Investigation of potential breath biomarkers for the early diagnosis of breast cancer using gas chromatography-mass spectrometry

Abstract

Background: Breast cancer (BC) remains the most commonly diagnosed malignancy in women. We investigated 4 straight aldehydes in the exhaled breath as potential early BC diagnostic biomarkers.

Methods: End-tailed breath were collected by Bio-VOC® sampler and assayed by gas chromatography-mass spectrometry. Kruskal-Wallis one-way analysis of variance test and binary logistic regression were used for data analysis. The diagnostic accuracies were evaluated by receiver operating characteristic curves. A predictive model/equation was generated using the 4 biomarkers and validated by leave-one-out cross-validation.

Results: All four potential biomarkers demonstrated significant differences in concentrations between BC and healthy controls (HC) (p<0.05). The areas under the curves (AUCs) in HC vs BCI-II model using hexanal, heptanal, octanal, and nonanal were 0.816, 0.809, 0.731, and 0.830, respectively. The AUC for their combined use was 0.934 (sensitivity 91.7%, specificity 95.8%) in the early diagnosis of BC. The predictive model/equation exhibited good sensitivity (72.7%) and specificity (91.7%) in distinguishing between HC and BC (cross-validation: sensitivity 68.2% and specificity 91.7%).

Conclusions: The diagnostic values of 4 exhaled straight aldehydes as early diagnostic biomarkers for BC were successfully verified and the diagnostic accuracy improved in their combined use.

Keywords: Biomarkers; Breast cancer; Breath analysis; Early diagnosis; Noninvasive diagnosis.