BMJ 2015;350:h1953 doi: 10.1136/bmj.h1953 (Published 15 April 2015)
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Research News
RESEARCH NEWS New breath technology identifies changes that lead to stomach cancer Jacqui Wise London
Nanoarray analysis, a technology that senses tiny changes in volatile organic compounds in exhaled breath, could be a useful non-invasive screening tool for stomach cancer, research in the journal Gut has concluded.1
No reliable accurate and non-invasive screening test is available for gastric cancer and related pre-cancerous lesions. Most patients with gastric cancer have it diagnosed at an advanced stage, when the chance of survival is relatively poor. The researchers collected 968 breath samples from 484 patients in Latvia after a 12 hour fast and abstention from smoking for at least three hours. Ninety nine of the patients had already had gastric cancer diagnosed but had not yet been treated with chemotherapy or radiotherapy. The samples were subjected to two analyses: gas chromatography linked to mass spectrometry, and cross reactive nanoarrays combined with pattern recognition.
considerable knowledge, so this procedure is not suitable for screening purposes. However, nanoarray analysis offers a much simpler and cheaper alternative. A large trial is currently under way in multiple European centres to test nanoarray analysis as a screening method for stomach cancer in real screening settings. The researchers wrote, “Distinguishing low risk lesions bearing low malignancy risk from gastric cancer and high risk conditions by a breath test would enable unnecessary endoscopies to be avoided, thus limiting endoscopic investigations only to patients who really need them. “The attraction of this test lies in its non-invasiveness, ease of use (therefore high compliance would be expected), rapid predictiveness, insensitivity to confounding factors, and potentially low cost.”
The gas chromatography results showed that patients with cancer and those without the disease had distinctive breath print compositions. From a total of 130 volatile organic compounds identified, eight showed levels that differed significantly when participants in the gastric cancer group were compared with those from the groups with pre-cancerous changes. The nanoarray analysis made it possible to discriminate between the patients with gastric cancer and the control group with 73% sensitivity, 98% specificity, and 92% accuracy. The nanoarray sensing patterns accurately distinguished between the different pre-cancerous stages, allowing identification of patients at high and low risk of developing gastric cancer. The results were not influenced by potential confounding factors such as age, gender, smoking habits, Helicobacter pylori infection, alcohol use, or medicines. The researchers noted that gas chromatography technology is expensive and requires lengthy processing times and
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1
Amal H, Leja M, Funka K, et al. Detection of precancerous gastric lesions and gastric cancer through exhaled breath. Gut 2015; doi:10.1136/gutjnl-2014-308536.
Cite this as: BMJ 2015;350:h1953 © BMJ Publishing Group Ltd 2015
Subscribe: http://www.bmj.com/subscribe
Page 1 of 1
Research News
RESEARCH NEWS New breath technology identifies changes that lead to stomach cancer Jacqui Wise London
Nanoarray analysis, a technology that senses tiny changes in volatile organic compounds in exhaled breath, could be a useful non-invasive screening tool for stomach cancer, research in the journal Gut has concluded.1
No reliable accurate and non-invasive screening test is available for gastric cancer and related pre-cancerous lesions. Most patients with gastric cancer have it diagnosed at an advanced stage, when the chance of survival is relatively poor. The researchers collected 968 breath samples from 484 patients in Latvia after a 12 hour fast and abstention from smoking for at least three hours. Ninety nine of the patients had already had gastric cancer diagnosed but had not yet been treated with chemotherapy or radiotherapy. The samples were subjected to two analyses: gas chromatography linked to mass spectrometry, and cross reactive nanoarrays combined with pattern recognition.
considerable knowledge, so this procedure is not suitable for screening purposes. However, nanoarray analysis offers a much simpler and cheaper alternative. A large trial is currently under way in multiple European centres to test nanoarray analysis as a screening method for stomach cancer in real screening settings. The researchers wrote, “Distinguishing low risk lesions bearing low malignancy risk from gastric cancer and high risk conditions by a breath test would enable unnecessary endoscopies to be avoided, thus limiting endoscopic investigations only to patients who really need them. “The attraction of this test lies in its non-invasiveness, ease of use (therefore high compliance would be expected), rapid predictiveness, insensitivity to confounding factors, and potentially low cost.”
The gas chromatography results showed that patients with cancer and those without the disease had distinctive breath print compositions. From a total of 130 volatile organic compounds identified, eight showed levels that differed significantly when participants in the gastric cancer group were compared with those from the groups with pre-cancerous changes. The nanoarray analysis made it possible to discriminate between the patients with gastric cancer and the control group with 73% sensitivity, 98% specificity, and 92% accuracy. The nanoarray sensing patterns accurately distinguished between the different pre-cancerous stages, allowing identification of patients at high and low risk of developing gastric cancer. The results were not influenced by potential confounding factors such as age, gender, smoking habits, Helicobacter pylori infection, alcohol use, or medicines. The researchers noted that gas chromatography technology is expensive and requires lengthy processing times and
For personal use only: See rights and reprints http://www.bmj.com/permissions
1
Amal H, Leja M, Funka K, et al. Detection of precancerous gastric lesions and gastric cancer through exhaled breath. Gut 2015; doi:10.1136/gutjnl-2014-308536.
Cite this as: BMJ 2015;350:h1953 © BMJ Publishing Group Ltd 2015
Subscribe: http://www.bmj.com/subscribe
