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. 2017 Apr 6;12(4):e0174802.
doi: 10.1371/journal.pone.0174802. eCollection 2017.

Clinical contributions of exhaled volatile organic compounds in the diagnosis of lung cancer

Tsuyoshi Oguma  1 , Takashi Nagaoka  2 , Muneshige Kurahashi  3 , Naofumi Kobayashi  3 , Shinji Yamamori  3 , Chizuko Tsuji  4 , Hiroto Takiguchi  1 , Kyoko Niimi  1 , Hiromi Tomomatsu  1 , Katsuyoshi Tomomatsu  1 , Naoki Hayama  1 , Takuya Aoki  1 , Tetsuya Urano  1 , Kazushige Magatani  5 , Sunao Takeda  2 , Tadashi Abe  1 , Koichiro Asano  1
Affiliations

Clinical contributions of exhaled volatile organic compounds in the diagnosis of lung cancer

Tsuyoshi Oguma et al. PLoS One. .

Abstract

Background: Exhaled volatile organic compounds (VOC) are being considered as biomarkers for various lungs diseases, including cancer. However, the accurate measurement of extremely low concentrations of VOC in expired air is technically challenging. We evaluated the clinical contribution of exhaled VOC measured with a new, double cold-trap method in the diagnosis of lung cancer.

Methods: Breath samples were collected from 116 patients with histologically confirmed lung cancer and 37 healthy volunteers (controls) after inspiration of purified air, synthesized through a cold-trap system. The exhaled VOC, trapped in the same system, were heat extracted. We analyzed 14 VOC with gas chromatography.

Results: The concentrations of exhaled cyclohexane and xylene were significantly higher in patients with lung cancer than in controls (p = 0.002 and 0.0001, respectively), increased significantly with the progression of the clinical stage of cancer (both p < 0.001), and decreased significantly after successful treatment of 6 patients with small cell lung cancer (p = 0.06 and 0.03, respectively).

Conclusion: Measurements of exhaled VOCs by a double cold-trap method may help diagnose lung cancer and monitor its progression and regression.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Exhaled cyclohexane (A) and xylene (B) concentrations in healthy subjects and patients with lung cancer.
The horizontal lines indicate the median values. *p = 0.002, **p = 0.0001 versus healthy subjects.
Fig 2
Fig 2. Relationships between exhaled cyclohexane (A) and xylene (B) and clinical stages of lung cancer and between exhaled cyclohexane (C) and xylene (D) and pathological types of lung cancer.
The horizontal lines indicate the median values. *p < 0.05, compared with healthy subjects by Kruskal-Wallis test. H = healthy subjects; 1,2 = clinical stage 1 or 2; 3 = clinical stage 3; 4 = clinical stage 4; Ad = adenocarcinoma; Sq = squamous cell carcinoma; SCLC = small cell carcinoma; Ot = others, including large cell neuroendocrine carcinoma and NSCLC not otherwise specified.
Fig 3
Fig 3. Identification of patients with lung cancer by cyclohexane (A) and xylene (B) ROC analysis.
Fig 4
Fig 4. Comparison between exhaled cyclohexane (A) and xylene (B) in 6 patients with small cell lung cancer before treatment and after response to therapy.
*p < 0.05 versus before treatment.
See this image and copyright information in PMC

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