Department of Experimental Medicine, University of Salento, 73100 Lecce, Italy.
Department of Precision and Regenerative Medicine and Ionian Area and Interdepartmental Research Center for Pelvic Floor Diseases (CIRPAP), University Aldo Moro of Bari, 70124 Bari, Italy.
Sensors (Basel). 2024 Apr 7;24(7):2343. doi: 10.3390/s24072343.
Screening methods available for colorectal cancer (CRC) to date are burdened by poor reliability and low patient adherence and compliance. An altered pattern of volatile organic compounds (VOCs) in exhaled breath has been proposed as a non-invasive potential diagnostic tool for distinguishing CRC patients from healthy controls (HC). The aim of this study was to evaluate the reliability of an innovative portable device containing a micro-gas chromatograph in enabling rapid, on-site CRC diagnosis through analysis of patients' exhaled breath. In this prospective trial, breath samples were collected in a tertiary referral center of colorectal surgery, and analysis of the chromatograms was performed by the Biomedical Engineering Department. The breath of patients with CRC and HC was collected into Tedlar bags through a Nafion filter and mouthpiece with a one-way valve. The breath samples were analyzed by an automated portable gas chromatography device. Relevant volatile biomarkers and discriminant chromatographic peaks were identified through machine learning, linear discriminant analysis and principal component analysis. A total of 68 subjects, 36 patients affected by histologically proven CRC with no evidence of metastases and 32 HC with negative colonoscopies, were enrolled. After testing a training set (18 CRC and 18 HC) and a testing set (18 CRC and 14 HC), an overall specificity of 87.5%, sensitivity of 94.4% and accuracy of 91.2% in identifying CRC patients was found based on three VOCs. Breath biopsy may represent a promising non-invasive method of discriminating CRC patients from HC.
迄今为止，用于结直肠癌 (CRC) 的筛查方法存在可靠性差、患者依从性低的问题。呼气中挥发性有机化合物 (VOC) 模式的改变已被提出作为一种非侵入性的潜在诊断工具，用于区分 CRC 患者和健康对照 (HC)。本研究旨在评估一种包含微型气相色谱仪的创新型便携式设备通过分析患者呼气来快速进行现场 CRC 诊断的可靠性。在这项前瞻性试验中，呼吸样本在一家三级转诊的结直肠外科中心采集，由生物医学工程部进行色谱分析。通过带有单向阀的 Nafion 过滤器和吸嘴将 CRC 患者和 HC 的呼吸收集到 Tedlar 袋中。使用自动化便携式气相色谱仪分析呼吸样本。通过机器学习、线性判别分析和主成分分析确定了相关的挥发性生物标志物和判别色谱峰。共纳入 68 名受试者，36 名患有组织学证实的 CRC 且无转移证据的患者和 32 名结肠镜检查阴性的 HC。在对一个训练集 (18 名 CRC 和 18 名 HC) 和一个测试集 (18 名 CRC 和 14 名 HC) 进行测试后，发现基于三种 VOCs，可识别 CRC 患者的总体特异性为 87.5%、敏感性为 94.4%和准确性为 91.2%。呼吸活检可能是一种有前途的、非侵入性的区分 CRC 患者和 HC 的方法。
