Sukaram Thanikan, Apiparakoon Terapap, Tiyarattanachai Thodsawit, Ariyaskul Darlene, Kulkraisri Kittipat, Marukatat Sanparith, Rerknimitr Rungsun, Chaiteerakij Roongruedee
Program in Medical Sciences, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.
Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.
Diagnostics (Basel). 2023 Jan 10;13(2):257. doi: 10.3390/diagnostics13020257.
Volatile organic compound (VOC) profiles as biomarkers for hepatocellular carcinoma (HCC) are understudied. We aimed to identify VOCs from the exhaled breath for HCC diagnosis and compare the performance of VOCs to alpha-fetoprotein (AFP). The performance of VOCs for predicting treatment response and the association between VOCs level and survival of HCC patients were also determined.
VOCs from 124 HCC patients and 219 controls were identified using the XGBoost algorithm. ROC analysis was used to determine VOCs performance in differentiating HCC patients from controls and in discriminating treatment responders from non-responders. The association between VOCs and the survival of HCC patients was analyzed using Cox proportional hazard analysis.
The combination of 9 VOCs yielded 70.0% sensitivity, 88.6% specificity, and 75.0% accuracy for HCC diagnosis. When differentiating early HCC from cirrhotic patients, acetone dimer had a significantly higher AUC than AFP, i.e., 0.775 vs. 0.714, respectively, = 0.001. Acetone dimer classified HCC patients into treatment responders and non-responders, with 95.7% sensitivity, 73.3% specificity, and 86.8% accuracy. Isopropyl alcohol was independently associated with the survival of HCC patients, with an adjusted hazard ratio of 7.23 (95%CI: 1.36-38.54), = 0.020.
Analysis of VOCs is a feasible noninvasive test for diagnosing and monitoring HCC treatment response.
作为肝细胞癌（HCC）生物标志物的挥发性有机化合物（VOC）谱研究不足。我们旨在从呼出气体中识别用于HCC诊断的VOC，并将VOC的性能与甲胎蛋白（AFP）进行比较。还确定了VOC预测治疗反应的性能以及VOC水平与HCC患者生存率之间的关联。
使用XGBoost算法识别124例HCC患者和219例对照的VOC。ROC分析用于确定VOC在区分HCC患者与对照以及区分治疗反应者与无反应者方面的性能。使用Cox比例风险分析来分析VOC与HCC患者生存率之间的关联。
9种VOC的组合对HCC诊断的敏感性为70.0%，特异性为88.6%，准确性为75.0%。在区分早期HCC与肝硬化患者时，丙酮二聚体的AUC显著高于AFP，分别为0.775和0.714，P = 0.001。丙酮二聚体将HCC患者分为治疗反应者和无反应者，敏感性为95.7%，特异性为73.3%，准确性为86.8%。异丙醇与HCC患者的生存率独立相关，调整后的风险比为7.23（95%CI：1.36 - 38.54），P = 0.020。
VOC分析是一种用于诊断和监测HCC治疗反应的可行的非侵入性检测方法。
