Picciariello A 1 , Zang W 3 , Sharma R 3 , Dezi A 1 , Vincenti L 2 , Fan X 3 , Altomare D. F 1 .
1. Dept of Emergency and Organ Transplantation, University Aldo Moro of Bari, Italy
2. Surgical Unit, AOU Policlinico Consorziale, Bari, Italy
3. Dept of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA
Background: Breath analysis examining specific patterns of volatile organic compounds (VOCs) has been demonstrated to be able to discriminate colorectal cancer (CRC) patients from healthy controls (HC). However, the existing technology uses complex, expensive, and low throughput analytical platforms to give an offline response, thus preventing its applicability for mass screening. The reliability of a new portable device to enable rapid, on-site CRC diagnosis is tested.
Methods The breath of patients with histologically proven CRC and HC (negative colonoscopy) was sampled into Tedlar bags through a Nafion filter and a one-way mouthpiece. The breath samples in the bags were then analyzed by an automated portable gas chromatography (GC) device developed in-house, which consisted of a thermal desorption tube, thermal injector, separation column, and photo-ionization detector, as well as other accessories such as pumps, valves, and a helium cartridge. The chromatograms were analyzed by chemometrics, machine learning, principal component analysis and linear discriminating analysis.
Results 36 CRC patients and 32 HC well matched for age, sex, smoking habit and comorbidities, entered the study. After a training set (18 CRC and 18 HC), and a testing set (18 CRC and 14 HC), an overall specificity of 87.5%, a sensitivity of 94.4% and an accuracy of 91.2% to identify CRC patients was found based on only three VOCs.
Conclusion These preliminary results represent a step forward to develop a simple, inexpensive, easy-to-access, and easy-to-use tool for rapid and on-site mass screening of CRC.