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Zhou M, Wang Q, Lu X, Zhang P, Yang R, Chen Y, Xia J, Chen D. Exhaled breath and urinary volatile organic compounds (VOCs) for cancer diagnoses, and microbial-related VOC metabolic pathway analysis: a systematic review and meta-analysis. Int J Surg 2024; 110:1755-1769. [PMID: 38484261 PMCID: PMC10942174 DOI: 10.1097/js9.0000000000000999] [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: 09/13/2023] [Accepted: 12/04/2023] [Indexed: 03/17/2024]
Abstract
BACKGROUND The gradual evolution of the detection and quantification of volatile organic compounds (VOCs) has been instrumental in cancer diagnosis. The primary objective of this study was to assess the diagnostic potential of exhaled breath and urinary VOCs in cancer detection. As VOCs are indicative of tumor and human metabolism, our work also sought to investigate the metabolic pathways linked to the development of cancerous tumors. MATERIALS AND METHODS An electronic search was performed in the PubMed database. Original studies on VOCs within exhaled breath and urine for cancer detection with a control group were included. A meta-analysis was conducted using a bivariate model to assess the sensitivity and specificity of the VOCs for cancer detection. Fagan's nomogram was designed to leverage the findings from our diagnostic analysis for the purpose of estimating the likelihood of cancer in patients. Ultimately, MetOrigin was employed to conduct an analysis of the metabolic pathways associated with VOCs in relation to both human and/or microbiota. RESULTS The pooled sensitivity, specificity and the area under the curve for cancer screening utilizing exhaled breath and urinary VOCs were determined to be 0.89, 0.88, and 0.95, respectively. A pretest probability of 51% can be considered as the threshold for diagnosing cancers with VOCs. As the estimated pretest probability of cancer exceeds 51%, it becomes more appropriate to emphasize the 'ruling in' approach. Conversely, when the estimated pretest probability of cancer falls below 51%, it is more suitable to emphasize the 'ruling out' approach. A total of 14, 14, 6, and 7 microbiota-related VOCs were identified in relation to lung, colorectal, breast, and liver cancers, respectively. The enrichment analysis of volatile metabolites revealed a significant enrichment of butanoate metabolism in the aforementioned tumor types. CONCLUSIONS The analysis of exhaled breath and urinary VOCs showed promise for cancer screening. In addition, the enrichment analysis of volatile metabolites revealed a significant enrichment of butanoate metabolism in four tumor types, namely lung, colorectum, breast and liver. These findings hold significant implications for the prospective clinical application of multiomics correlation in disease management and the exploration of potential therapeutic targets.
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Affiliation(s)
- Min Zhou
- Department of Breast Surgery, The Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical University, Wuxi Maternity and Child Health Care Hospital
| | - Qinghua Wang
- Research Institute for Reproductive Health and Genetic Diseases, Women’s Hospital of Jiangnan University
| | - Xinyi Lu
- Department of Breast Surgery, The Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical University, Wuxi Maternity and Child Health Care Hospital
| | - Ping Zhang
- Department of Breast Surgery, The Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical University, Wuxi Maternity and Child Health Care Hospital
| | - Rui Yang
- Research Institute for Reproductive Health and Genetic Diseases, Women’s Hospital of Jiangnan University
| | - Yu Chen
- Research Institute for Reproductive Health and Genetic Diseases, Women’s Hospital of Jiangnan University
| | - Jiazeng Xia
- Department of General Surgery and Translational Medicine Center, The Affiliated Wuxi No. 2 People’s Hospital of Nanjing Medical University, Jiangnan University Medical Center, Wuxi, People’s Republic of China
| | - Daozhen Chen
- Department of Breast Surgery, The Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical University, Wuxi Maternity and Child Health Care Hospital
- Research Institute for Reproductive Health and Genetic Diseases, Women’s Hospital of Jiangnan University
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Vassilenko V, Moura PC, Raposo M. Diagnosis of Carcinogenic Pathologies through Breath Biomarkers: Present and Future Trends. Biomedicines 2023; 11:3029. [PMID: 38002028 PMCID: PMC10669878 DOI: 10.3390/biomedicines11113029] [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: 10/04/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 11/26/2023] Open
Abstract
The assessment of volatile breath biomarkers has been targeted with a lot of interest by the scientific and medical communities during the past decades due to their suitability for an accurate, painless, non-invasive, and rapid diagnosis of health states and pathological conditions. This paper reviews the most relevant bibliographic sources aiming to gather the most pertinent volatile organic compounds (VOCs) already identified as putative cancer biomarkers. Here, a total of 265 VOCs and the respective bibliographic sources are addressed regarding their scientifically proven suitability to diagnose a total of six carcinogenic diseases, namely lung, breast, gastric, colorectal, prostate, and squamous cell (oesophageal and laryngeal) cancers. In addition, future trends in the identification of five other forms of cancer, such as bladder, liver, ovarian, pancreatic, and thyroid cancer, through perspective volatile breath biomarkers are equally presented and discussed. All the results already achieved in the detection, identification, and quantification of endogenous metabolites produced by all kinds of normal and abnormal processes in the human body denote a promising and auspicious future for this alternative diagnostic tool, whose future passes by the development and employment of newer and more accurate collection and analysis techniques, and the certification for utilisation in real clinical scenarios.
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Affiliation(s)
- Valentina Vassilenko
- Laboratory for Instrumentation, Biomedical Engineering and Radiation Physics (LIBPhys-UNL), Department of Physics, NOVA School of Science and Technology, NOVA University of Lisbon, Campus FCT-UNL, 2829-516 Caparica, Portugal;
| | - Pedro Catalão Moura
- Laboratory for Instrumentation, Biomedical Engineering and Radiation Physics (LIBPhys-UNL), Department of Physics, NOVA School of Science and Technology, NOVA University of Lisbon, Campus FCT-UNL, 2829-516 Caparica, Portugal;
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Shinozuka T, Kanda M, Kodera Y. Site-specific protein biomarkers in gastric cancer: a comprehensive review of novel biomarkers and clinical applications. Expert Rev Mol Diagn 2023; 23:701-712. [PMID: 37395000 DOI: 10.1080/14737159.2023.2232298] [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: 04/27/2023] [Accepted: 06/29/2023] [Indexed: 07/04/2023]
Abstract
INTRODUCTION Gastric cancer (GC) is the fifth most common cancer and the fourth leading cause of cancer-related death worldwide, thus representing a significant global health burden. Early detection and monitoring of GC are essential to improve patient outcomes. While traditional cancer biomarkers such as carcinoembryonic antigen, carbohydrate antigen (CA) 19-9, and CA 72-4 are widely used, their limited sensitivity and specificity necessitate the exploration of alternative biomarkers. AREAS COVERED This review comprehensively analyzes the landscape of GC protein biomarkers identified from 2019 to 2022, with a focus on tissue, blood, urine, saliva, gastric juice, ascites, and exhaled breath as sample sources. We address the potential clinical applications of these biomarkers in early diagnosis, monitoring recurrence, and predicting survival and therapeutic response of GC patients. EXPERT OPINION The discovery of novel protein biomarkers holds great promise for improving the clinical management of GC. However, further validation in large, diverse cohorts is needed to establish the clinical utility of these biomarkers. Integrating these biomarkers with existing diagnostic and monitoring approaches will likely lead to improved personalized treatment plans and patient outcomes.
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Affiliation(s)
- Takahiro Shinozuka
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Mitsuro Kanda
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yasuhiro Kodera
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Acem I, van Praag VM, Mostert CQ, van der Wal RJ, Neijenhuis RM, Verhoef C, Grünhagen DJ, van de Sande MA. Noninvasive detection of soft tissue sarcoma using volatile organic compounds in exhaled breath: a pilot study. Future Oncol 2023; 19:697-704. [PMID: 37129048 DOI: 10.2217/fon-2022-1122] [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] [Indexed: 05/03/2023] Open
Abstract
Aim: The aim of this pilot study was to assess whether an electronic nose can detect patients with soft tissue sarcoma (STS) based on volatile organic compound profiles in exhaled breath. Patients & methods: In this cross-sectional pilot study, patients with primary STS and healthy controls, matched on sex and age, were included for breath analysis. Machine learning techniques were used to develop the best-fitting model. Results: Fifty-nine breath samples were collected (29 STS and 30 control) from March 2018 to March 2022. The final model yielded a c-statistic of 0.85 with a sensitivity of 83% and specificity of 60%. Conclusion: This study suggests that exhaled volatile organic compound analysis could serve as a noninvasive diagnostic biomarker for the detection of STS with a good performance.
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Affiliation(s)
- Ibtissam Acem
- Department of Surgical Oncology & Gastrointestinal Surgery, Erasmus MC Cancer Institute, Dr. Molewaterplein 40, Rotterdam, 3015, GD, The Netherlands
- Department of Orthopedic Oncology, Leiden University Medical Centre, Albinusdreef 2, Leiden, 2333, ZA, The Netherlands
| | - Veroniek M van Praag
- Department of Orthopedic Oncology, Leiden University Medical Centre, Albinusdreef 2, Leiden, 2333, ZA, The Netherlands
| | - Cassidy Qb Mostert
- Department of Orthopedic Oncology, Leiden University Medical Centre, Albinusdreef 2, Leiden, 2333, ZA, The Netherlands
| | - Robert Jp van der Wal
- Department of Orthopedic Oncology, Leiden University Medical Centre, Albinusdreef 2, Leiden, 2333, ZA, The Netherlands
| | - Ralph Ml Neijenhuis
- Department of Orthopedic Oncology, Leiden University Medical Centre, Albinusdreef 2, Leiden, 2333, ZA, The Netherlands
| | - Cornelis Verhoef
- Department of Surgical Oncology & Gastrointestinal Surgery, Erasmus MC Cancer Institute, Dr. Molewaterplein 40, Rotterdam, 3015, GD, The Netherlands
| | - Dirk J Grünhagen
- Department of Surgical Oncology & Gastrointestinal Surgery, Erasmus MC Cancer Institute, Dr. Molewaterplein 40, Rotterdam, 3015, GD, The Netherlands
| | - Michiel Aj van de Sande
- Department of Orthopedic Oncology, Leiden University Medical Centre, Albinusdreef 2, Leiden, 2333, ZA, The Netherlands
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Development of an Algorithm for Cervical High-Grade Squamous Intraepithelial Lesion Based on Breath Print Analysis. J Low Genit Tract Dis 2022; 27:7-11. [PMID: 36196881 DOI: 10.1097/lgt.0000000000000707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This study was designed to develop an algorithm for the diagnosis of cervical high-grade squamous intraepithelial lesions (HSIL), based on patterns of volatile organic compounds, evaluated using an e-nose. METHODS For this pilot study, the study population consisted of a group of 25 patients with histologically confirmed HSIL and a group of 26 controls. Controls consisted of women visiting the outpatient department for gynecological complaints unrelated to cancer. Women had a negative high-risk human papillomavirus and/or normal cytology (negative for intraepithelial lesions of malignancy) of their most recent test performed in the context of participation in routine cervical cancer screening. Breath tests were performed and labeled with the correct diagnosis. Machine-learning techniques were used to develop a model for predicting HSIL. Based on the receiver operating characteristics curve, both sensitivity and specificity were calculated. RESULTS Individual classifications of all patients with HSIL and controls, as calculated by the model, showed a sensitivity of 0.88 (95% CI = 0.68-0.97) and specificity of 0.92 (95% CI = 0.73-0.99). The positive predictive value and the negative predictive value were 0.92 (95% CI = 0.72-0.99) and 0.89 (95% CI = 0.70-0.97), respectively. The Cohen κ coefficient was 0.80. CONCLUSIONS E-nose can detect distinctive patterns of volatile organic compounds between cervical HSIL patients and controls. Validation of the algorithm in further studies is necessary before possible implementation into daily practice.
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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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Scheepers MHMC, Al-Difaie Z, Brandts L, Peeters A, van Grinsven B, Bouvy ND. Diagnostic Performance of Electronic Noses in Cancer Diagnoses Using Exhaled Breath: A Systematic Review and Meta-analysis. JAMA Netw Open 2022; 5:e2219372. [PMID: 35767259 PMCID: PMC9244610 DOI: 10.1001/jamanetworkopen.2022.19372] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
IMPORTANCE There has been a growing interest in the use of electronic noses (e-noses) in detecting volatile organic compounds in exhaled breath for the diagnosis of cancer. However, no systematic evaluation has been performed of the overall diagnostic accuracy and methodologic challenges of using e-noses for cancer detection in exhaled breath. OBJECTIVE To provide an overview of the diagnostic accuracy and methodologic challenges of using e-noses for the detection of cancer. DATA SOURCES An electronic search was performed in the PubMed and Embase databases (January 1, 2000, to July 1, 2021). STUDY SELECTION Inclusion criteria were the following: (1) use of e-nose technology, (2) detection of cancer, and (3) analysis of exhaled breath. Exclusion criteria were (1) studies published before 2000; (2) studies not performed in humans; (3) studies not performed in adults; (4) studies that only analyzed biofluids; and (5) studies that exclusively used gas chromatography-mass spectrometry to analyze exhaled breath samples. DATA EXTRACTION AND SYNTHESIS PRISMA guidelines were used for the identification, screening, eligibility, and selection process. Quality assessment was performed using Quality Assessment of Diagnostic Accuracy Studies 2. Generalized mixed-effects bivariate meta-analysis was performed. MAIN OUTCOMES AND MEASURES Main outcomes were sensitivity, specificity, and mean area under the receiver operating characteristic curve. RESULTS This review identified 52 articles with a total of 3677 patients with cancer. All studies were feasibility studies. The sensitivity of e-noses ranged from 48.3% to 95.8% and the specificity from 10.0% to 100.0%. Pooled analysis resulted in a mean (SE) area under the receiver operating characteristic curve of 94% (95% CI, 92%-96%), a sensitivity of 90% (95% CI, 88%-92%), and a specificity of 87% (95% CI, 81%-92%). Considerable heterogeneity existed among the studies because of differences in the selection of patients, endogenous and exogenous factors, and collection of exhaled breath. CONCLUSIONS AND RELEVANCE Results of this review indicate that e-noses have a high diagnostic accuracy for the detection of cancer in exhaled breath. However, most studies were feasibility studies with small sample sizes, a lack of standardization, and a high risk of bias. The lack of standardization and reproducibility of e-nose research should be addressed in future research.
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Affiliation(s)
- Max H. M. C. Scheepers
- GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands
| | - Zaid Al-Difaie
- GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands
| | - Lloyd Brandts
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, the Netherlands
| | - Andrea Peeters
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, the Netherlands
| | - Bart van Grinsven
- Sensor Engineering, Faculty of Science and Engineering, Maastricht University, Maastricht, the Netherlands
| | - Nicole D. Bouvy
- Department of Surgery, Maastricht University Medical Center, Maastricht, the Netherlands
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Modular Point-of-Care Breath Analyzer and Shape Taxonomy-Based Machine Learning for Gastric Cancer Detection. Diagnostics (Basel) 2022; 12:diagnostics12020491. [PMID: 35204584 PMCID: PMC8871298 DOI: 10.3390/diagnostics12020491] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/01/2022] [Accepted: 02/11/2022] [Indexed: 01/17/2023] Open
Abstract
Background: Gastric cancer is one of the deadliest malignant diseases, and the non-invasive screening and diagnostics options for it are limited. In this article, we present a multi-modular device for breath analysis coupled with a machine learning approach for the detection of cancer-specific breath from the shapes of sensor response curves (taxonomies of clusters). Methods: We analyzed the breaths of 54 gastric cancer patients and 85 control group participants. The analysis was carried out using a breath analyzer with gold nanoparticle and metal oxide sensors. The response of the sensors was analyzed on the basis of the curve shapes and other features commonly used for comparison. These features were then used to train machine learning models using Naïve Bayes classifiers, Support Vector Machines and Random Forests. Results: The accuracy of the trained models reached 77.8% (sensitivity: up to 66.54%; specificity: up to 92.39%). The use of the proposed shape-based features improved the accuracy in most cases, especially the overall accuracy and sensitivity. Conclusions: The results show that this point-of-care breath analyzer and data analysis approach constitute a promising combination for the detection of gastric cancer-specific breath. The cluster taxonomy-based sensor reaction curve representation improved the results, and could be used in other similar applications.
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Wojnowski W, Kalinowska K. Machine Learning and Electronic Noses for Medical Diagnostics. Artif Intell Med 2022. [DOI: 10.1007/978-3-030-64573-1_329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
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Hu W, Wu W, Jian Y, Haick H, Zhang G, Qian Y, Yuan M, Yao M. Volatolomics in healthcare and its advanced detection technology. NANO RESEARCH 2022; 15:8185-8213. [PMID: 35789633 PMCID: PMC9243817 DOI: 10.1007/s12274-022-4459-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/18/2022] [Accepted: 04/20/2022] [Indexed: 05/21/2023]
Abstract
Various diseases increasingly challenge the health status and life quality of human beings. Volatolome emitted from patients has been considered as a potential family of markers, volatolomics, for diagnosis/screening. There are two fundamental issues of volatolomics in healthcare. On one hand, the solid relationship between the volatolome and specific diseases needs to be clarified and verified. On the other hand, effective methods should be explored for the precise detection of volatolome. Several comprehensive review articles had been published in this field. However, a timely and systematical summary and elaboration is still desired. In this review article, the research methodology of volatolomics in healthcare is critically considered and given out, at first. Then, the sets of volatolome according to specific diseases through different body sources and the analytical instruments for their identifications are systematically summarized. Thirdly, the advanced electronic nose and photonic nose technologies for volatile organic compounds (VOCs) detection are well introduced. The existed obstacles and future perspectives are deeply thought and discussed. This article could give a good guidance to researchers in this interdisciplinary field, not only understanding the cutting-edge detection technologies for doctors (medicinal background), but also making reference to clarify the choice of aimed VOCs during the sensor research for chemists, materials scientists, electronics engineers, etc.
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Affiliation(s)
- Wenwen Hu
- School of Aerospace Science and Technology, Xidian University, Xi’an, 730107 China
| | - Weiwei Wu
- Interdisciplinary Research Center of Smart Sensors, School of Advanced Materials and Nanotechnology, Xidian University, Xi’an, 730107 China
| | - Yingying Jian
- Interdisciplinary Research Center of Smart Sensors, School of Advanced Materials and Nanotechnology, Xidian University, Xi’an, 730107 China
| | - Hossam Haick
- Faculty of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa, 3200002 Israel
| | - Guangjian Zhang
- Department of Thoracic Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710061 China
| | - Yun Qian
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006 China
| | - Miaomiao Yuan
- The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518033 China
| | - Mingshui Yao
- State Key Laboratory of Multi-phase Complex Systems, Institute of Process Engineering, Chinese Academy of Sciences, Beijing, 310006 China
- Institute for Integrated Cell-Material Sciences, Kyoto University Institute for Advanced Study, Kyoto University, Kyoto, 606-8501 Japan
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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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Dima AC, Balaban DV, Dima A. Diagnostic Application of Volatile Organic Compounds as Potential Biomarkers for Detecting Digestive Neoplasia: A Systematic Review. Diagnostics (Basel) 2021; 11:diagnostics11122317. [PMID: 34943554 PMCID: PMC8700395 DOI: 10.3390/diagnostics11122317] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 11/30/2021] [Accepted: 12/03/2021] [Indexed: 02/07/2023] Open
Abstract
Volatile organic compounds (VOCs) are part of the exhaled breath that were proposed as non-invasive breath biomarkers via different human discharge products like saliva, breath, urine, blood, or tissues. Particularly, due to the non-invasive approach, VOCs were considered as potential biomarkers for non-invasive early cancer detection. We herein aimed to review the data over VOCs utility in digestive neoplasia as early diagnosis or monitoring biomarkers. A systematic literature search was done using MEDLINE via PubMed, Cochrane Library, and Thomson Reuters' Web of Science Core Collection. We identified sixteen articles that were included in the final analysis. Based on the current knowledge, we cannot identify a single VOC as a specific non-invasive biomarker for digestive neoplasia. Several combinations of up to twelve VOCs seem promising for accurately detecting some neoplasia types. A combination of different VOCs breath expression are promising tools for digestive neoplasia screening.
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Affiliation(s)
- Augustin Catalin Dima
- Department of General Surgery and Department of Gastroenterology, Dr. Carol Davila Central Military Emergency University Hospital, 010825 Bucharest, Romania;
- Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Daniel Vasile Balaban
- Department of General Surgery and Department of Gastroenterology, Dr. Carol Davila Central Military Emergency University Hospital, 010825 Bucharest, Romania;
- Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Correspondence:
| | - Alina Dima
- Department of Rheumatology, Colentina Clinical Hospital, 020125 Bucharest, Romania;
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Wintjens AGWE, Hintzen KFH, Engelen SME, Lubbers T, Savelkoul PHM, Wesseling G, van der Palen JAM, Bouvy ND. Applying the electronic nose for pre-operative SARS-CoV-2 screening. Surg Endosc 2021; 35:6671-6678. [PMID: 33269428 PMCID: PMC7709806 DOI: 10.1007/s00464-020-08169-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 11/15/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Infection with SARS-CoV-2 causes corona virus disease (COVID-19). The most standard diagnostic method is reverse transcription-polymerase chain reaction (RT-PCR) on a nasopharyngeal and/or an oropharyngeal swab. The high occurrence of false-negative results due to the non-presence of SARS-CoV-2 in the oropharyngeal environment renders this sampling method not ideal. Therefore, a new sampling device is desirable. This proof-of-principle study investigated the possibility to train machine-learning classifiers with an electronic nose (Aeonose) to differentiate between COVID-19-positive and negative persons based on volatile organic compounds (VOCs) analysis. METHODS Between April and June 2020, participants were invited for breath analysis when a swab for RT-PCR was collected. If the RT-PCR resulted negative, the presence of SARS-CoV-2-specific antibodies was checked to confirm the negative result. All participants breathed through the Aeonose for five minutes. This device contains metal-oxide sensors that change in conductivity upon reaction with VOCs in exhaled breath. These conductivity changes are input data for machine learning and used for pattern recognition. The result is a value between - 1 and + 1, indicating the infection probability. RESULTS 219 participants were included, 57 of which COVID-19 positive. A sensitivity of 0.86 and a negative predictive value (NPV) of 0.92 were found. Adding clinical variables to machine-learning classifier via multivariate logistic regression analysis, the NPV improved to 0.96. CONCLUSIONS The Aeonose can distinguish COVID-19 positive from negative participants based on VOC patterns in exhaled breath with a high NPV. The Aeonose might be a promising, non-invasive, and low-cost triage tool for excluding SARS-CoV-2 infection in patients elected for surgery.
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Affiliation(s)
- Anne G W E Wintjens
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Kim F H Hintzen
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Sanne M E Engelen
- Department of Surgery, Maastricht University Medical Center, PO Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - Tim Lubbers
- Department of Surgery, Maastricht University Medical Center, PO Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - Paul H M Savelkoul
- Department of Medical Microbiology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Geertjan Wesseling
- Department of Respiratory Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Job A M van der Palen
- Department of Research Methodology, Measurement, and Data Analysis, University of Twente, Enschede, The Netherlands
- Department of Epidemiology, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Nicole D Bouvy
- Department of Surgery, Maastricht University Medical Center, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.
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14
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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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15
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Zhang J, Tian Y, Luo Z, Qian C, Li W, Duan Y. Breath volatile organic compound analysis: an emerging method for gastric cancer detection. J Breath Res 2021; 15. [PMID: 34610588 DOI: 10.1088/1752-7163/ac2cde] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 10/05/2021] [Indexed: 12/14/2022]
Abstract
Gastric cancer is a common malignancy, being the fifth most frequently diagnosed cancer and the fourth leading cause of cancer-related deaths worldwide. Diagnosis of gastric cancer at the early stage is critical to effectively improve the survival rate. However, a substantial proportion of patients with gastric cancer in the early stages lack specific symptoms or are asymptomatic. Moreover, the imaging techniques currently used for gastric cancer screening, such as computed tomography and barium examination, are usually radioactive and have low sensitivity and specificity. Even though endoscopy has high accuracy for gastric cancer screening, its application is limited by the invasiveness of the technique. Breath analysis is an economic, effective, easy to perform, non-invasive detection method, and has no undesirable side effects on subjects. Extensive worldwide research has been conducted on breath volatile organic compounds (VOCs), which reveals its prospect as a potential method for gastric cancer detection. Many interesting results have been obtained and innovative methods have been introduced in this subject; hence, an extensive review would be beneficial. By providing a comprehensive list of breath VOCs identified by gastric cancer would promote further research in this field. This review summarizes the commonly used technologies for exhaled breath analysis, focusing on the application of analytical instruments in the detection of breath VOCs in gastric cancers, and the alterations in the profile of breath biomarkers in gastric cancer patients are discussed as well.
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Affiliation(s)
- Jing Zhang
- Research Center of Analytical Instrumentation, Key Laboratory of Synthetic and Natural Functional Molecule Chemistry of Ministry of Education, College of Chemistry & Materials Science, Northwest University, Xi'an 710069, People's Republic of China
| | - Yonghui Tian
- Research Center of Analytical Instrumentation, Key Laboratory of Synthetic and Natural Functional Molecule Chemistry of Ministry of Education, College of Chemistry & Materials Science, Northwest University, Xi'an 710069, People's Republic of China
| | - Zewei Luo
- Research Center of Analytical Instrumentation, Key Laboratory of Synthetic and Natural Functional Molecule Chemistry of Ministry of Education, College of Chemistry & Materials Science, Northwest University, Xi'an 710069, People's Republic of China
| | - Cheng Qian
- Shaanxi Key Laboratory of Earth Surface System and Environmental Carrying Capacity, College of Urban and Environmental Sciences, Northwest University, Xi'an 710127, People's Republic of China
| | - Wenwen Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - Yixiang Duan
- Research Center of Analytical Instrumentation, Key Laboratory of Synthetic and Natural Functional Molecule Chemistry of Ministry of Education, College of Chemistry & Materials Science, Northwest University, Xi'an 710069, People's Republic of China
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16
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Kim C, Raja IS, Lee JM, Lee JH, Kang MS, Lee SH, Oh JW, Han DW. Recent Trends in Exhaled Breath Diagnosis Using an Artificial Olfactory System. BIOSENSORS 2021; 11:337. [PMID: 34562928 PMCID: PMC8467588 DOI: 10.3390/bios11090337] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/06/2021] [Accepted: 09/10/2021] [Indexed: 12/26/2022]
Abstract
Artificial olfactory systems are needed in various fields that require real-time monitoring, such as healthcare. This review introduces cases of detection of specific volatile organic compounds (VOCs) in a patient's exhaled breath and discusses trends in disease diagnosis technology development using artificial olfactory technology that analyzes exhaled human breath. We briefly introduce algorithms that classify patterns of odors (VOC profiles) and describe artificial olfactory systems based on nanosensors. On the basis of recently published research results, we describe the development trend of artificial olfactory systems based on the pattern-recognition gas sensor array technology and the prospects of application of this technology to disease diagnostic devices. Medical technologies that enable early monitoring of health conditions and early diagnosis of diseases are crucial in modern healthcare. By regularly monitoring health status, diseases can be prevented or treated at an early stage, thus increasing the human survival rate and reducing the overall treatment costs. This review introduces several promising technical fields with the aim of developing technologies that can monitor health conditions and diagnose diseases early by analyzing exhaled human breath in real time.
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Affiliation(s)
- Chuntae Kim
- BIO-IT Foundry Technology Institute, Pusan National University, Busan 46241, Korea
| | | | - Jong-Min Lee
- School of Nano Convergence Technology, Hallym University, Chuncheon 24252, Korea
| | | | - Moon Sung Kang
- Department of Cogno-Mechatronics Engineering, Pusan National University, Busan 46241, Korea
| | - Seok Hyun Lee
- Department of Cogno-Mechatronics Engineering, Pusan National University, Busan 46241, Korea
| | - Jin-Woo Oh
- BIO-IT Foundry Technology Institute, Pusan National University, Busan 46241, Korea
- Department of Nanoenergy Engineering, Pusan National University, Busan 46241, Korea
| | - Dong-Wook Han
- BIO-IT Foundry Technology Institute, Pusan National University, Busan 46241, Korea
- Department of Cogno-Mechatronics Engineering, Pusan National University, Busan 46241, Korea
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17
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Hintzen KFH, Grote J, Wintjens AGWE, Lubbers T, Eussen MMM, van Schooten FJ, Bouvy ND, Peeters A. Breath analysis for the detection of digestive tract malignancies: systematic review. BJS Open 2021; 5:6226007. [PMID: 33855362 PMCID: PMC8047095 DOI: 10.1093/bjsopen/zrab013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 11/27/2020] [Accepted: 02/03/2021] [Indexed: 01/01/2023] Open
Abstract
Background In recent decades there has been growing interest in the use of volatile organic compounds (VOCs) in exhaled breath as biomarkers for the diagnosis of multiple variants of cancer. This review aimed to evaluate the diagnostic accuracy and current status of VOC analysis in exhaled breath for the detection of cancer in the digestive tract. Methods PubMed and the Cochrane Library database were searched for VOC analysis studies, in which exhaled air was used to detect gastro-oesophageal, liver, pancreatic, and intestinal cancer in humans, Quality assessment was performed using the QUADAS-2 criteria. Data on diagnostic performance, VOCs with discriminative power, and methodological information were extracted from the included articles. Results Twenty-three articles were included (gastro-oesophageal cancer n = 14, liver cancer n = 1, pancreatic cancer n = 2, colorectal cancer n = 6). Methodological issues included different modalities of patient preparation and sampling and platform used. The sensitivity and specificity of VOC analysis ranged from 66.7 to 100 per cent and from 48.1 to 97.9 per cent respectively. Owing to heterogeneity of the studies, no pooling of the results could be performed. Of the VOCs found, 32 were identified in more than one study. Nineteen were reported as cancer type-specific, whereas 13 were found in different cancer types. Overall, decanal, nonanal, and acetone were the most frequently identified. Conclusion The literature on VOC analysis has documented a lack of standardization in study designs. Heterogeneity between the studies and insufficient validation of the results make interpretation of the outcomes challenging. To reach clinical applicability, future studies on breath analysis should provide an accurate description of the methodology and validate their findings.
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Affiliation(s)
- K F H Hintzen
- Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands.,Department of Pharmacology and Toxicology, Maastricht University, Maastricht, the Netherlands
| | - J Grote
- Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - A G W E Wintjens
- Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - T Lubbers
- Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - M M M Eussen
- Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - F J van Schooten
- Department of Pharmacology and Toxicology, Maastricht University, Maastricht, the Netherlands
| | - N D Bouvy
- Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - A Peeters
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, the Netherlands
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18
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Xiang L, Wu S, Hua Q, Bao C, Liu H. Volatile Organic Compounds in Human Exhaled Breath to Diagnose Gastrointestinal Cancer: A Meta-Analysis. Front Oncol 2021; 11:606915. [PMID: 33747921 PMCID: PMC7970758 DOI: 10.3389/fonc.2021.606915] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 01/21/2021] [Indexed: 12/11/2022] Open
Abstract
Introduction Human exhaled volatile organic compounds (VOCs) are being extensively studied for the purposes of noninvasive cancer diagnoses. This article was primarily to assess the feasibility of utilizing exhaled VOCs analysis for gastrointestinal cancer (GIC) diagnosis. Methods PRISMA-based system searches were conducted for related studies of exhaled VOCs in GIC diagnosis based on predetermined criteria. Relevant articles on colorectal cancer and gastroesophageal cancer were summarized, and meta analysis was performed on articles providing sensitivity and specificity data. Results From 2,227 articles, 14 were found to meet inclusion criteria, six of which were on colorectal cancer (CRC) and eight on Gastroesophageal cancer(GEC). Five articles could provide specific data of sensitivity and specificity in GEC, which were used for meta-analysis. The pooled sensitivity, specificity, diagnostic odds ratio (DOR), and area under the curve (AUC) were calculated based on the combination of these data, and were 85.0% [95% confidence interval (CI): 79.0%-90.0%], 89.0% (95%CI: 86.0%-91.0%), 41.30 (21.56-79.10), and 0.93, respectively. Conclusion VOCs can distinguish gastrointestinal cancers from other gastrointestinal diseases, opening up a new avenue for the diagnosis and identification of gastrointestinal cancers, and the analysis of VOCs in exhaled breath has potential clinical application in screening. VOCs are promising tumor biomarkers for GIC diagnosis. Furthermore, limitations like the heterogeneity of diagnostic VOCs between studies should be minded.
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Affiliation(s)
- Lijuan Xiang
- Department of Tumor Biotherapy (5th Ward of the Department of Oncology), Anhui Provincial Cancer Hospital, West District of The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.,Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Sihan Wu
- Department of Tumor Biotherapy (5th Ward of the Department of Oncology), Anhui Provincial Cancer Hospital, West District of The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.,Department of Oncology, Affiliated Provincial Hospital of Anhui Medical University, Hefei, China
| | - Qingling Hua
- Department of Oncology, Yijishan Hospital, Wannan Medical College, Wuhu, China
| | - Chuyang Bao
- Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Hu Liu
- Department of Tumor Biotherapy (5th Ward of the Department of Oncology), Anhui Provincial Cancer Hospital, West District of The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
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19
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Machine Learning and Electronic Noses for Medical Diagnostics. Artif Intell Med 2021. [DOI: 10.1007/978-3-030-58080-3_329-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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20
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Chernov VI, Choynzonov EL, Kulbakin DE, Obkhodskaya EV, Obkhodskiy AV, Popov AS, Sachkov VI, Sachkova AS. Cancer Diagnosis by Neural Network Analysis of Data from Semiconductor Sensors. Diagnostics (Basel) 2020; 10:E677. [PMID: 32899544 PMCID: PMC7555125 DOI: 10.3390/diagnostics10090677] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 08/19/2020] [Accepted: 09/04/2020] [Indexed: 01/27/2023] Open
Abstract
"Electronic nose" technology, including technical and software tools to analyze gas mixtures, is promising regarding the diagnosis of malignant neoplasms. This paper presents the research results of breath samples analysis from 59 people, including patients with a confirmed diagnosis of respiratory tract cancer. The research was carried out using a gas analytical system including a sampling device with 14 metal oxide sensors and a computer for data analysis. After digitization and preprocessing, the data were analyzed by a neural network with perceptron architecture. As a result, the accuracy of determining oncological disease was 81.85%, the sensitivity was 90.73%, and the specificity was 61.39%.
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Affiliation(s)
- Vladimir I. Chernov
- Tomsk National Research Medical Center of the Russian Academy of Sciences, Cancer Research Institute, 5 Kooperativny Street, 634009 Tomsk, Russia; (V.I.C.); (E.L.C.); (D.E.K.)
| | - Evgeniy L. Choynzonov
- Tomsk National Research Medical Center of the Russian Academy of Sciences, Cancer Research Institute, 5 Kooperativny Street, 634009 Tomsk, Russia; (V.I.C.); (E.L.C.); (D.E.K.)
| | - Denis E. Kulbakin
- Tomsk National Research Medical Center of the Russian Academy of Sciences, Cancer Research Institute, 5 Kooperativny Street, 634009 Tomsk, Russia; (V.I.C.); (E.L.C.); (D.E.K.)
| | - Elena V. Obkhodskaya
- Laboratory of Chemical Technologies, National Research Tomsk State University, 36 Lenin Avenue, 634050 Tomsk, Russia; (E.V.O.); (A.S.P.)
| | - Artem V. Obkhodskiy
- Laboratory of Chemical Technologies, National Research Tomsk State University, 36 Lenin Avenue, 634050 Tomsk, Russia; (E.V.O.); (A.S.P.)
- School of Nuclear Science & Engineering, National Research Tomsk Polytechnic University, 30 Lenin Avenue, 634050 Tomsk, Russia;
| | - Aleksandr S. Popov
- Laboratory of Chemical Technologies, National Research Tomsk State University, 36 Lenin Avenue, 634050 Tomsk, Russia; (E.V.O.); (A.S.P.)
- School of Nuclear Science & Engineering, National Research Tomsk Polytechnic University, 30 Lenin Avenue, 634050 Tomsk, Russia;
| | - Victor I. Sachkov
- Laboratory of Chemical Technologies, National Research Tomsk State University, 36 Lenin Avenue, 634050 Tomsk, Russia; (E.V.O.); (A.S.P.)
| | - Anna S. Sachkova
- School of Nuclear Science & Engineering, National Research Tomsk Polytechnic University, 30 Lenin Avenue, 634050 Tomsk, Russia;
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21
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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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22
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Steenhuis EGM, Schoenaker IJH, de Groot JWB, Fiebrich HB, de Graaf JC, Brohet RM, van Dijk JD, van Westreenen HL, Siersema PD, de Vos Tot Nederveen Cappel WH. Feasibility of volatile organic compound in breath analysis in the follow-up of colorectal cancer: A pilot study. Eur J Surg Oncol 2020; 46:2068-2073. [PMID: 32778485 DOI: 10.1016/j.ejso.2020.07.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/18/2020] [Accepted: 07/19/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Colorectal carcinoma (CRC) has a worldwide incidence of 1.4 million patients and a large share in cancer-related mortality. After curative treatment, the risk of recurrence is 30-65%. Early detection may result in curative treatment. However, current follow-up (FU) examinations have low sensitivity ranging from 49 to 85% and are associated with high costs. Therefore, the search for a new diagnostic tool is justified. Analysis of volatile organic compound in exhaled air through an electronic nose (eNose) is a promising new patient-friendly diagnostic tool. We studied whether the eNose under investigation, the Aeonose™, is able to detect local recurrence or metastases of CRC. METHODS In this cross-sectional study we included 62 patients, all of whom underwent curative treatment for CRC in the past 5 years. Thirty-six of them had no metastases and 26 had extraluminal local recurrence or metastases of CRC, detected during FU. Breath testing was performed and machine learning was used to predict extraluminal recurrences or metastases, and based on the receiver operating characteristics (ROC)-curve both sensitivity and specificity were calculated. RESULTS The eNose identified extra luminal local recurrences or metastases of CRC with a sensitivity and specificity of 0.88 (CI 0.69-0.97) and 0.75 (CI 0.57-0.87), respectively, with an overall accuracy of 0.81. DISCUSSION This eNose may be a promising tool in detecting extraluminal local recurrences or metastases in the FU of curatively treated CRC. However, a well-designed prospective study is warranted to show its accuracy and predictive value before it can be used in clinical practice.
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Affiliation(s)
- E G M Steenhuis
- Dept of Gastroenterology and Hepatology, Isala, Dokter van Heesweg 2, 8025, AB Zwolle, the Netherlands.
| | - I J H Schoenaker
- Isala Oncology Center, Isala, Dokter van Heesweg 2, 8025, AB Zwolle, the Netherlands
| | - J W B de Groot
- Isala Oncology Center, Isala, Dokter van Heesweg 2, 8025, AB Zwolle, the Netherlands
| | - H B Fiebrich
- Isala Oncology Center, Isala, Dokter van Heesweg 2, 8025, AB Zwolle, the Netherlands
| | - J C de Graaf
- Isala Oncology Center, Isala, Dokter van Heesweg 2, 8025, AB Zwolle, the Netherlands
| | - R M Brohet
- Dept of Epidemiology & Statistics, Isala, Dokter van Heesweg 2, 8025, AB Zwolle, the Netherlands
| | - J D van Dijk
- Dept of Nuclear Medicine, Isala, Dokter van Heesweg 2, 8025, AB Zwolle, the Netherlands
| | - H L van Westreenen
- Dept of Surgery, Isala, Dokter van Heesweg 2, 8025, AB Zwolle, the Netherlands
| | - P D Siersema
- Dept of Gastroenterology and Hepatology, Radboud University Medical Center, Geert Grooteplein 10, 6525, GA Nijmegen, the Netherlands
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Mommers EHH, van Kooten L, Nienhuijs SW, de Vries Reilingh TS, Lubbers T, Mees BME, Schurink GWH, Bouvy ND. Can Electric Nose Breath Analysis Identify Abdominal Wall Hernia Recurrence and Aortic Aneurysms? A Proof-of-Concept Study. Surg Innov 2020; 27:366-372. [PMID: 32449457 PMCID: PMC7804369 DOI: 10.1177/1553350620917898] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Introduction. This pilot study evaluates if an electronic nose
(eNose) can distinguish patients at risk for recurrent hernia formation and
aortic aneurysm patients from healthy controls based on volatile organic
compound analysis in exhaled air. Both hernia recurrence and aortic aneurysm are
linked to impaired collagen metabolism. If patients at risk for hernia
recurrence and aortic aneurysms can be identified in a reliable, low-cost,
noninvasive manner, it would greatly enhance preventive options such as
prophylactic mesh placement after abdominal surgery. Methods.
From February to July 2017, a 3-armed proof-of-concept study was conducted at 3
hospitals including 3 groups of patients (recurrent ventral hernia, aortic
aneurysm, and healthy controls). Patients were measured once at the outpatient
clinic using an eNose with 3 metal-oxide sensors. A total of 64 patients
(hernia, n = 29; aneurysm, n = 35) and 37 controls were included. Data were
analyzed by an automated neural network, a type of self-learning software to
distinguish patients from controls. Results. Receiver operating
curves showed that the automated neural network was able to differentiate
between recurrent hernia patients and controls (area under the curve 0.74,
sensitivity 0.79, and specificity 0.65) as well as between aortic aneurysm
patients and healthy controls (area under the curve 0.84, sensitivity 0.83, and
specificity of 0.81). Conclusion. This pilot study shows that
the eNose can distinguish patients at risk for recurrent hernia and aortic
aneurysm formation from healthy controls.
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Affiliation(s)
| | | | | | | | - Tim Lubbers
- Maastricht University Medical Center, Maastricht, Netherlands
| | - Barend M E Mees
- Maastricht University Medical Center, Maastricht, Netherlands
| | | | - Nicole D Bouvy
- Maastricht University Medical Center, Maastricht, Netherlands
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Jian Y, Hu W, Zhao Z, Cheng P, Haick H, Yao M, Wu W. Gas Sensors Based on Chemi-Resistive Hybrid Functional Nanomaterials. NANO-MICRO LETTERS 2020; 12:71. [PMID: 34138318 PMCID: PMC7770957 DOI: 10.1007/s40820-020-0407-5] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 02/02/2020] [Indexed: 05/12/2023]
Abstract
Chemi-resistive sensors based on hybrid functional materials are promising candidates for gas sensing with high responsivity, good selectivity, fast response/recovery, great stability/repeatability, room-working temperature, low cost, and easy-to-fabricate, for versatile applications. This progress report reviews the advantages and advances of these sensing structures compared with the single constituent, according to five main sensing forms: manipulating/constructing heterojunctions, catalytic reaction, charge transfer, charge carrier transport, molecular binding/sieving, and their combinations. Promises and challenges of the advances of each form are presented and discussed. Critical thinking and ideas regarding the orientation of the development of hybrid material-based gas sensor in the future are discussed.
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Affiliation(s)
- Yingying Jian
- School of Advanced Materials and Nanotechnology, Interdisciplinary Research Center of Smart Sensors, Xidian University, Xi'an, 710071, People's Republic of China
| | - Wenwen Hu
- School of Aerospace Science and Technology, Xidian University, Xi'an, 710071, People's Republic of China
| | - Zhenhuan Zhao
- School of Advanced Materials and Nanotechnology, Interdisciplinary Research Center of Smart Sensors, Xidian University, Xi'an, 710071, People's Republic of China
| | - Pengfei Cheng
- School of Aerospace Science and Technology, Xidian University, Xi'an, 710071, People's Republic of China
| | - Hossam Haick
- School of Advanced Materials and Nanotechnology, Interdisciplinary Research Center of Smart Sensors, Xidian University, Xi'an, 710071, People's Republic of China.
- Department of Chemical Engineering, Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, 3200003, Haifa, Israel.
| | - Mingshui Yao
- Institute for Integrated Cell-Material Sciences (WPI-iCeMS), Kyoto University Institute for Advanced Study, Kyoto University, Yoshida Ushinomiya-cho, Sakyo-ku, Kyoto, 606-8501, Japan.
| | - Weiwei Wu
- School of Advanced Materials and Nanotechnology, Interdisciplinary Research Center of Smart Sensors, Xidian University, Xi'an, 710071, People's Republic of China.
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25
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Broza YY, Zhou X, Yuan M, Qu D, Zheng Y, Vishinkin R, Khatib M, Wu W, Haick H. Disease Detection with Molecular Biomarkers: From Chemistry of Body Fluids to Nature-Inspired Chemical Sensors. Chem Rev 2019; 119:11761-11817. [DOI: 10.1021/acs.chemrev.9b00437] [Citation(s) in RCA: 164] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Yoav Y. Broza
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion—Israel Institute of Technology, Haifa 3200003, Israel
| | - Xi Zhou
- School of Natural and Applied Sciences, Northwestern Polytechnical University, Xi’an 710072, P.R. China
| | - Miaomiao Yuan
- The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong 518033, P.R. China
| | - Danyao Qu
- School of Advanced Materials and Nanotechnology, Interdisciplinary Research Center of Smart Sensors, Xidian University, Shaanxi 710126, P.R. China
| | - Youbing Zheng
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion—Israel Institute of Technology, Haifa 3200003, Israel
| | - Rotem Vishinkin
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion—Israel Institute of Technology, Haifa 3200003, Israel
| | - Muhammad Khatib
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion—Israel Institute of Technology, Haifa 3200003, Israel
| | - Weiwei Wu
- School of Advanced Materials and Nanotechnology, Interdisciplinary Research Center of Smart Sensors, Xidian University, Shaanxi 710126, P.R. China
| | - Hossam Haick
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion—Israel Institute of Technology, Haifa 3200003, Israel
- School of Advanced Materials and Nanotechnology, Interdisciplinary Research Center of Smart Sensors, Xidian University, Shaanxi 710126, P.R. China
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26
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Bijl EJ, Groeneweg JG, Wesselius DW, Stronks DL, Huygen FJPM. Diagnosing complex regional pain syndrome using an electronic nose, a pilot study. J Breath Res 2019; 13:036004. [PMID: 30566914 DOI: 10.1088/1752-7163/aaf9c1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Complex regional pain syndrome (CRPS) is a complication after surgery or trauma and is characterized by a continuing regional pain in a distal extremity. The pain is disproportionate in severity and duration in relation to the preceding trauma. Currently, the diagnosis is based on the patients' signs and symptoms. There is no objective clinically applicable test available to confirm the diagnosis of CRPS, however this could contribute to a more reliable and valid diagnosis. Since the treatment of CRPS differs from that of other types of pain this could thereby lead to earlier and (more) appropriate treatment and possibly to lower medical costs. The Aeonose™ is a diagnostic test device which detects volatile organic profiles in exhaled air. Exhaled breath analysis using an electronic nose has been successfully applied to differentiate between sick and healthy persons for various indications. This study was a feasibility study in which we investigated whether the Aeonose™ is able to measure a difference in the volatome of CRPS patients compared to the volatome of healthy controls. DESIGN Prospective observational study. SETTING University Center for Pain Medicine. SUBJECTS Adult patients diagnosed with CRPS according to the latest IASP criteria (n = 36) and matched healthy controls (n = 36). METHODS Breath profiles were sampled by breathing in and out through the Aeonose™. Data were compressed using a Tucker3-like solution and subsequently used for training an artificial neural network together with the classification 'CRPS: Yes' or 'CRPS: No'. Cross-validation was applied using the leave-10%-out method. RESULTS Data of the 72 participants were analyzed, resulting in a sensitivity of 83% (95% CI 67%-93%), specificity of 78% (95% CI 60%-89%), and an overall accuracy of 81%. CONCLUSIONS This study suggests that the Aeonose™ can possibly distinguish patients with CRPS from healthy controls based on analysis of their volatome (MEC-2014-149).
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Affiliation(s)
- E J Bijl
- Center for Pain Medicine, Erasmus MC, Medical University Center Rotterdam, The Netherlands
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27
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Sedda G, Gasparri R, Spaggiari L. Comments on "Pilot Study: Detection of Gastric Cancer From Exhaled Air Analyzed With an Electronic Nose in Chinese Patients". Surg Innov 2019; 26:268-269. [PMID: 30632463 DOI: 10.1177/1553350618822863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Giulia Sedda
- 1 Division of Thoracic Surgery, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Roberto Gasparri
- 1 Division of Thoracic Surgery, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Lorenzo Spaggiari
- 1 Division of Thoracic Surgery, IEO European Institute of Oncology IRCCS, Milan, Italy.,2 Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
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28
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Hu W, Wan L, Jian Y, Ren C, Jin K, Su X, Bai X, Haick H, Yao M, Wu W. Electronic Noses: From Advanced Materials to Sensors Aided with Data Processing. ADVANCED MATERIALS TECHNOLOGIES 2018:1800488. [DOI: 10.1002/admt.201800488] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Affiliation(s)
- Wenwen Hu
- School of Aerospace Science and TechnologyXidian University Shaanxi 710126 P. R. China
| | - Liangtian Wan
- The Key Laboratory for Ubiquitous Network and Service Software of Liaoning ProvinceSchool of SoftwareDalian University of Technology Dalian 116620 China
| | - Yingying Jian
- School of Advanced Materials and NanotechnologyXidian University Shaanxi 710126 P. R. China
| | - Cong Ren
- School of Advanced Materials and NanotechnologyXidian University Shaanxi 710126 P. R. China
| | - Ke Jin
- School of Aerospace Science and TechnologyXidian University Shaanxi 710126 P. R. China
| | - Xinghua Su
- School of Materials Science and EngineeringChang'an University Xi'an 710061 China
| | - Xiaoxia Bai
- School of Advanced Materials and NanotechnologyXidian University Shaanxi 710126 P. R. China
| | - Hossam Haick
- School of Advanced Materials and NanotechnologyXidian University Shaanxi 710126 P. R. China
- Department of Chemical Engineering and Russell Berrie Nanotechnology InstituteTechnion‐Israel Institute of Technology Haifa 3200003 Israel
| | - Mingshui Yao
- Fujian Institute of Research on the Structure of MatterChinese Academy of Sciences Fuzhou 350002 P. R. China
| | - Weiwei Wu
- School of Advanced Materials and NanotechnologyXidian University Shaanxi 710126 P. R. China
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