detection of colorectal cancer (crc) by urinary volatile organic compound analysis
尿液挥发性有机物分析检测结直肠癌（crc）
ramesh p. arasaradnam1,3*, michael j. mcfarlane3, courtenay ryan-fisher3, erik westenbrink2,
paula hodges3, matthew g. thomas2,6, samantha chambers3, nicola o’connell3, catherine bailey3,
christopher harmston5, chuka u. nwokolo3, karna d. bardhan1,4, james a. covington2
1 clinical sciences research institute, university of warwick, coventry, warwickshire, united kingdom,
2 school of engineering, university of warwick, coventry,warwickshire, united kingdom,
3 department of gastroenterology, university hospital coventry & warwickshire, coventry, warwickshire, united kingdom,
4 departmentof gastroenterology, rotherham general hospital, rotherham, yorkshire, united kingdom,
5 department of surgery, university hospital coventry and warwickshire,coventry, warwickshire, united kingdom,
6 moac doctoral training centre, university of warwick, coventry, warwickshire, united kingdom
abstract
colorectal cancer (crc) is a leading cause of cancer related death in europe and the usa. there is no universally accepted effective non-invasive screening test for crc. guaiac based faecal occult blood (gfob) testing has largely been superseded by faecal immunochemical testing (fit), but sensitivity still remains poor. the uptake of population based fobt testing in the uk is also low at around 50%. the detection of volatile organic compounds (vocs) signature(s) for many cancer subtypes is receiving increasing interest using a variety of gas phase analytical instruments. one such example is faims (field asymmetric ion mobility spectrometer). faims is able to identify inflammatory bowel disease (ibd) patients by analysing shifts in vocs patterns in both urine and faeces. this study extends this concept to determine whether crc patients can be identified through non-invasive analysis of urine, using faims. 133 patients were recruited; 83 crc patients and 50 healthy controls. urine was collected at the time of crc diagnosis and headspace analysis undertaken using a faims instrument (owlstone, lonestar, uk). data was processed using fisher discriminant analysis (fda) after feature extraction from the raw data. faims analyses demonstrated that the voc profiles of crc patients were tightly clustered and could be distinguished from healthy controls. sensitivity and specificity for crc detection with faims were 88% and 60% respectively. this study suggests that voc signatures emanating from urine can be detected in patients with crc using ion mobility spectroscopy technology (faims) with potential as a novel screening tool.
结直肠癌(crc)是欧美肿瘤相关死亡的主要原因，目前尚无*的有效的无创性crc筛查方法。以愈创木酚为基础的粪便隐血(gfob)检测已基本被粪便免疫化学检测(fit)所取代，但敏感性仍然很差。在英国，基于人群的fobt检测的普及率也很低，只有50%左右。使用各种气相分析仪器检测多种癌症亚型的挥发性有机化合物(vocs)特征越来越受到关注。其中一个例子是场非对称离子迁移率谱仪(faims)。faims能够通过分析尿液和粪便中vocs模式的变化来识别炎症性肠病(ibd)患者。这项研究扩展了这一概念，以确定是否可以通过非侵入性分析尿液，使用faims结直肠癌患者。共招募133名患者，83名大肠癌患者和50名健康对照者。采用faims仪器(owlstone，lonestar，uk公司)进行crc诊断和顶空分析时收集尿液。从原始数据中提取特征后，使用fisher判别分析(fda)对数据进行处理。faims分析表明，crc患者的voc谱是紧密聚集的，可以与健康对照组区分开来。faims检测crc的敏感性为88%，特异性为60%。这项研究表明，利用离子迁移谱技术(faims)可以检测出crc患者尿液中的voc信号，这可能是一种新的筛查手段