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. 2016 Oct;102(4):1095-100.
doi: 10.1016/j.athoracsur.2016.04.068. Epub 2016 Jun 9.

Normalization of Exhaled Carbonyl Compounds After Lung Cancer Resection

Erin M Schumer  1 , Matthew C Black  1 , Michael Bousamra 2nd  1 , Jaimin R Trivedi  1 , Mingxiao Li  2 , Xiao-An Fu  2 , Victor van Berkel  3
Affiliations

Normalization of Exhaled Carbonyl Compounds After Lung Cancer Resection

Erin M Schumer et al. Ann Thorac Surg. 2016 Oct.

Abstract

Background: Quantitative analysis of specific exhaled carbonyl compounds (ECCs) has shown promise for the detection of lung cancer. The purpose of this study is to demonstrate the normalization of ECCs in patients after lung cancer resection.

Methods: Patients from a single center gave consent and were enrolled in the study from 2011 onward. Breath analysis was performed on lung cancer patients before and after surgical resection of their tumors. One liter of breath from a single exhalation was collected and evacuated over a silicon microchip. Carbonyls were captured by oximation reaction and analyzed by mass spectrometry. Concentrations of four cancer-specific ECCs were measured and compared by using the Wilcoxon test. A given cancer marker was considered elevated at 1.5 or more standard deviations greater than the mean of the control population.

Results: There were 34 cancer patients with paired samples and 187 control subjects. The median values after resection were significantly lower for all four ECCs and were equivalent to the control patient values for three of the four ECCs.

Conclusions: The analysis of ECCs demonstrates reduction to the level of control patients after surgical resection for lung cancer. This technology has the potential to be a useful tool to detect disease after lung cancer resection. Continued follow-up will determine whether subsequent elevation of ECCs is indicative of recurrent disease.

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Figures

Fig 1
Fig 1
Median concentrations for carbonyl compounds before and after resection in patients who underwent lung transplantation compared with median control values. Error bars represent 95% confidence interval. Concentrations are in nmol/L. *p < 0.05. (4-HHE = 4-hydroxyhexanal.)
Fig 2
Fig 2
Values for 2-butanone, 3-hydroxy-2-butanone, 2-hydroxyacetaldehyde, and 4-hydroxyhexanal (4-HHE) before and after resection when the value before resection is elevated. The dashed line is the threshold for an elevated carbonyl compound. Concentrations are in nmol/L.
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