (95% CI: 0.74-0.81). The pooled sensitivity of VOCs diagnosing PC is 0.88 (95% CI: 0.80-0.93), the pooled specificity is 0.82 (95% CI: 0.62-0.93), and the AUC is 0.92 (95% CI: 0.89-0.94). Conclusions: Volatile organic compounds have potential role in diagnosing GI cancer with comparatively high sensitivity, specificity, and AUC (PROSPERO registration number: CRD42021260039).
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Affiliation(s)
- Hang Yang
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Yi Mou
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Bing Hu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
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19
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Astolfi M, Rispoli G, Benedusi M, Zonta G, Landini N, Valacchi G, Malagù C. Chemoresistive Sensors for Cellular Type Discrimination Based on Their Exhalations. NANOMATERIALS 2022; 12:nano12071111. [PMID: 35407231 PMCID: PMC9000844 DOI: 10.3390/nano12071111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 03/24/2022] [Accepted: 03/25/2022] [Indexed: 12/03/2022]
Abstract
The detection of volatile organic compounds (VOCs) exhaled by human body fluids is a recent and promising method to reveal tumor formations. In this feasibility study, a patented device, based on nanostructured chemoresistive gas sensors, was employed to explore the gaseous exhalations of tumoral, immortalized, and healthy cell lines, with the aim of distinguishing their VOC patterns. The analysis of the device output to the cell VOCs, emanated at different incubation times and initial plating concentrations, was performed to evaluate the device suitability to identify the cell types and to monitor their growth. The sensors ST25 (based on tin and titanium oxides), STN (based on tin, titanium, and niobium oxides), and TiTaV (based on titanium, tantalum and vanadium oxides) used here, gave progressively increasing responses upon the cell density increase and incubation time; the sensor W11 (based on tungsten oxide) gave instead unreliable responses to all cell lines. All sensors (except for W11) gave large and consistent responses to RKO and HEK293 cells, while they were less responsive to CHO, A549, and CACO-2 ones. The encouraging results presented here, although preliminary, foresee the development of sensor arrays capable of identifying tumor presence and its type.
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Affiliation(s)
- Michele Astolfi
- Department of Physics and Earth Sciences, University of Ferrara, 44122 Ferrara, Italy; (G.Z.); (N.L.); (C.M.)
- SCENT S.r.l., Via Quadrifoglio 11, 44124 Ferrara, Italy
- Correspondence: (M.A.); (G.R.)
| | - Giorgio Rispoli
- Department of Neuroscience and Rehabilitation, University of Ferrara, 44121 Ferrara, Italy;
- Correspondence: (M.A.); (G.R.)
| | - Mascia Benedusi
- Department of Neuroscience and Rehabilitation, University of Ferrara, 44121 Ferrara, Italy;
| | - Giulia Zonta
- Department of Physics and Earth Sciences, University of Ferrara, 44122 Ferrara, Italy; (G.Z.); (N.L.); (C.M.)
- SCENT S.r.l., Via Quadrifoglio 11, 44124 Ferrara, Italy
| | - Nicolò Landini
- Department of Physics and Earth Sciences, University of Ferrara, 44122 Ferrara, Italy; (G.Z.); (N.L.); (C.M.)
- SCENT S.r.l., Via Quadrifoglio 11, 44124 Ferrara, Italy
| | - Giuseppe Valacchi
- Department of Environmental Science and Prevention, University of Ferrara, 44121 Ferrara, Italy;
- Plants for Human Health Institute, NC State University, Kannapolis, NC 28081, USA
- Department of Food and Nutrition, Kyung Hee University, Seoul 130-701, Korea
| | - Cesare Malagù
- Department of Physics and Earth Sciences, University of Ferrara, 44122 Ferrara, Italy; (G.Z.); (N.L.); (C.M.)
- SCENT S.r.l., Via Quadrifoglio 11, 44124 Ferrara, Italy
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Abstract
The technological developments of recent times have allowed the use of innovative approaches to support the diagnosis of various diseases. Many of such clinical conditions are often associated with metabolic unbalance, in turn producing an alteration of the gut microbiota even during asymptomatic stages. As such, studies regarding the microbiota composition in biological fluids obtained by humans are continuously growing, and the methodologies for their investigation are rapidly changing, making it less invasive and more affordable. To this extent, Electronic Nose and Electronic Tongue tools are gaining importance in the relevant field, making them a useful alternative—or support—to traditional analytical methods. In light of this, the present manuscript seeks to investigate the development and use of such tools in the gut microbiota assessment according to the current literature. Significant gaps are still present, particularly concerning the Electronic Tongue systems, however the current evidence highlights the strong potential such tools own to enter the daily clinical practice, with significant advancement concerning the patients’ acceptability and cost saving for healthcare providers.
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21
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Biomarkers to Detect Early-Stage Colorectal Cancer. Biomedicines 2022; 10:biomedicines10020255. [PMID: 35203465 PMCID: PMC8869393 DOI: 10.3390/biomedicines10020255] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 01/17/2022] [Accepted: 01/20/2022] [Indexed: 02/06/2023] Open
Abstract
Colorectal cancer is a leading cause of mortality worldwide. The high incidence and the acceleration of incidence in younger people reinforces the need for better techniques of early detection. The use of noninvasive biomarkers has potential to more accurately inform how patients are prioritised for clinical investigation, which, in turn, may ultimately translate into improved survival for those subsequently found to have curable-stage CRC. This review surveys a wide range of CRC biomarkers that may (alone or in combination) identify symptomatic patients presenting in primary care who should be progressed for clinical investigation.
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22
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Volatile organic compounds as a potential screening tool for neoplasm of the digestive system: a meta-analysis. Sci Rep 2021; 11:23716. [PMID: 34887450 PMCID: PMC8660806 DOI: 10.1038/s41598-021-02906-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 11/24/2021] [Indexed: 02/02/2023] Open
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.
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23
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Gouzerh F, Bessière JM, Ujvari B, Thomas F, Dujon AM, Dormont L. Odors and cancer: Current status and future directions. Biochim Biophys Acta Rev Cancer 2021; 1877:188644. [PMID: 34737023 DOI: 10.1016/j.bbcan.2021.188644] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 10/22/2021] [Accepted: 10/23/2021] [Indexed: 02/07/2023]
Abstract
Cancer is the second leading cause of death in the world. Because tumors detected at early stages are easier to treat, the search for biomarkers-especially non-invasive ones-that allow early detection of malignancies remains a central goal to reduce cancer mortality. Cancer, like other pathologies, often alters body odors, and much has been done by scientists over the last few decades to assess the value of volatile organic compounds (VOCs) as signatures of cancers. We present here a quantitative review of 208 studies carried out between 1984 and 2020 that explore VOCs as potential biomarkers of cancers. We analyzed the main findings of these studies, listing and classifying VOCs related to different cancer types while considering both sampling methods and analysis techniques. Considering this synthesis, we discuss several of the challenges and the most promising prospects of this research direction in the war against cancer.
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Affiliation(s)
- Flora Gouzerh
- CREEC/CANECEV (CREES), Montpellier, France; MIVEGEC, Université de Montpellier, CNRS, IRD, Montpellier, France; CEFE, Univ Montpellier, CNRS, EPHE, IRD, Univ Paul Valéry Montpellier 3, Montpellier, France.
| | - Jean-Marie Bessière
- Ecole Nationale de Chimie de Montpellier, Laboratoire de Chimie Appliquée, Montpellier, France
| | - Beata Ujvari
- Deakin University, School of Life and Environmental Sciences, Centre for Integrative Ecology, Waurn Ponds, Vic 3216, Australia
| | - Frédéric Thomas
- CREEC/CANECEV (CREES), Montpellier, France; MIVEGEC, Université de Montpellier, CNRS, IRD, Montpellier, France
| | - Antoine M Dujon
- CREEC/CANECEV (CREES), Montpellier, France; MIVEGEC, Université de Montpellier, CNRS, IRD, Montpellier, France; Deakin University, School of Life and Environmental Sciences, Centre for Integrative Ecology, Waurn Ponds, Vic 3216, Australia
| | - Laurent Dormont
- CEFE, Univ Montpellier, CNRS, EPHE, IRD, Univ Paul Valéry Montpellier 3, Montpellier, France
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Tyagi H, Daulton E, Bannaga AS, Arasaradnam RP, Covington JA. Non-Invasive Detection and Staging of Colorectal Cancer Using a Portable Electronic Nose. SENSORS (BASEL, SWITZERLAND) 2021; 21:5440. [PMID: 34450881 PMCID: PMC8398649 DOI: 10.3390/s21165440] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 07/30/2021] [Accepted: 07/30/2021] [Indexed: 12/24/2022]
Abstract
Electronic noses (e-nose) offer potential for the detection of cancer in its early stages. The ability to analyse samples in real time, at a low cost, applying easy-to-use and portable equipment, gives e-noses advantages over other technologies, such as Gas Chromatography-Mass Spectrometry (GC-MS). For diseases such as cancer with a high mortality, a technology that can provide fast results for use in routine clinical applications is important. Colorectal cancer (CRC) is among the highest occurring cancers and has high mortality rates, if diagnosed late. In our study, we investigated the use of portable electronic nose (PEN3), with further analysis using GC-TOF-MS, for the analysis of gases and volatile organic compounds (VOCs) to profile the urinary metabolome of colorectal cancer. We also compared the different cancer stages with non-cancers using the PEN3 and GC-TOF-MS. Results obtained from PEN3, and GC-TOF-MS demonstrated high accuracy for the separation of CRC and non-cancer. PEN3 separated CRC from non-cancerous group with 0.81 AUC (Area Under the Curve). We used data from GC-TOF-MS to obtain a VOC profile for CRC, which identified 23 potential biomarker VOCs for CRC. Thus, the PEN3 and GC-TOF-MS were found to successfully separate the cancer group from the non-cancer group.
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Affiliation(s)
- Heena Tyagi
- School of Engineering, University of Warwick, Coventry CV4 7AL, UK; (H.T.); (E.D.)
| | - Emma Daulton
- School of Engineering, University of Warwick, Coventry CV4 7AL, UK; (H.T.); (E.D.)
| | - Ayman S. Bannaga
- Department of Gastroenterology, University Hospital Coventry & Warwickshire, Coventry CV2 2DX, UK; (A.S.B.); (R.P.A.)
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
| | - Ramesh P. Arasaradnam
- Department of Gastroenterology, University Hospital Coventry & Warwickshire, Coventry CV2 2DX, UK; (A.S.B.); (R.P.A.)
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
- School of Health Sciences, Coventry University, Coventry CV1 5FB, UK
- Leicester Cancer Centre, University of Leicester, Leicester LE1 7RH, UK
| | - James A. Covington
- School of Engineering, University of Warwick, Coventry CV4 7AL, UK; (H.T.); (E.D.)
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25
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Chandrapalan S, Bosch S, Cubiella J, Guardiola J, Kimani P, Mulder C, Persaud K, de Meij TGJ, Altomare DF, Brenner H, de Boer NKH, Ricciardiello L, Arasaradnam RP. Systematic review with meta-analysis: volatile organic compound analysis to improve faecal immunochemical testing in the detection of colorectal cancer. Aliment Pharmacol Ther 2021; 54:14-23. [PMID: 34004036 DOI: 10.1111/apt.16405] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 03/20/2021] [Accepted: 04/24/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Faecal immunochemical test (FIT) is emerging as a valid test to rule-out the presence of colorectal cancer (CRC). However, the accuracy of FIT is dependent on the cut-off applied. An additional low-cost test could improve further detection of CRC. AIMS To evaluate the efficacy of combined FIT and volatile organic compounds (VOC) in the detection of CRC within symptomatic populations. METHODS Systematic reviews on the diagnostic accuracy of FIT and VOC, for the detection of CRC, were updated. Meta-analyses were performed adopting a bivariate model for sensitivity and specificity. Clinical utility of combined FIT and VOC was estimated using Fagan's nomogram. Post-test probability of FIT negatives was used as a pre-test probability for VOC. RESULTS The pooled sensitivity and specificity of FIT at 10 µg/g faeces, for the detection of CRC, were 0.914 (95% confidence interval [CI] = 0.894-0.936) and 0.783 (CI = 0.850-0.696), respectively. For VOC, the sensitivity was 0.837 (CI = 0.781-0.881) and the specificity was 0.803 (CI = 0.870-0.712). The area under the curve for FIT and VOC were 0.926 and 0.885, respectively. In a population with 5% CRC prevalence, the estimated probability of having CRC following a negative FIT was 0.5% and following both negative FIT and VOC was 0.1%. CONCLUSIONS In a FIT-negative symptomatic population, VOC can be a good test to rule-out the presence of CRC. The estimated probability reduction by 0.4% when both tests being negative offers adequate safety netting in primary care for the exclusion of CRC. The number needed to colonoscope to identify one CRC is eight if either FIT or VOC positive. Cost-effectiveness and clinical accuracy of this approach will need further evaluation.
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26
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Are Volatile Organic Compounds Accurate Markers in the Assessment of Colorectal Cancer and Inflammatory Bowel Diseases? A Review. Cancers (Basel) 2021; 13:cancers13102361. [PMID: 34068419 PMCID: PMC8153598 DOI: 10.3390/cancers13102361] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/05/2021] [Accepted: 05/10/2021] [Indexed: 02/06/2023] Open
Abstract
Simple Summary Early diagnosis is crucial for reducing colorectal cancer-related mortality in both the general population and inflammatory bowel disease. Volatile organic compound (VOC) analysis is a promising alternative to the gold standard procedure, endoscopy, for early detection and surveillance of colorectal diseases. This review aimed to provide a general overview of the most recent evidence in this area on VOC testing in breath, stool, and urine samples. Abstract Colorectal cancer (CRC) is one of the leading causes of cancer-related death in the Western world. Early detection decreases incidence and mortality. Screening programs based on fecal occult blood testing help identify patients requiring endoscopic examination, but accuracy is far from optimal. Among the alternative strategies, volatile organic compounds (VOCs) represent novel potentially useful biomarkers of colorectal cancer. They also represent a promising tool for the screening of both intestinal inflammation and related CRC. The review is focused on the diagnostic potential of VOCs in sporadic CRC and in inflammatory bowel diseases (IBD), which increase the risk of CRC, analyzing future clinical applications. Despite limitations related to inadequate strength of evidence, differing analytical platforms identify different VOCs, and this unconventional approach for diagnosing colorectal cancer is promising. Some VOC profiles, besides identifying inflammation, seem disease-specific in inflammatory bowel diseases. Thus, breath, urine, and fecal VOCs provide a new and promising clinical approach to differential diagnosis, evaluation of the inflammatory status, and possibly the assessment of treatment efficacy in IBD. Conversely, specific VOC patterns correlating inflammatory bowel disease and cancer risk are still lacking, and studies focused on this issue are strongly encouraged. No prospective studies have assessed the risk of CRC development by using VOCs in samples collected before the onset of disease, both in the general population and in patients with IBD.
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27
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Rodríguez-Hernández P, Cardador MJ, Arce L, Rodríguez-Estévez V. Analytical Tools for Disease Diagnosis in Animals via Fecal Volatilome. Crit Rev Anal Chem 2020; 52:917-932. [PMID: 33180561 DOI: 10.1080/10408347.2020.1843130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Volatilome analysis is growing in attention for the diagnosis of diseases in animals and humans. In particular, volatilome analysis in fecal samples is starting to be proposed as a fast, easy and noninvasive method for disease diagnosis. Volatilome comprises volatile organic compounds (VOCs), which are produced during both physiological and patho-physiological processes. Thus, VOCs from a pathological condition often differ from those of a healthy state and therefore the VOCs profile can be used in the detection of some diseases. Due to their strengths and advantages, feces are currently being used to obtain information related to health status in animals. However, they are complex samples, that can present problems for some analytical techniques and require special consideration in their use and preparation before analysis. This situation demands an effort to clarify which analytic options are currently being used in the research context to analyze the possibilities these offer, with the final objectives of contributing to develop a standardized methodology and to exploit feces potential as a diagnostic matrix. The current work reviews the studies focused on the diagnosis of animal diseases through fecal volatilome in order to evaluate the analytical methods used and their advantages and limitations. The alternatives found in the literature for sampling, storage, sample pretreatment, measurement and data treatment have been summarized, considering all the steps involved in the analytical process.
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Affiliation(s)
| | - M J Cardador
- Department of Analytical Chemistry, Institute of Fine Chemistry and Nanochemistry, University of Córdoba, Córdoba, Spain
| | - L Arce
- Department of Analytical Chemistry, Institute of Fine Chemistry and Nanochemistry, University of Córdoba, Córdoba, Spain
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28
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van den Brink DA, de Meij T, Brals D, Bandsma RHJ, Thitiri J, Ngari M, Mwalekwa L, de Boer NKH, Wicaksono A, Covington JA, van Rheenen PF, Voskuijl WP. Prediction of mortality in severe acute malnutrition in hospitalized children by faecal volatile organic compound analysis: proof of concept. Sci Rep 2020; 10:18785. [PMID: 33154417 PMCID: PMC7645771 DOI: 10.1038/s41598-020-75515-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 09/08/2020] [Indexed: 11/08/2022] Open
Abstract
Children with severe acute malnutrition (SAM) display immature, altered gut microbiota and have a high mortality risk. Faecal volatile organic compounds (VOCs) reflect the microbiota composition and may provide insight into metabolic dysfunction that occurs in SAM. Here we determine whether analysis of faecal VOCs could identify children with SAM with increased risk of mortality. VOC profiles from children who died within six days following admission were compared to those who were discharged alive using machine learning algorithms. VOC profiles of children who died could be separated from those who were discharged with fair accuracy (AUC) = 0.71; 95% CI 0.59-0.87; P = 0.004). We present the first study showing differences in faecal VOC profiles between children with SAM who survived and those who died. VOC analysis holds potential to help discover metabolic pathways within the intestinal microbiome with causal association with mortality and target treatments in children with SAM.Trial Registration: The F75 study is registered at clinicaltrials.gov/ct2/show/NCT02246296.
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Affiliation(s)
- Deborah A van den Brink
- Department of Paediatrics, Centre for Liver, Digestive and Metabolic Diseases, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.
- Amsterdam Centre for Global Child Health, Emma Children's Hospital, Amsterdam University Medical Centres, Amsterdam, The Netherlands.
| | - Tim de Meij
- Department of Paediatric Gastroenterology, Emma, Children's Hospital, Amsterdam University Medical Centres, Amsterdam, The Netherlands
| | - Daniella Brals
- Amsterdam Centre for Global Child Health, Emma Children's Hospital, Amsterdam University Medical Centres, Amsterdam, The Netherlands
- Department of Global Health, Amsterdam Institute for Global Health and Development, Amsterdam University Medical Centres, Amsterdam, The Netherlands
| | - Robert H J Bandsma
- Department of Paediatrics, Centre for Liver, Digestive and Metabolic Diseases, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
- Division of Gastroenterology, Hepatology and Nutrition and Translational Medicine Program, Hospital for Sick Children, Toronto, Canada
- The Childhood Acute Illness & Nutrition Network (CHAIN), Nairobi, Kenya
- Department of Biomedical Sciences, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Johnstone Thitiri
- The Childhood Acute Illness & Nutrition Network (CHAIN), Nairobi, Kenya
- KEMRI/Welcome Trust Research Programme, Kilifi, Kenya
| | - Moses Ngari
- The Childhood Acute Illness & Nutrition Network (CHAIN), Nairobi, Kenya
- KEMRI/Welcome Trust Research Programme, Kilifi, Kenya
| | | | - Nanne K H de Boer
- Department of Gastroenterology and Hepatology, Amsterdam Gastroenterology and Metabolism Research Institute, Amsterdam University Medical Centres, Amsterdam, The Netherlands
| | | | | | - Patrick F van Rheenen
- Department of Paediatrics, Centre for Liver, Digestive and Metabolic Diseases, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Wieger P Voskuijl
- Amsterdam Centre for Global Child Health, Emma Children's Hospital, Amsterdam University Medical Centres, Amsterdam, The Netherlands.
- Department of Global Health, Amsterdam Institute for Global Health and Development, Amsterdam University Medical Centres, Amsterdam, The Netherlands.
- The Childhood Acute Illness & Nutrition Network (CHAIN), Nairobi, Kenya.
- Department of Paediatrics, College of Medicine, University of Malawi, Blantyre, Malawi.
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29
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Altomare DF, Picciariello A, Rotelli MT, De Fazio M, Aresta A, Zambonin CG, Vincenti L, Trerotoli P, De Vietro N. Chemical signature of colorectal cancer: case-control study for profiling the breath print. BJS Open 2020; 4:1189-1199. [PMID: 32990407 PMCID: PMC8444279 DOI: 10.1002/bjs5.50354] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 08/18/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Effective screening for colorectal cancer can reduce mortality by early detection of tumours and colonic polyps. An altered pattern of volatile organic compounds (VOCs) in exhaled breath has been proposed as a potential non-invasive diagnostic tool for detection of cancer. The aim of this study was to evaluate the reliability of breath-testing for colorectal cancer screening and early diagnosis using an advanced breath sampler. METHODS The exhaled breath of patients with colorectal cancer and non-cancer controls with negative findings on colonoscopy was collected using the ReCIVA® Breath Sampler. This portable device is able to capture the alveolar breath fraction without environmental contamination. VOCs were desorbed thermally and analysed by gas chromatography-mass spectrometry. The discriminatory ability of VOCs in detecting colorectal cancer was evaluated by receiver operating characteristic (ROC) curve analysis for each VOC, followed by cross-validation by the leave-one-out method, and by applying stepwise logistic regression analysis. RESULTS The study included 83 patients with colorectal cancer and 90 non-cancer controls. Fourteen VOCs were found to have significant discriminatory ability in detecting patients with colorectal cancer. The model with the diagnosis of cancer versus no cancer resulted in a statistically significant likelihood of discrimination of 173·45 (P < 0·001), with an area under the ROC curve of 0·979. Cross-validation of the model resulted in a true predictive value for colorectal cancer of 93 per cent overall. Reliability of the breath analysis was maintained irrespective of cancer stage. CONCLUSION This study demonstrated that analysis of exhaled VOCs can discriminate patients with colorectal cancer from those without. This finding may eventually lead to the creation of a smart online sensory device, capable of providing a binary answer (cancer/no cancer) and directing to further screening.
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Affiliation(s)
- D. F. Altomare
- Surgical Unit ‘M. Rubino’, Department of Emergency and Organ TransplantationBariItaly
- Apulian Breath Analysis Centre (CeRBA)Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Tumori Giovanni Paolo IIBariItaly
| | - A. Picciariello
- Surgical Unit ‘M. Rubino’, Department of Emergency and Organ TransplantationBariItaly
| | - M. T. Rotelli
- Surgical Unit ‘M. Rubino’, Department of Emergency and Organ TransplantationBariItaly
| | - M. De Fazio
- Surgical Unit ‘M. Rubino’, Department of Emergency and Organ TransplantationBariItaly
| | - A. Aresta
- Department of ChemistryUniversity Aldo Moro of BariBariItaly
| | - C. G. Zambonin
- Department of ChemistryUniversity Aldo Moro of BariBariItaly
| | - L. Vincenti
- Surgical UnitAzienda Ospedaliero‐Universitaria Policlinico BariBariItaly
| | - P. Trerotoli
- Statistical Unit, Department of Biomedical Sciences and Human OncologyBariItaly
| | - N. De Vietro
- Department of ChemistryUniversity Aldo Moro of BariBariItaly
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30
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Bosch S, Bot R, Wicaksono A, Savelkoul E, van der Hulst R, Kuijvenhoven J, Stokkers P, Daulton E, Covington JA, de Meij TGJ, de Boer NKH. Early detection and follow-up of colorectal neoplasia based on faecal volatile organic compounds. Colorectal Dis 2020; 22:1119-1129. [PMID: 32040880 DOI: 10.1111/codi.15009] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Accepted: 02/03/2020] [Indexed: 12/22/2022]
Abstract
AIM Early detection and removal of colorectal cancer (CRC) and advanced adenomas (AAs) decreases the incidence of and mortality from the disease. We aimed to evaluate the potential of faecal volatile organic compounds (VOCs) for detection and follow-up of colorectal adenoma using advanced electronic nose technology. METHOD This was a prospective multi-centre case-control cohort including two district hospitals and one tertiary referral hospital. Patients undergoing colonoscopy were instructed to collect a faecal sample prior to bowel cleansing and were included in the study when CRC, AAs, large adenomas (LAs; 0.5-1.0 cm), small adenomas (SAs; 0.1-0.5 cm) or no endoscopic abnormalities (controls) were observed. Patients undergoing polypectomy and controls were asked for a second sample after 3 months. Faecal VOCs were measured with gas chromatography-ion mobility spectrometry. Random forest, support vector machine, Gaussian process and neural net classification were used to evaluate accuracy. RESULTS In total, 14 patients with CRC, 64 with AAs, 69 with LAs, 127 with SAs and 227 controls were included. A second sample was collected from 32 polypectomy patients and 32 controls. Faecal VOCs discriminated CRC and adenomas from control [AUC (95% CI): CRC vs control 0.96 (0.89-1); AA vs control 0.96 (0.93-1); LA vs control 0.96 (0.92-0.99); SA vs control 0.96 (0.94-0.99)]. There were no significant differences between CRC and adenoma groups. Patients with adenomas and controls were discriminated prior to polypectomy, whereas 3 months after polypectomy VOC profiles were similar [T0 adenoma vs control 0.98 (0.95-1); T1 adenoma vs control 0.55 (0.40-0.69)]. CONCLUSIONS Faecal VOC profiles may be useful for early detection of CRC and adenomas and the timing of polyp surveillance as polypectomy led to a normalization of the VOC profile.
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Affiliation(s)
- S Bosch
- Department of Gastroenterology and Hepatology, AG&M Research Institute, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - R Bot
- Department of Gastroenterology and Hepatology, AG&M Research Institute, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - A Wicaksono
- School of Engineering, University of Warwick, Coventry, UK
| | - E Savelkoul
- Department of Gastroenterology and Hepatology, AG&M Research Institute, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - R van der Hulst
- Department of Gastroenterology and Hepatology, Spaarne Gasthuis, Hoofddorp and Haarlem, The Netherlands
| | - J Kuijvenhoven
- Department of Gastroenterology and Hepatology, Spaarne Gasthuis, Hoofddorp and Haarlem, The Netherlands
| | - P Stokkers
- Department of Gastroenterology and Hepatology, OLVG West, Amsterdam, The Netherlands
| | - E Daulton
- School of Engineering, University of Warwick, Coventry, UK
| | - J A Covington
- School of Engineering, University of Warwick, Coventry, UK
| | - T G J de Meij
- Department of Paediatric Gastroenterology, Amsterdam UMC, Amsterdam, The Netherlands
| | - N K H de Boer
- Department of Gastroenterology and Hepatology, AG&M Research Institute, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
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Raspagliesi F, Bogani G, Benedetti S, Grassi S, Ferla S, Buratti S. Detection of Ovarian Cancer through Exhaled Breath by Electronic Nose: A Prospective Study. Cancers (Basel) 2020; 12:cancers12092408. [PMID: 32854242 PMCID: PMC7565069 DOI: 10.3390/cancers12092408] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 08/22/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Diagnostic methods for the early identification of ovarian cancer (OC) represent an unmet clinical need, as no reliable diagnostic tools are available. Here, we tested the feasibility of electronic nose (e-nose), composed of ten metal oxide semiconductor (MOS) sensors, as a diagnostic tool for OC detection. METHODS Women with suspected ovarian masses and healthy subjects had volatile organic compounds analysis of the exhaled breath using e-nose. RESULTS E-nose analysis was performed on breath samples collected from 251 women divided into three groups: 86 OC cases, 51 benign masses, and 114 controls. Data collected were analyzed by Principal Component Analysis (PCA) and K-Nearest Neighbors' algorithm (K-NN). A first 1-K-NN (cases vs. controls) model has been developed to discriminate between OC cases and controls; the model performance tested in the prediction gave 98% of sensitivity and 95% of specificity, when the strict class prediction was applied; a second 1-K-NN (cases vs. controls + benign) model was built by grouping the non-cancer groups (controls + benign), thus considering two classes, cases and controls + benign; the model performance in the prediction was of 89% for sensitivity and 86% for specificity when the strict class prediction was applied. CONCLUSIONS Our preliminary results suggested the potential role of e-nose for the detection of OC. Further studies aiming to test the potential adoption of e-nose in the early diagnosis of OC are needed.
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Affiliation(s)
- Francesco Raspagliesi
- Department of Gynecologic Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, 20133 Milan, Italy; (F.R.); (S.F.)
| | - Giorgio Bogani
- Department of Gynecologic Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, 20133 Milan, Italy; (F.R.); (S.F.)
- Correspondence: or
| | - Simona Benedetti
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, 20133 Milan, Italy; (S.B.); (S.G.); (S.B.)
| | - Silvia Grassi
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, 20133 Milan, Italy; (S.B.); (S.G.); (S.B.)
| | - Stefano Ferla
- Department of Gynecologic Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, 20133 Milan, Italy; (F.R.); (S.F.)
| | - Susanna Buratti
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, 20133 Milan, Italy; (S.B.); (S.G.); (S.B.)
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Baldini C, Billeci L, Sansone F, Conte R, Domenici C, Tonacci A. Electronic Nose as a Novel Method for Diagnosing Cancer: A Systematic Review. BIOSENSORS-BASEL 2020; 10:bios10080084. [PMID: 32722438 PMCID: PMC7459473 DOI: 10.3390/bios10080084] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 07/13/2020] [Accepted: 07/21/2020] [Indexed: 12/13/2022]
Abstract
Cancer is fast becoming the most important cause of death worldwide, its mortality being mostly caused by late or wrong diagnosis. Novel strategies have been developed to identify early signs of cancer in a minimally obtrusive way, including the Electronic Nose (E-Nose) technology, user-friendly, cost- and time-saving alternative to classical approaches. This systematic review, conducted under the PRISMA guidelines, identified 60 articles directly dealing with the E-Nose application in cancer research published up to 31 January 2020. Among these works, the vast majority reported successful E-Nose use for diagnosing Lung Cancer, showing promising results especially when employing the Aeonose tool, discriminating subjects with Lung Cancer from controls in more than 80% of individuals, in most studies. In order to tailor the main limitations of the proposed approach, including the application of the protocol to advanced stage of cancer, sample heterogeneity and massive confounders, future studies should be conducted on early stage patients, and on larger cohorts, as to better characterize the specific breathprint associated with the various subtypes of cancer. This would ultimately lead to a better and faster diagnosis and to earlier treatment, possibly reducing the burden associated to such conditions.
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Affiliation(s)
- Chiara Baldini
- School of Engineering, University of Pisa, Largo Lucio Lazzarino 1, 56122 Pisa, Italy;
| | - Lucia Billeci
- Institute of Clinical Physiology—National Research Council of Italy (IFC-CNR), Via Moruzzi 1, 56124 Pisa, Italy; (L.B.); (F.S.); (R.C.); (C.D.)
| | - Francesco Sansone
- Institute of Clinical Physiology—National Research Council of Italy (IFC-CNR), Via Moruzzi 1, 56124 Pisa, Italy; (L.B.); (F.S.); (R.C.); (C.D.)
| | - Raffaele Conte
- Institute of Clinical Physiology—National Research Council of Italy (IFC-CNR), Via Moruzzi 1, 56124 Pisa, Italy; (L.B.); (F.S.); (R.C.); (C.D.)
| | - Claudio Domenici
- Institute of Clinical Physiology—National Research Council of Italy (IFC-CNR), Via Moruzzi 1, 56124 Pisa, Italy; (L.B.); (F.S.); (R.C.); (C.D.)
| | - Alessandro Tonacci
- Institute of Clinical Physiology—National Research Council of Italy (IFC-CNR), Via Moruzzi 1, 56124 Pisa, Italy; (L.B.); (F.S.); (R.C.); (C.D.)
- Correspondence:
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Zhou W, Tao J, Li J, Tao S. Volatile organic compounds analysis as a potential novel screening tool for colorectal cancer: A systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e20937. [PMID: 32629696 PMCID: PMC7337537 DOI: 10.1097/md.0000000000020937] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
The purpose of this meta-analysis was to assess the usefulness of volatile organic compounds (VOC) as a potential novel biomarker for colorectal cancer (CRC).We systematically searched PubMed, Embase, Web of Science, and Cochrane Library databases for observational studies (published before November 25th, 2019; no language restrictions) comparing the VOC analysis between patients with CRC and healthy controls. We evaluated the pooled sensitivity, specificity, diagnostic odds ratio, positive and negative likelihood ratio, as well as summary receiver operating characteristic curve and area under the curve.We identified a total of 10 observational studies that included 381 patients with CRC and 436 healthy controls. Bivariate analysis yielded a pooled sensitivity of 0.82 (95% confidence interval [CI] = 0.77-0.86), specificity of 0.79 (95% CI = 0.71-0.85), positive likelihood ratio of 3.8 (95% CI = 2.8-5.3), and negative likelihood ratio of 0.23 (95% CI = 0.17-0.30). The area under the curve was 0.87 (95% CI = 0.84-0.90). The pooled diagnostic odds ratio was 17 (95% CI = 10-28). Sensitivity analysis indicated that the pooled results were stabilized. The Deeks' funnel plot asymmetry test (P = .41) suggested no potential publication bias.Our pooled data confirmed the associations between VOC analysis and CRC, highlighting the usefulness of VOC analysis as a potential novel screening tool for CRC. However, standardization of VOC collection and analysis methods for CRC screening is required in future research.
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Affiliation(s)
- Wenchuan Zhou
- Department of Emergency and Critical Care Medicine, Second Affiliated Hospital of Nanchang University
- Department of Clinical Medicine, The Second Clinical Medical College, Nanchang University, Nanchang, China
| | - Jinxin Tao
- Department of Emergency and Critical Care Medicine, Second Affiliated Hospital of Nanchang University
- Department of Clinical Medicine, The Second Clinical Medical College, Nanchang University, Nanchang, China
| | - Jin Li
- Department of Emergency and Critical Care Medicine, Second Affiliated Hospital of Nanchang University
| | - Shaoyu Tao
- Department of Emergency and Critical Care Medicine, Second Affiliated Hospital of Nanchang University
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Bosch S, Wintjens DSJ, Wicaksono A, Kuijvenhoven J, van der Hulst R, Stokkers P, Daulton E, Pierik MJ, Covington JA, de Meij TGJ, de Boer NKH. The faecal scent of inflammatory bowel disease: Detection and monitoring based on volatile organic compound analysis. Dig Liver Dis 2020; 52:745-752. [PMID: 32402741 DOI: 10.1016/j.dld.2020.03.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 03/07/2020] [Accepted: 03/10/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Inflammatory bowel disease (IBD) is diagnosed and monitored using endoscopic assessment, which is invasive and costly. In this study, potential of faecal volatile organic compounds (VOC) analysis for IBD detection and identification of disease activity was evaluated. METHODS IBD patients visiting outpatient clinics of participating tertiary hospitals were included. Active disease was defined as FCP ≥250 mg/g, remission as FCP <100 mg/g with Harvey Bradshaw Index <4 for Crohn's disease (CD) or Simple Clinical Colitis Activity Index <3 for ulcerative colitis (UC). Healthy controls (HC) were patients without mucosal abnormalities during colonoscopy. Faecal samples were measured using gas chromatography-ion mobility spectrometry. RESULTS A total of 280 IBD patients collected 107 CDa, 84 CDr, 80 UCa and 63 UCr samples. Additionally, 227 HC provided one faecal sample. UC and CD were discriminated from HC with high accuracy (AUC (95%CI): UCa vs HC 0.96(0.94-0.99); UCr vs HC 0.95(0.93-0.98); CDa vs HC 0.96(0.94-0.99); CDr vs HC 0.95(0.93-0.98)). There were small differences between UC and CD (0.55(0.50-0.6)) and no differences between active disease and remission (UCa vs UCr 0.63(0.44-0.82); CDa vs CDr 0.52(0.39-0.65)). CONCLUSION Our study outcomes imply that faecal VOC analysis holds potential for identifying biomarkers for IBD detection but not for monitoring disease activity.
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Affiliation(s)
- Sofie Bosch
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Gastroenterology and Hepatology, AG&M research institute, Amsterdam, The Netherlands.
| | - Dion S J Wintjens
- MUMC+, Maastricht University, Department of Gastroenterology and Hepatology, Maastricht, The Netherlands
| | - Alfian Wicaksono
- University of Warwick, School of Engineering, Coventry, United Kingdom
| | - Johan Kuijvenhoven
- Spaarne Gasthuis, Department of Gastroenterology and Hepatology, Hoofddorp and Haarlem, The Netherlands
| | - René van der Hulst
- Spaarne Gasthuis, Department of Gastroenterology and Hepatology, Hoofddorp and Haarlem, The Netherlands
| | - Pieter Stokkers
- OLVG West, Department of Gastroenterology and hepatology, Amsterdam, The Netherlands
| | - Emma Daulton
- University of Warwick, School of Engineering, Coventry, United Kingdom
| | - Marieke J Pierik
- MUMC+, Maastricht University, Department of Gastroenterology and Hepatology, Maastricht, The Netherlands
| | - James A Covington
- University of Warwick, School of Engineering, Coventry, United Kingdom
| | - Tim G J de Meij
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Pediatric Gastroenterology, AG&M research institute, Amsterdam, The Netherlands
| | - Nanne K H de Boer
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Gastroenterology and Hepatology, AG&M research institute, Amsterdam, The Netherlands
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Pauliukaite R, Voitechovič E. Multisensor Systems and Arrays for Medical Applications Employing Naturally-Occurring Compounds and Materials. SENSORS (BASEL, SWITZERLAND) 2020; 20:E3551. [PMID: 32585936 PMCID: PMC7349305 DOI: 10.3390/s20123551] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 06/17/2020] [Accepted: 06/20/2020] [Indexed: 12/14/2022]
Abstract
The significant improvement of quality of life achieved over the last decades has stimulated the development of new approaches in medicine to take into account the personal needs of each patient. Precision medicine, providing healthcare customization, opens new horizons in the diagnosis, treatment and prevention of numerous diseases. As a consequence, there is a growing demand for novel analytical devices and methods capable of addressing the challenges of precision medicine. For example, various types of sensors or their arrays are highly suitable for simultaneous monitoring of multiple analytes in complex biological media in order to obtain more information about the health status of a patient or to follow the treatment process. Besides, the development of sustainable sensors based on natural chemicals allows reducing their environmental impact. This review is concerned with the application of such analytical platforms in various areas of medicine: analysis of body fluids, wearable sensors, drug manufacturing and screening. The importance and role of naturally-occurring compounds in the development of electrochemical multisensor systems and arrays are discussed.
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Affiliation(s)
- Rasa Pauliukaite
- Department of Nanoengineering, Center for Physical Sciences and Technology, Savanoriu Ave. 231, LT-02300 Vilnius, Lithuania;
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Hosfield BD, Pecoraro AR, Baxter NT, Hawkins TB, Markel TA. The Assessment of Fecal Volatile Organic Compounds in Healthy Infants: Electronic Nose Device Predicts Patient Demographics and Microbial Enterotype. J Surg Res 2020; 254:340-347. [PMID: 32526503 DOI: 10.1016/j.jss.2020.05.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 05/04/2020] [Accepted: 05/05/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND The assessment of fecal volatile organic compounds (VOCs) has emerged as a noninvasive biomarker in many different pathologies. Before assessing whether VOCs can be used to diagnose intestinal diseases, including necrotizing enterocolitis (NEC), it is necessary to measure the impact of variable infant demographic factors on VOC signals. MATERIALS AND METHODS Stool samples were collected from term infants at four hospitals in a large metropolitan area. Samples were heated, and fecal VOCs assessed by the Cyranose 320 Electronic Nose. Twenty-eight sensors were combined into an overall smellprint and were also assessed individually. 16s rRNA gene sequencing was used to categorize infant microbiomes. Smellprints were correlated to feeding type (formula versus breastmilk), sex, hospital of birth, and microbial enterotype. Overall smellprints were assessed by PERMANOVA with Euclidean distances, and individual sensors from each smellprint were assessed by Mann-Whitney U-tests. P < 0.05 was significant. RESULTS Overall smellprints were significantly different according to diet. Individual sensors were significantly different according to sex and hospital of birth, but overall smellprints were not significantly different. Using a decision tree model, two individual sensors could reliably predict microbial enterotype. CONCLUSIONS Assessment of fecal VOCs with an electronic nose is impacted by several demographic characteristics of infants and can be used to predict microbiome composition. Further studies are needed to design appropriate algorithms that are able to predict NEC based on fecal VOC profiles.
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Affiliation(s)
- Brian D Hosfield
- Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana
| | - Anthony R Pecoraro
- Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana
| | | | | | - Troy A Markel
- Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana.
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37
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Zonta G, Malagù C, Gherardi S, Giberti A, Pezzoli A, De Togni A, Palmonari C. Clinical Validation Results of an Innovative Non-Invasive Device for Colorectal Cancer Preventive Screening through Fecal Exhalation Analysis. Cancers (Basel) 2020; 12:cancers12061471. [PMID: 32512911 PMCID: PMC7352827 DOI: 10.3390/cancers12061471] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 05/28/2020] [Accepted: 06/02/2020] [Indexed: 01/05/2023] Open
Abstract
Screening is recommended to reduce both incidence and mortality of colorectal cancer. Currently, many countries employ fecal occult blood test (FOBT). In Emilia-Romagna (Italy), since 2005, FOBT immunochemical version (FIT) is performed every two years on people aged between 50 and 69 years. A colonoscopy is then carried out on those who are FIT positive. However, FIT shows approximately 65% false positives (non-tumoral bleedings), leading to many negative colonoscopies. The use of an economic and easy-to-use method to check FOBT-positives will improve screening effectiveness, reducing costs to the national health service. This work illustrates the results of a three-year clinical validation protocol (started in 2016) of a patented device composed of a core of nanostructured gas sensors. This device was designed to identify CRC presence by fecal volatile compounds, with a non-invasive, in vitro and low-cost analysis. Feces are, in fact, affected by tumor-volatile biomarkers, produced by cellular peroxidation and metabolic alterations. The protocol consisted in the analysis of fecal samples of FIT-positive subjects, using colonoscopy as a gold standard. A total of 398 samples were analyzed with machine learning techniques, leading to a sensitivity and specificity of 84.1% and 82.4%, respectively, and a positive predictive value of 72% (25-35% for FIT).
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Affiliation(s)
- Giulia Zonta
- Department of Physics and Earth Sciences, University of Ferrara, Via Savonarola, 9-44121 Ferrara, Italy; (C.M.); (C.P.)
- SCENT (Semiconductor-Based Electronic Network for Tumors) S.r.l., Via Quadrifoglio 11, 44124 Ferrara, Italy;
- Correspondence: ; Tel.: +39-0532-974286
| | - Cesare Malagù
- Department of Physics and Earth Sciences, University of Ferrara, Via Savonarola, 9-44121 Ferrara, Italy; (C.M.); (C.P.)
- SCENT (Semiconductor-Based Electronic Network for Tumors) S.r.l., Via Quadrifoglio 11, 44124 Ferrara, Italy;
| | - Sandro Gherardi
- SCENT (Semiconductor-Based Electronic Network for Tumors) S.r.l., Via Quadrifoglio 11, 44124 Ferrara, Italy;
| | - Alessio Giberti
- MIST E-R s.c.r.l. (MISTER Smart Innovation), Via P. Gobetti 101, 40129 Bologna, Italy;
| | | | - Aldo De Togni
- Department of Public Health (AUSL)—UO Igiene Pubblica—Via Fausto Beretta, 7-44121 Ferrara, Italy;
| | - Caterina Palmonari
- Department of Physics and Earth Sciences, University of Ferrara, Via Savonarola, 9-44121 Ferrara, Italy; (C.M.); (C.P.)
- Department of Public Health (AUSL)—UO Igiene Pubblica—Via Fausto Beretta, 7-44121 Ferrara, Italy;
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van Dartel D, Schelhaas HJ, Colon AJ, Kho KH, de Vos CC. Breath analysis in detecting epilepsy. J Breath Res 2020; 14:031001. [PMID: 31972555 DOI: 10.1088/1752-7163/ab6f14] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The aim of this proof of concept study is to investigate if an electronic nose (eNose) is able to make a distinction between breath profiles of diagnosed epilepsy patients and epilepsy-free control subjects. An eNose is a non-invasive device, with a working mechanism that is based on the presence of volatile organic compounds (VOCs) in exhaled breath. These VOCs interact with the sensors of the eNose, and the eNose has to be trained to distinguish between breath patterns from patients with a specific disease and control subjects without that disease. During the measurement participants were asked to breathe through the eNose for five minutes via a disposable mouthpiece. Seventy-four epilepsy patients and 110 control subjects were measured to train the eNose and create a classification model. To assess the effects of anti-epileptic drugs (AEDs) usage on the classification, additional test groups were measured: seven patients who (temporarily) did not use AEDs and 11 patients without epilepsy who used AEDs. The results show that an eNose is able to make a distinction between epilepsy and control subjects with a sensitivity of 76%, a specificity of 67%, and an accuracy of 71%. The results of the two additional groups of subjects show that the created model classifies one out of seven epilepsy patients without AEDs and six out of 13 patients without epilepsy but with AEDs correctly. In this proof of concept study, the AeonoseTM is able to differentiate between epilepsy patients and control subjects. However, the number of false positives and false negatives is still high, which suggests that this first model is still mainly based on the usage of various AEDs.
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Affiliation(s)
- Dieuwke van Dartel
- Department of Neurology and Neurosurgery, Medisch Spectrum Twente, Enschede, the Netherlands. Biomedical Signals and Systems group, University of Twente, Enschede, the Netherlands
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Zhgun ES, Ilina EN. Fecal Metabolites As Non-Invasive Biomarkers of Gut Diseases. Acta Naturae 2020; 12:4-14. [PMID: 32742723 PMCID: PMC7385093 DOI: 10.32607/actanaturae.10954] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 03/04/2020] [Indexed: 12/14/2022] Open
Abstract
Recent studies have shown the importance of the human intestinal microbiome in maintaining a healthy gastrointestinal tract, as well as in the development of pathological processes. The intestinal microbiome manifests itself primarily as fecal metabolites. In the past decade, there has been growing interest in studying its composition, which for the most part had to do with the possibility of using the metabolomic analysis in clinical diagnosis. In contrast to the comprehensive description of blood serum, urine, saliva, and cerebrospinal fluid metabolites, data on fecal metabolites is sparse. Despite the instrumental and methodological achievements in the metabolomic analysis in general, the analysis of fecal metabolome remains less well developed, mainly because of the inhomogeneity of its composition and the lack of standardized methods for collecting, processing, and analyzing fecal samples. This review summarizes data on methods for studying and describing various groups of fecal metabolites. It also assesses their potential as tools in the diagnosis of gastrointestinal diseases.
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Affiliation(s)
- E. S. Zhgun
- Federal Research and Clinical Center of Physical-chemical Medicine of Federal Medical Biological Agency, Moscow, 119435 Russia
| | - E. N. Ilina
- Federal Research and Clinical Center of Physical-chemical Medicine of Federal Medical Biological Agency, Moscow, 119435 Russia
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Elevated levels of proinflammatory volatile metabolites in feces of high fat diet fed KK-A y mice. Sci Rep 2020; 10:5681. [PMID: 32231228 PMCID: PMC7105489 DOI: 10.1038/s41598-020-62541-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 03/13/2020] [Indexed: 11/08/2022] Open
Abstract
When the microfloral composition deteriorates, it triggers low-level chronic inflammation associated with several lifestyle-related diseases including obesity and diabetic mellitus. Fecal volatile organic compounds (VOCs) have been found to differ in gastrointestinal diseases as well as intestinal infection. In this study, to evaluate a potential association between the pathogenesis of lifestyle-related diseases and VOCs in the intestinal tract, fecal VOCs from obese/diabetic KK-Ay mice (KK) or controls (C57BL/6J mice; BL) fed a normal or high fat diet (NFD or HFD) were investigated using headspace sampler-GC-EI-MS. Principal component analysis (PCA) of fecal VOC profiles clearly separated the experimental groups depending on the mouse lineage (KK vs BL) and the diet type (NFD vs HFD). 16 s rRNA sequencing revealed that the PCA distribution of VOCs was in parallel with the microfloral composition. We identified that some volatile metabolites including n-alkanals (nonanal and octanal), acetone and phenol were significantly increased in the HFD and/or KK groups. Additionally, these volatile metabolites induced proinflammatory activity in the RAW264 murine macrophage cell line indicating these bioactive metabolites might trigger low-level chronic inflammation. These results suggest that proinflammatory VOCs detected in HFD-fed and/or diabetic model mice might be novel noninvasive diagnosis biomarkers for diabetes.
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van Keulen KE, Jansen ME, Schrauwen RWM, Kolkman JJ, Siersema PD. Volatile organic compounds in breath can serve as a non-invasive diagnostic biomarker for the detection of advanced adenomas and colorectal cancer. Aliment Pharmacol Ther 2020; 51:334-346. [PMID: 31858615 PMCID: PMC7003780 DOI: 10.1111/apt.15622] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 07/03/2019] [Accepted: 12/04/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Colorectal cancer (CRC) is the third most common cancer diagnosis in the Western world. AIM To evaluate exhaled volatile organic compounds (VOCs) as a non-invasive biomarker for the detection of CRC and precursor lesions using an electronic nose. METHODS In this multicentre study adult colonoscopy patients, without inflammatory bowel disease or (previous) malignancy, were invited for breath analysis. Two-thirds of the breath tests were randomly assigned to develop training models which were used to predict the diagnosis of the remaining patients (external validation). In the end, all data were used to develop final-disease models to further improve the discriminatory power of the algorithms. RESULTS Five hundred and eleven breath samples were collected. Sixty-four patients were excluded due to an inadequate breath test (n = 51), incomplete colonoscopy (n = 8) or colitis (n = 5). Classification was based on the most advanced lesion found; CRC (n = 70), advanced adenomas (AAs) (n = 117), non-advanced adenoma (n = 117), hyperplastic polyp (n = 15), normal colonoscopy (n = 125). Training models for CRC and AAs had an area under the curve (AUC) of 0.76 and 0.71 and blind validation resulted in an AUC of 0.74 and 0.61 respectively. Final models for CRC and AAs yielded an AUC of 0.84 (sensitivity 95% and specificity 64%) and 0.73 (sensitivity and specificity 79% and 59%) respectively. CONCLUSIONS This study suggests that exhaled VOCs could potentially serve as a non-invasive biomarker for the detection of CRC and AAs. Future studies including more patients could further improve the discriminatory potential of VOC analysis for the detection of (pre-)malignant colorectal lesions. (https://clinicaltrials.gov Identifier NCT03488537).
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Affiliation(s)
- Kelly E. van Keulen
- Department of Gastroenterology and HepatologyRadboud University Medical CenterNijmegenThe Netherlands
| | - Maud E. Jansen
- Department of Gastroenterology and HepatologyMedisch Spectrum TwenteEnschedeThe Netherlands,University Medical Center GroningenGroningenThe Netherlands
| | | | - Jeroen J. Kolkman
- Department of Gastroenterology and HepatologyMedisch Spectrum TwenteEnschedeThe Netherlands,University Medical Center GroningenGroningenThe Netherlands
| | - Peter D. Siersema
- Department of Gastroenterology and HepatologyRadboud University Medical CenterNijmegenThe Netherlands
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Swanson B, Fogg L, Julion W, Arrieta MT. Electronic Nose Analysis of Exhaled Breath Volatiles to Identify Lung Cancer Cases: A Systematic Review. J Assoc Nurses AIDS Care 2020; 31:71-79. [PMID: 31860595 DOI: 10.1097/jnc.0000000000000146] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The purpose of our review was to analyze evidence of the validity of electronic noses to discriminate persons with lung cancer from healthy control subjects and to advance implications for this technology in the care of people living with HIV. A computerized database search of the literature (published 1946-2018) was conducted to identify studies that used electronic nose-generated smellprints to discriminate persons with lung cancer from healthy control subjects. Fifteen articles met the sampling criteria. In 14 studies, mean sensitivity and specificity values from a single training sample were 84.1% and 80.9%, respectively. Five studies applied the prediction model obtained from the training sample to a separate validation sample; mean sensitivity was 88.2%, and mean specificity was 70.2%. Findings suggest that breath smellprints are valid markers of lung cancer and may be useful screening measures for cancer. No studies included people living with HIV; additional studies are needed to assess generalizability to this population.
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Plat VD, Bootsma BT, Neal M, Nielsen K, Sonneveld DJA, Tersteeg JJC, Crolla RMPH, van Dam DA, Cense HA, Stockmann HBAC, Covington JA, de Meij TGJ, Tuynman JB, de Boer NKH, Daams F. Urinary volatile organic compound markers and colorectal anastomotic leakage. Colorectal Dis 2019; 21:1249-1258. [PMID: 31207011 DOI: 10.1111/codi.14732] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 05/27/2019] [Indexed: 02/08/2023]
Abstract
AIM Inflammatory markers such as serum C-reactive protein (CRP) are used as routine markers to detect anastomotic leakage following colorectal surgery. However, CRP is characterized by a relatively low predictive value, emphasizing the need for the development of novel diagnostic approaches. Volatile organic compounds (VOCs) are gaseous metabolic products deriving from all conceivable bodily excrements and reflect (alterations in) the patient's physical status. Therefore, VOCs are increasingly considered as potential non-invasive diagnostic biomarkers. The aim of this study was to assess the diagnostic accuracy of urinary VOCs for colorectal anastomotic leakage. METHODS In this explorative multicentre study, urinary VOC profiles of 22 patients with confirmed anastomotic leakage and 27 uneventful control patients following colorectal surgery were analysed by field asymmetric ion mobility spectrometry (FAIMS). RESULTS Urinary VOCs of patients with anastomotic leakage could be distinguished from those of control patients with high accuracy: area under the receiver operating characteristics curve 0.91 (95% CI 0.81-1.00, P < 0.001), sensitivity 86% and specificity 93%. Serum CRP was significantly increased in patients with a confirmed anastomotic leak but with lower diagnostic accuracy compared to VOC analysis (area under the receiver operating characteristics curve 0.82, 95% CI 0.68-0.95, P < 0.001). Combining VOCs and CRP did not result in a significant improvement of the diagnostic performance compared to VOCs alone. CONCLUSION Analysis by FAIMS allowed for discrimination between urinary VOC profiles of patients with a confirmed anastomotic leak and control patients following colorectal surgery. A superior accuracy compared to CRP and apparently high specificity was observed, underlining the potential as a non-invasive biomarker for the detection of colorectal anastomotic leakage.
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Affiliation(s)
- V D Plat
- Department of Gastrointestinal Surgery, Amsterdam UMC, VU University Medical Center, Amsterdam, The Netherlands
| | - B T Bootsma
- Department of Gastrointestinal Surgery, Amsterdam UMC, VU University Medical Center, Amsterdam, The Netherlands
| | - M Neal
- Department of Statistics, University of Warwick, Coventry, UK
| | - K Nielsen
- Department of Gastrointestinal Surgery, Dijklander Ziekenhuis, Hoorn, The Netherlands
| | - D J A Sonneveld
- Department of Gastrointestinal Surgery, Dijklander Ziekenhuis, Hoorn, The Netherlands
| | - J J C Tersteeg
- Department of Gastrointestinal Surgery, Amphia Ziekenhuis, Breda, The Netherlands
| | - R M P H Crolla
- Department of Gastrointestinal Surgery, Amphia Ziekenhuis, Breda, The Netherlands
| | - D A van Dam
- Department of Gastrointestinal Surgery, Rode Kruis Ziekenhuis, Beverwijk, The Netherlands
| | - H A Cense
- Department of Gastrointestinal Surgery, Rode Kruis Ziekenhuis, Beverwijk, The Netherlands
| | - H B A C Stockmann
- Department of Gastrointestinal Surgery, Spaarne Gasthuis, Haarlem, The Netherlands
| | - J A Covington
- School of Engineering, University of Warwick, Coventry, UK
| | - T G J de Meij
- Department of Paediatric Gastroenterology and Hepatology, Amsterdam UMC, VU University Medical Center, Amsterdam, The Netherlands
| | - J B Tuynman
- Department of Gastrointestinal Surgery, Amsterdam UMC, VU University Medical Center, Amsterdam, The Netherlands
| | - N K H de Boer
- Department of Gastroenterology and Hepatology, Amsterdam UMC, VU University Medical Center, Amsterdam, The Netherlands
| | - F Daams
- Department of Gastrointestinal Surgery, Amsterdam UMC, VU University Medical Center, Amsterdam, The Netherlands
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McFarlane M, Millard A, Hall H, Savage R, Constantinidou C, Arasaradnam R, Nwokolo C. Urinary volatile organic compounds and faecal microbiome profiles in colorectal cancer. Colorectal Dis 2019; 21:1259-1269. [PMID: 31282600 DOI: 10.1111/codi.14739] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 06/03/2019] [Indexed: 02/06/2023]
Abstract
AIM Volatile organic compounds (VOCs) are potential biomarkers for diagnosing colorectal cancer (CRC). We characterized urinary VOCs from CRC patients, their spouses/cohabitors (spouses) and first-degree relatives (relatives) to determine any differences. Correlation with stool-derived microbiomes was also undertaken. METHODS Urine from 56 CRC patients, 45 spouses and 37 relatives was assayed using liquid chromatography, field asymmetric ion mobility spectrometry (FAIMS), mass spectrometer technology. Analysis was performed using five-fold cross-validation and a random forest classifier. Faecal microbiome 16S rRNA was sequenced using Illumina MiSeq protocols and analysed using UPARSE and QIIME pipelines. VOC and microbiome profiles were also compared before and after cancer treatment. RESULTS Urinary VOC profiles of CRC patients were indistinguishable from either spouses or relatives. When spouses and relatives were grouped together to form a larger non-cancer control group (n = 82), their VOC profiles became distinguishable from those of CRC patients (n = 56) with 69% sensitivity and specificity, area under the curve 0.72 (P < 0.001). Microbiome analysis identified > 1300 operational taxonomic units across all groups. The analysis of similarity R value was 0.067 (P < 0.001), with significantly different bacterial abundances in 82 operational taxonomic units (6.2%) by Kruskal-Wallis testing. CRC patients' VOC or stool microbiome profiles were unchanged after treatment. CONCLUSION Although CRC patients' urinary VOC profiles cannot be differentiated from those of spouses or relatives they can be differentiated from a larger non-cancer control group. Comparison of the groups' microbiomes confirmed differences in bacterial species abundance. The current FAIMS-based assay can detect a unique, but modest, signal in CRC patients' urinary VOCs, which remains unaltered after treatment.
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Affiliation(s)
- M McFarlane
- Department of Gastroenterology, University Hospitals Coventry and Warwickshire, Coventry, UK
| | - A Millard
- Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
| | - H Hall
- Department of Life Sciences, University of Warwick, Coventry, UK
| | - R Savage
- Warwick Systems Biology Centre, University of Warwick, Coventry, UK
| | - C Constantinidou
- Department of Life Sciences, University of Warwick, Coventry, UK
| | - R Arasaradnam
- Department of Gastroenterology, University Hospitals Coventry and Warwickshire, Coventry, UK.,Department of Life Sciences, University of Leicester, Leicester, UK
| | - C Nwokolo
- Department of Gastroenterology, University Hospitals Coventry and Warwickshire, Coventry, UK
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Hissong E, Pittman ME. Colorectal carcinoma screening: Established methods and emerging technology. Crit Rev Clin Lab Sci 2019; 57:22-36. [PMID: 31603697 DOI: 10.1080/10408363.2019.1670614] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Colorectal carcinoma screening programs have shown success in lowering both the incidence and mortality rate of colorectal carcinoma at a population level, in part because this carcinoma is relatively slow growing and has an identifiable premalignant lesion. Still, many patients do not undergo the recommended screening for colorectal carcinoma, and of those who do, a subset may be over- or under-diagnosed by the currently available testing methods. The primary purpose of this article is to review the data regarding currently available colorectal cancer screening modalities, which include fecal occult blood testing, direct colonic visualization, and noninvasive imaging techniques. In addition, readers will be introduced to a variety of biomarkers that may serve as stand-alone or adjunct tests in the future. Finally, there is a brief discussion of the current epidemiologic considerations that public health officials must address as they create population screening guidelines. The data we provide as laboratory physicians and scientists are critical to the construction of appropriate recommendations that ultimately decrease the burden of disease from colorectal carcinoma.
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Affiliation(s)
- Erika Hissong
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York City, NY, USA
| | - Meredith E Pittman
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York City, NY, USA
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Thrift WJ, Cabuslay A, Laird AB, Ranjbar S, Hochbaum AI, Ragan R. Surface-Enhanced Raman Scattering-Based Odor Compass: Locating Multiple Chemical Sources and Pathogens. ACS Sens 2019; 4:2311-2319. [PMID: 31416304 DOI: 10.1021/acssensors.9b00809] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Olfaction is important for identifying and avoiding toxic substances in living systems. Many efforts have been made to realize artificial olfaction systems that reflect the capacity of biological systems. A sophisticated example of an artificial olfaction device is the odor compass which uses chemical sensor data to identify odor source direction. Successful odor compass designs often rely on plume-based detection and mobile robots, where active, mechanical motion of the sensor platform is employed. Passive, diffusion-based odor compasses remain elusive as detection of low analyte concentrations and quantification of small concentration gradients from within the sensor platform are necessary. Further, simultaneously identifying multiple odor sources using an odor compass remains an ongoing challenge, especially for similar analytes. Here, we show that surface-enhanced Raman scattering (SERS) sensors overcome these challenges, and we present the first SERS odor compass. Using a grid array of SERS sensors, machine learning analysis enables reliable identification of multiple odor sources arising from diffusion of analytes from one or two localized sources. Specifically, convolutional neural network and support vector machine classifier models achieve over 90% accuracy for a multiple odor source problem. This system is then used to identify the location of an Escherichia coli biofilm via its complex signature of volatile organic compounds. Thus, the fabricated SERS chemical sensors have the needed limit of detection and quantification for diffusion-based odor compasses. Solving the multiple odor source problem with a passive platform opens a path toward an Internet of things approach to monitor toxic gases and indoor pathogens.
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Review and Comparison of Cancer Biomarker Trends in Urine as a Basis for New Diagnostic Pathways. Cancers (Basel) 2019; 11:cancers11091244. [PMID: 31450698 PMCID: PMC6770126 DOI: 10.3390/cancers11091244] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 08/20/2019] [Accepted: 08/22/2019] [Indexed: 12/24/2022] Open
Abstract
Cancer is one of the major causes of mortality worldwide and its already large burden is projected to increase significantly in the near future with a predicted 22 million new cancer cases and 13 million cancer-related deaths occurring annually by 2030. Unfortunately, current procedures for diagnosis are characterized by low diagnostic accuracies. Given the proved correlation between cancer presence and alterations of biological fluid composition, many researchers suggested their characterization to improve cancer detection at early stages. This paper reviews the information that can be found in the scientific literature, regarding the correlation of different cancer forms with the presence of specific metabolites in human urine, in a schematic and easily interpretable form, because of the huge amount of relevant literature. The originality of this paper relies on the attempt to point out the odor properties of such metabolites, and thus to highlight the correlation between urine odor alterations and cancer presence, which is proven by recent literature suggesting the analysis of urine odor for diagnostic purposes. This investigation aims to evaluate the possibility to compare the results of studies based on different approaches to be able in the future to identify those compounds responsible for urine odor alteration.
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Germanese D, Colantonio S, D'Acunto M, Romagnoli V, Salvati A, Brunetto M. An E-Nose for the Monitoring of Severe Liver Impairment: A Preliminary Study. SENSORS 2019; 19:s19173656. [PMID: 31443499 PMCID: PMC6749560 DOI: 10.3390/s19173656] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 07/25/2019] [Accepted: 08/09/2019] [Indexed: 11/16/2022]
Abstract
Biologically inspired to mammalian olfactory system, electronic noses became popular during the last three decades. In literature, as well as in daily practice, a wide range of applications are reported. Nevertheless, the most pioneering one has been (and still is) the assessment of the human breath composition. In this study, we used a prototype of electronic nose, called Wize Sniffer (WS) and based it on an array of semiconductor gas sensor, to detect ammonia in the breath of patients suffering from severe liver impairment. In the setting of severely impaired liver, toxic substances, such as ammonia, accumulate in the systemic circulation and in the brain. This may result in Hepatic Encephalopathy (HE), a spectrum of neuro-psychiatric abnormalities which include changes in cognitive functions, consciousness, and behaviour. HE can be detected only by specific but time-consuming and burdensome examinations, such as blood ammonia levels assessment and neuro-psychological tests. In the presented proof-of-concept study, we aimed at investigating the possibility of discriminating the severity degree of liver impairment on the basis of the detected breath ammonia, in view of the detection of HE at its early stage.
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Affiliation(s)
- Danila Germanese
- Institute of Information Science and Technology (ISTI), National Research Council (CNR), 56127 Pisa, Italy.
| | - Sara Colantonio
- Institute of Information Science and Technology (ISTI), National Research Council (CNR), 56127 Pisa, Italy
| | - Mario D'Acunto
- Institute of Biophysics (IBF), National Research Council (CNR), 56127 Pisa, Italy
| | - Veronica Romagnoli
- Gastroenterology and Hepatology Unit, University Hospital of Pisa, 56127 Pisa, Italy
| | - Antonio Salvati
- Gastroenterology and Hepatology Unit, University Hospital of Pisa, 56127 Pisa, Italy
| | - Maurizia Brunetto
- Gastroenterology and Hepatology Unit, University Hospital of Pisa, 56127 Pisa, Italy
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The electronic nose technology in clinical diagnosis: A systematic review. Porto Biomed J 2019; 4:e42. [PMID: 31930178 PMCID: PMC6924976 DOI: 10.1097/j.pbj.0000000000000042] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 06/06/2019] [Indexed: 12/13/2022] Open
Abstract
Supplemental Digital Content is available in the text Background: Volatile organic compounds (VOC) are end products of human metabolism (normal and disease-associated) that can be mainly excreted in breath, urine, and feces. Therefore, VOC can be very useful as markers of diseases and helpful for clinicians since its sampling is noninvasive, inexpensive, and painless. Electronic noses, or eNoses, provide an easy and inexpensive way to analyze gas samples. Thus, this device may be used for diagnosis, monitoring or phenotyping diseases according to specific breathprints (breath profile). Objective: In this review, we summarize data showing the ability of eNose to be used as a noninvasive tool to improve diagnosis in clinical settings. Methods: A PRISMA-oriented search was performed in PubMed and Cochrane Library. Only studies performed in humans and published since 2000 were included. Results: A total of 48 original articles, 21 reviews, and 7 other documents were eligible and fully analyzed. The quality assessment of the selected studies was conducted according to the Standards for Reporting of Diagnostic Accuracy. Airway obstructive diseases were the most studied and Cyranose 320 was the most used eNose. Conclusions: Several case–control studies were performed to test this technology in diverse fields. More than a half of the selected studies showed good accuracy. However, there are some limitations regarding sampling methodology, analysis, reproducibility, and external validation that need to be standardized. Additionally, it is urgent to test this technology in intend-to-treat populations. Thus, it is possible to think in the contribution of VOC analysis by eNoses in a clinical setting.
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Bosch S, Lemmen JP, Menezes R, van der Hulst R, Kuijvenhoven J, Stokkers PC, de Meij TG, de Boer NK. The influence of lifestyle factors on fecal volatile organic compound composition as measured by an electronic nose. J Breath Res 2019; 13:046001. [PMID: 31170704 DOI: 10.1088/1752-7163/ab2775] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Fecal volatile organic compounds (VOCs) are gaseous metabolic products which are increasingly considered potential non-invasive biomarkers for the detection of various (gastrointestinal) diseases. The influence of lifestyle factors on fecal VOC patterns remains unexplored but is of importance prior to implementation of VOC analysis as a diagnostic tool. The aim of this study was to investigate the effects of age, gender, body mass index, smoking status, dietary preferences, medication use and co-morbidity on fecal VOC patterns. METHODS For this study, fecal samples of patients undergoing a colonoscopy were collected prior to endoscopy. All participants completed a questionnaire on lifestyle factors, co-morbidity and medication use. Patients without colonic abnormalities were included in this study. Fecal VOC patterns were analyzed by means of an electronic nose (eNose) device (Cyranose® 320). RESULTS From the 1039 participants willing to participate in the initial study, 211 were eligible as controls. All unique lifestyle variables investigated in this study affected the fecal VOC composition. The strongest influences were caused by low BMI, a vegetarian diet and an active smoking status, whereas the least influence was found for the variables gender, age > 55 years and previous smokers. DISCUSSION Age, gender, BMI, smoking habits, dietary preferences, co-morbidity and medication use all have unique effects on fecal VOC composition. Future studies should carefully consider this influence on VOC outcome when defining VOC signatures as biomarker for diagnostic purposes.
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Affiliation(s)
- Sofie Bosch
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Gastroenterology and Hepatology, AG&M Research Institute, Amsterdam, The Netherlands
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