Department of Urology, Philipps-Universität Marburg, Baldingerstraße, 35033, Marburg, Germany.
Department of General and Visceral Surgery, München Klinik Neuperlach, Oskar-Maria-Graf-Ring 51, 81737, Munich, Germany.
World J Urol. 2024 May 25;42(1):353. doi: 10.1007/s00345-024-05047-5.
Despite many efforts, no reliable urinary marker system has so far shown the potential to substitute cystoscopy. Measuring volatile organic compounds (VOCs) from urine is a promising alternative. VOCs are metabolic products which can be measured from the headspace of urine samples. Previous studies confirmed that the urine of bladder tumor patients has a different VOC profile than healthy controls. In this pilot study, the feasibility of discriminating VOCs from urine of bladder cancer patients from that of healthy control subjects was investigated. Aim of this study was to investigate whether VOC-based diagnosis of bladder cancer from urine samples is feasible using multicapillary column ion mobility spectrometry (MCC/IMS) and to identify potential molecular correlates to the relevant analytes.
Headspace measurements of urine samples of 30 patients with confirmed transitional cell carcinoma (TCC) and 30 healthy controls were performed using MCC/IMS. In the results of the measurements, peaks showing significant differences between both groups were identified and implemented into a decision tree with respect to achieve group separation. Molecular correlates were predicted using a pre-defined dataset.
Eight peaks with significantly differing intensity were identified, 5 of which were highly significant. Using a six-step decision tree, MCC/IMS showed a sensitivity of 90% and specificity of 100% in group separation.
VOC-based detection of bladder cancer is feasible. MCC/IMS is a suitable method for urine-based diagnosis and should be further validated. The molecular characteristics and metabolic background of the analytes require further workup.
尽管已经做了很多努力，但到目前为止，还没有一种可靠的尿标志物系统显示出替代膀胱镜检查的潜力。测量尿液中的挥发性有机化合物（VOC）是一种很有前途的替代方法。VOC 是代谢产物，可以从尿液样本的顶空部分进行测量。先前的研究证实，膀胱癌患者的尿液与健康对照组的尿液具有不同的 VOC 特征。在这项初步研究中，研究了从膀胱癌患者的尿液中区分 VOC 的可行性，以及从健康对照组中区分的可能性。本研究的目的是调查使用多毛细管柱离子迁移谱（MCC/IMS）是否可以基于尿液中的 VOC 对膀胱癌进行诊断，并确定与相关分析物相关的潜在分子相关性。
使用 MCC/IMS 对 30 名经证实患有移行细胞癌（TCC）的患者和 30 名健康对照者的尿液样本进行顶空测量。在测量结果中，鉴定出两组之间存在显著差异的峰，并将其纳入决策树中，以实现组间分离。使用预定义数据集预测分子相关性。
确定了 8 个具有显著差异强度的峰，其中 5 个具有高度显著性。使用六步决策树，MCC/IMS 在组间分离中显示出 90%的敏感性和 100%的特异性。
基于 VOC 的膀胱癌检测是可行的。MCC/IMS 是一种适合基于尿液的诊断方法，应进一步验证。分析物的分子特征和代谢背景需要进一步研究。
