Alsaadi Daniah, Clements Nicolle, Gabuniya Natiya, Francis Nader, Chand Manish
The Division of Surgery and Interventional Science, University College London, London, United Kingdom.
Clinical Research Facility Galway, Galway University Hospital, National University of Ireland, Galway, Republic of Ireland.
EXCLI J. 2024 May 17;23:795-810. doi: 10.17179/excli2024-7042. eCollection 2024.
There is an apparent need for novel non-invasive colorectal cancer (CRC) screening tests that are more acceptable to patients and can reliably detect CRC or reduce the number of unnecessary colonoscopies performed in cancer-free patients. An emerging number of studies demonstrate the potential value of exhaled volatile organic compounds (VOCs) as a diagnostic and triaging test for CRC. A systematic appraisal and meta-analysis of the published evidence was done to determine whether exhaled VOCs can be used in the detection and screening of CRC. Nine electronic databases were searched from inception of the databases until August 2020. Quantitative and descriptive data of CRC patients and healthy control (HC) participants who underwent VOCs breath analysis was extracted. In addition, where possible, sampling methods, analytical platforms, processors, and specific breath biomarkers found in each study were recorded. Fourteen articles were included in the systematic review with 491 colorectal patients and 754 HC participants (n=1245). Sub-group meta-analysis was conducted on nine of those articles and the pooled sensitivity was estimated to be 0.89 (95 % CI = 0.80-0.99) whereas specificity was 0.83 (95 % CI = 0.74-0.92). Heterogeneity of pooled sensitivity and specificity was estimated as I=11.11 %. Although this study was limited by small sample size and different analytical platforms, the proposed future framework resolves such limitations and standardizes future research. It is reasonable to deduce that VOCs breath analysis is certainly a field of research that can progress to replace traditional methods within the framework of CRC screening and diagnosis.
显然需要新的非侵入性结直肠癌（CRC）筛查测试，这些测试要更易被患者接受，并且能够可靠地检测CRC或减少对无癌患者进行不必要结肠镜检查的数量。越来越多的研究表明，呼出的挥发性有机化合物（VOCs）作为CRC的诊断和分诊测试具有潜在价值。对已发表的证据进行了系统评估和荟萃分析，以确定呼出的VOCs是否可用于CRC的检测和筛查。从数据库建立之初到2020年8月，检索了九个电子数据库。提取了接受VOCs呼气分析的CRC患者和健康对照（HC）参与者的定量和描述性数据。此外，在可能的情况下，记录了每项研究中发现的采样方法、分析平台、处理程序和特定的呼气生物标志物。系统评价纳入了14篇文章，涉及491例结直肠癌患者和754名HC参与者（n = 1245）。对其中9篇文章进行了亚组荟萃分析，汇总敏感性估计为0.89（95%CI = 0.80 - 0.99），而特异性为0.83（95%CI = 0.74 - 0.92）。汇总敏感性和特异性的异质性估计为I = 11.11%。尽管这项研究受到样本量小和分析平台不同的限制，但所提出的未来框架解决了这些限制并规范了未来的研究。可以合理推断，VOCs呼气分析肯定是一个可以在CRC筛查和诊断框架内取得进展以取代传统方法的研究领域。
