Department of Surgery and Science, Kyushu University, Fukuoka, Japan.
Gut. 2011 Jun;60(6):814-9. doi: 10.1136/gut.2010.218305. Epub 2011 Jan 31.
Early detection and early treatment are of vital importance to the successful treatment of various cancers. The development of a novel screening method that is as economical and non-invasive as the faecal occult blood test (FOBT) for early detection of colorectal cancer (CRC) is needed. A study was undertaken using canine scent detection to determine whether odour material can become an effective tool in CRC screening.
Exhaled breath and watery stool samples were obtained from patients with CRC and from healthy controls prior to colonoscopy. Each test group consisted of one sample from a patient with CRC and four control samples from volunteers without cancer. These five samples were randomly and separately placed into five boxes. A Labrador retriever specially trained in scent detection of cancer and a handler cooperated in the tests. The dog first smelled a standard breath sample from a patient with CRC, then smelled each sample station and sat down in front of the station in which a cancer scent was detected.
33 and 37 groups of breath and watery stool samples, respectively, were tested. Among patients with CRC and controls, the sensitivity of canine scent detection of breath samples compared with conventional diagnosis by colonoscopy was 0.91 and the specificity was 0.99. The sensitivity of canine scent detection of stool samples was 0.97 and the specificity was 0.99. The accuracy of canine scent detection was high even for early cancer. Canine scent detection was not confounded by current smoking, benign colorectal disease or inflammatory disease.
This study shows that a specific cancer scent does indeed exist and that cancer-specific chemical compounds may be circulating throughout the body. These odour materials may become effective tools in CRC screening. In the future, studies designed to identify cancer-specific volatile organic compounds will be important for the development of new methods for early detection of CRC.
早期发现和早期治疗对各种癌症的成功治疗至关重要。需要开发一种新的筛查方法,其经济性和非侵入性与粪便潜血试验(FOBT)相当,用于早期检测结直肠癌(CRC)。本研究采用犬嗅觉检测来确定气味物质是否可以成为 CRC 筛查的有效工具。
在结肠镜检查前,从 CRC 患者和健康对照者中获得呼气和水样粪便样本。每个测试组由一个 CRC 患者的样本和四个无癌症志愿者的对照样本组成。这五个样本被随机且单独放入五个盒子中。一只经过专门训练用于检测癌症气味的拉布拉多猎犬和一名 handler 合作进行了测试。该犬首先嗅闻一名 CRC 患者的标准呼气样本,然后嗅闻每个样本站,并在检测到癌症气味的站前面坐下。
分别对 33 组和 37 组呼气和水样粪便样本进行了测试。在 CRC 患者和对照组中,犬嗅觉检测呼气样本的敏感性与结肠镜常规诊断相比为 0.91,特异性为 0.99。犬嗅觉检测粪便样本的敏感性为 0.97,特异性为 0.99。即使是早期癌症,犬嗅觉检测的准确性也很高。犬嗅觉检测不受当前吸烟、良性结直肠疾病或炎症性疾病的干扰。
本研究表明,确实存在特定的癌症气味,并且癌症特异性化学化合物可能在整个体内循环。这些气味物质可能成为 CRC 筛查的有效工具。未来,旨在鉴定癌症特异性挥发性有机化合物的研究对于开发 CRC 早期检测的新方法将非常重要。