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Stool VOCs superior to other fecal biomarkers for identifying CRC

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An analysis of volatile organic compounds emitted from stool showed superior diagnostic utility for identifying colorectal adenocarcinoma compared with other fecal biomarkers, according to data presented at the British Society of Gastroenterology Annual Meeting.

To evaluate the utility of stool volatile organic compounds (VOCs) as a biomarker for colonic neoplasia, researchers obtained stool specimens from symptomatic patients referred for colonoscopy and others enrolled in the UK Bowel Cancer Screening Program (n = 137; mean age, 64 years; 54% men). Sixty patients did not have neoplasia, 56 had adenomatous polyp(s) and 21 had colorectal cancer.

The researchers performed headspace sampling with solid phase microextraction and gas chromatography mass spectrometry analysis to identify VOCs, and performed logistic regression modeling to test potential biomarkers. They identified 162 VOCs overall (mean, 58.1 in patents without neoplasia; mean, 55.2 in those with neoplasia).

Analysis of VOCs identified patients with higher risk neoplasia with the greatest confidence, and one VOC in particular (compound A) was significantly more abundant in specimens from patients with colorectal cancer compared with those with no neoplasia (P < .0001; area under the receiver operating characteristic [AUROC] curve, 0.76). When combined with another VOC (compound B), the AUROC curve increased to 0.82, and this combination performed with 87.9% sensitivity (95% CI, 0.87-0.99) and 84.6% specificity (95% CI, 0.65-1).

The researchers then performed further logistic regression analysis and identified a three VOC panel (compounds A, X and Y) that increased the AUROC curve to 0.86. The presence of each of these VOCs corresponded to a sixfold higher likelihood of cancer (P < .0001), and these findings were supported by factor analysis.

They concluded that the ability to identify colorectal adenocarcinoma is superior with VOC analysis compared with other fecal biomarkers, including those currently used in colorectal cancer screening in the U.K. – by Adam Leitenberger

Reference:

Bond A, et al. Abstract #OC-048. Presented at: British Society of Gastroenterology Annual Meeting; June 20-23, 2016; Liverpool, U.K.

Disclosures: The researchers report no relevant financial disclosures.