Department of Paediatric Gastroenterology, VU University medical centre, Amsterdam, The Netherlands.
Int J Cancer. 2014 Mar 1;134(5):1132-8. doi: 10.1002/ijc.28446. Epub 2013 Sep 2.
In the course and prognosis of colorectal cancer (CRC), early detection and treatment are essential factors. Fecal immunochemical tests (FITs) are currently the most commonly used non-invasive screening tests for CRC and premalignant (advanced) adenomas, however, with restricted sensitivity. We hypothesized that fecal volatile organic compounds (VOCs) may serve as a diagnostic biomarker of CRC and adenomas. In this proof of concept study, we aimed to assess disease-specific VOC smellprints in fecal gas to distinguish patients with CRC and advanced adenomas from healthy controls. Fecal samples of patients who were scheduled to undergo an elective colonoscopy were collected. An electronic nose (Cyranose 320) was used to measure VOC patterns in fecal gas from patients with histopathologically proven CRC, with advanced adenomas and from controls (no abnormalities seen at colonoscopy). Receiver operator characteristic curves and corresponding sensitivity and specificity for detection of CRC and advanced adenomas were calculated. A total of 157 stool samples (40 patients with CRC, 60 patients with advanced adenomas, and 57 healthy controls) were analyzed by electronic nose. Fecal VOC profiles of patients with CRC differed significantly from controls (area under curve ± 95%CI, p-value, sensitivity, specificity; 0.92 ± 0.03, <0.001, 85%, 87%). Also VOC profiles of patients with advanced adenomas could be discriminated from controls (0.79 ± 0.04, <0.001, 62%, 86%). The results of this proof of concept study suggest that fecal gas analysis by an electronic nose seems to hold promise as a novel screening tool for the (early) detection of advanced neoplasia and CRC.
在结直肠癌（CRC）的病程和预后中，早期发现和治疗是至关重要的因素。粪便免疫化学检测（FIT）是目前最常用于CRC 和癌前（高级）腺瘤的非侵入性筛查检测方法，但其敏感性有限。我们假设粪便挥发性有机化合物（VOC）可能作为 CRC 和腺瘤的诊断生物标志物。在本概念验证研究中，我们旨在评估粪便气体中疾病特异性 VOC 气味特征，以区分 CRC 和高级腺瘤患者与健康对照者。收集计划接受择期结肠镜检查的患者的粪便样本。使用电子鼻（Cyranose 320）测量经组织病理学证实的 CRC、高级腺瘤患者和对照组（结肠镜检查未见异常）粪便气体中的 VOC 模式。计算用于检测 CRC 和高级腺瘤的接收器工作特征曲线及其相应的敏感性和特异性。通过电子鼻分析了 157 个粪便样本（40 例 CRC 患者、60 例高级腺瘤患者和 57 例健康对照者）。CRC 患者的粪便 VOC 谱与对照组有显著差异（曲线下面积±95%CI，p 值，敏感性，特异性；0.92±0.03，<0.001，85%，87%）。高级腺瘤患者的粪便 VOC 谱也可以与对照组区分（0.79±0.04，<0.001，62%，86%）。本概念验证研究的结果表明，电子鼻分析粪便似乎有希望成为一种新的筛查工具，用于（早期）检测高级肿瘤和 CRC。
