Early detection is challenging due to the lack of clinical manifestations and specific biomarkers.
June 22, 2022 | | Reading time: 5 minutes
Early diagnosis and treatment are essential to improve survival in patients with lung cancer. Photo: Shutterstock.
A study published in The Lancet’s eClinicalMedicine journal reports that breath tests are one step closer to becoming a reality as a screening tool for lung cancer.
The tool was used successfully to identify, in 84 patients, 16 carcinogenic volatile organic compounds (VOCs) associated with the lung cancersuch as aldehydes, hydrocarbons, ketones, carboxylic acids, and furans, some of which are compounds used in the production of household products such as furniture, carpets, and hardwood floors.
“The test is expected to be used for initial screening of lung cancer, but not for final diagnosisaccording to study authors led by Peiyu Wang, MD, Ph.D., chief of social medicine and health at Peking University, in Beijing, China.
Although early diagnosis and treatment are essential to improve survival in patients with lung cancer, early detection is challenging due to lack of clinical manifestations and specific biomarkers. Annual CT scans are expensive and involve radiation exposure, Dr. Wang and his colleagues wrote.
Breath tests are considered a promising method for the detection and screening of lung cancer. They have been under study for years and in 2014, researchers from Belgium published a review in Cancer Epidemiology Biomarkers and Prevention documenting the use of volatile organic compounds as early diagnostic or prognostic biomarkers for mesothelioma.
The breath biomarkers of lung cancer identified in several studies have been very heterogeneous due to different sample collection methods, different patient conditions, testing environments, and analysis methods. As a result, there is currently no breath test for the detection of lung cancersaid Dr. Wang in an interview.
As for its potential as a screening tool, “doctors may introduce this test for people at high risk, such as elderly smokers or people with suspicious symptoms. It can also be introduced for young populations with subjective or objective needs to detect the lung cancer. Since the proportion of lung adenocarcinoma in young women who do not smoke is increasing, the test could be a good method to detect lung cancer in this populationsaid Dr. Wang.
After adjusting for age, gender, smoking, and comorbidities, the researchers found elevated levels of 16 organic compounds volatile in patients with lung cancer. A diagnostic model that included all 16 organic compounds volatiles achieved an area under the curve of 0.952, a sensitivity of 89.2%, a specificity of 89.1% and an accuracy of 89.1% in the diagnosis of lung cancer. A model that included all eight organic compounds Major volatiles achieved an area under the curve of 0.931, a sensitivity of 86.0%, a specificity of 87.2%, and an accuracy of 86.9%.
After selecting 28 organic compounds volatile as candidates through a review of the literature, Dr. Wang and colleagues conducted a prospective study from September 1 to December 31, 2020, using high-pressure photon ionization time-of-flight analyzer mass spectrometry (HPPI-TOFMS) to assess its ability to diagnose lung cancer. The validation study included 157 patients with lung cancer (mean age: 57.0 years; 54.1% women) and 368 volunteers (mean age: 44.5 years; 31.3% women).
“The external validation confirmed the good performance of these biomarkers in the detection of lung cancer“, the researchers said. They added that it helped resolve the heterogeneity between published studies by establishing both 16 organic compounds volatile as 8 organic compounds volatiles for the detection of lung cancer.
The authors stated that there is a large gap between breath test research and clinical practice for lung cancer detection and screening. Although the 16 organic compounds validated volatiles, mainly aldehydes and hydrocarbons, showed potential to promote this detection strategy, further scientific studies are required to investigate the underlying mechanisms of the organic compounds volatile of lung cancer identified.
Source consulted here.