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Breath test distinguished between gastric cancer, precancerous lesions
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Volatile organic compound marker detection-based nanoarray technology differentiated gastric cancer and precancerous lesions with high accuracy, according to results from a recent clinical trial.
“Our results demonstrate the feasibility of the sensors nanoarray (technology) for distinguishing between malignant and nonmalignant conditions, as well as patients with different stages of precancerous gastric lesions from gastric cancers, by a breath test,” Hossam Haick, PhD, from the Israel Institute of Technology, told Healio Gastroenterology.
Haick and colleagues collected two exhaled breath samples (968 total) from each of 484 patients (99 of whom had gastric cancer) and analyzed them using two different methods. The first method was gas chromatography linked to mass spectrometry (GCMS) used to identify and quantify volatile organic compounds (VOCs) in each group studied, and the second was cross-reactive nanoarrays combined with pattern recognition used to provide collective VOC patterns. For the second method, 70% of the samples were included in a training set and the remaining samples were included in a validation set.
GCMS analysis demonstrated that patients with gastric cancer and those at high risk for gastric cancer had distinctive breath-print compositions. Eight VOCs significantly differed between groups (P < .017). Nanoarray analysis was able to discriminate between patients with gastric cancer and controls included in the operative link on gastric intestinal metaplasia group (OLGIM 0-IV, with stages III-IV considered “high risk”) with 73% sensitivity, 98% specificity and 92% accuracy. Classification between subgroups was achieved with 97% sensitivity, 84% specificity and 87% accuracy for gastric cancer vs. OLGIM 0-II; with 93% sensitivity, 80% specificity and 90% accuracy for gastric cancer vs. OLGIM III-IV; and with 83% sensitivity, 60% specificity and 61% accuracy for OLGIM I-II vs. OLGIM III-IV plus dysplasia. Analysis of potential confounding factors (Helicobacter pylori-status, gender, age, smoking, alcohol use, proton pump inhibitor intake 1 month before sampling) showed that none had significant influence on results.
“Our future vision suggests the breath test as a follow-up tool for surveillance of high-risk patients,” Haick said. “Once a patient is diagnosed with risk lesions in the stomach by sensors nanoarray technology, and this is confirmed by conventional endoscopy, the breath test could be used for monitoring, to identify those progressing to cancer or more advanced lesions. Similarly, the test could be used for timely identification of gastric cancer recurrence following initially successful therapy. The attractiveness of this test lies in its noninvasiveness, ease of use, rapid predictiveness, insensitivity to confounding factors and potentially low cost.” – by Adam Leitenberger
Disclosure: The researchers report no relevant financial disclosures.
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