Value of exhaled hydrogen sulfide in early diagnosis of esophagogastric junction adenocarcinoma

Abstract

Esophagogastric junction adenocarcinoma (EJA) has increased in recent years, and it exhibits a poor prognosis and a short survival period for patients. Hydrogen sulfide (H₂S) plays an important role in the pathogenesis of cancer and has been studied as a diagnostic factor in some tumor diseases. However, few studies have explored the diagnostic value of H₂S for EJA. In the present study, a total of 56 patients with early-stage EJA were enrolled while 57 healthy individuals were selected as the healthy control group. Clinical features were recorded, and exhaled H₂S and blood samples were collected from both groups. Exhaled H₂S and serum interleukin-8 (IL-8) expression levels were detected in both groups. The correlation between exhaled H₂S and serum IL-8 levels was analyzed using Pearson's correlation method. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of exhaled H₂S combined with IL-8 detection in EJA. The results showed that patients with EJA exhaled more H₂S than healthy individuals. In addition, exhaled H₂S was positively correlated with increased IL-8 expression. The ROC curve revealed that the exhaled H₂S test had an acceptable diagnostic effect and could be used to diagnose EJA. The increase in H₂S exhaled by patients with EJA indicated that H₂S may be related to the occurrence and development of EJA; however, the in vivo mechanism needs to be further explored. Collectively, it was determined in the present study that exhaled H₂S was significantly higher in patients with early-stage EJA than in healthy controls and combined diagnosis with patient serum IL-8 could improve diagnostic accuracy, which has potential diagnostic value for early diagnosis and screening of EJA.

Keywords: cancer; diagnosis; esophagogastric junction adenocarcinoma; exhaled hydrogen sulfide; interleukin-8.

Figure 1.

Exhaled H₂S in patients with EJA. ***P<0.05, the EJA group vs. the healthy group. H₂S, hydrogen sulfide; EJA, esophagogastric junction adenocarcinoma.

Figure 2.

Increased expression of IL-8 in patients with EJA. ***P<0.05, the EJA group vs. the healthy group. IL-8, interleukin-8; EJA, esophagogastric junction adenocarcinoma.

Figure 3.

Correlation between the expression of exhaled H₂S and IL-8 in serum of patients with esophagogastric junction adenocarcinoma. IL-8 expression is positively correlated with exhaled H₂S (R=0.866 and P<0.001). H₂S, hydrogen sulfide; IL-8, interleukin-8.

Figure 4.

Evaluation of the clinical value of exhaled H₂S in the diagnosis of EJA. (A) ROC curve based on exhaled H₂S. (B) ROC curve based on exhaled H₂S + interleukin-8 expression. H₂S, hydrogen sulfide; EJA, esophagogastric junction adenocarcinoma; ROC, receiver operating characteristic; AUC, area under the curve; CI, confidence interval; TPR, true predictive rate; FPR, false predictive rate.