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Review
. 2024 Aug 6;5(9):822-833.
doi: 10.1002/bco2.423. eCollection 2024 Sep.

Analysis of urinary volatile organic compounds for prostate cancer diagnosis: A systematic review

Jonathon Dawson  1   2 , Kraig Green  1 , Henry Lazarowicz  2 , Phil Cornford  2 , Chris Probert  1   2
Affiliations
Review

Analysis of urinary volatile organic compounds for prostate cancer diagnosis: A systematic review

Jonathon Dawson et al. BJUI Compass. .

Erratum in

  • Erratum.
    [No authors listed] [No authors listed] BJUI Compass. 2024 Dec 30;5(12):1324-1329. doi: 10.1002/bco2.482. eCollection 2024 Dec. BJUI Compass. 2024. PMID: 39744071 Free PMC article.

Abstract

Context: Prostate-specific antigen is non-specific for prostate cancer. This is improved by multiparametric MRI but a significant amount of indolent prostate cancer is detected by the current MRI pathway and data is emerging that clinically significant cancers maybe missed using a standard PSA threshold. Volatile organic compound (VOC) analysis may offer novel biomarkers for prostate cancer and clinically significant disease.

Objective: To perform a systematic review of the literature to evaluate the current evidence for the use of VOCs as novel biomarkers for prostate cancer and clinically significant prostate cancer.

Evidence acquisition: A systematic search of MEDLINE, Scopus, Web of Science and the Cochrane Library was undertaken by two independent reviewers and papers were assessed for inclusion in the review. Study characteristics, sensitivity and specificity of GC-MS or eNose were extracted. Risk of bias and applicability issues were determined using QUADAS 2 and the quality of reporting using the STARD checklist.

Evidence synthesis: Nineteen studies were included, of which 6 utilised eNose and 13 GC-MS. eNose sensitivity and specificity were 0.71-0.95 and 0.79-0.96, respectively, and GC-MS found a sensitivity and specificity of 0.66-1.00 and 0.53-0.97, respectively. There were concerns about bias in patient recruitment due to differences in the timing of the index test relative to the reference standard.

Conclusion: This review has found promising early results for urinary metabolomics in the detection of prostate cancer. However, there is a need for larger, high-quality studies to validate this. Future work should focus on the detection of clinically significant prostate cancer.

Keywords: diagnostics; eNose; gas chromatography mass spectrometry; metabolomics; prostate cancer; volatile organic compounds.

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Conflict of interest statement

We wish to confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome. We confirm that the manuscript has been read and approved by all named authors and that there are no other persons who satisfied the criteria for authorship but are not listed. We further confirm that the order of authors listed in the manuscript has been approved by all of us. We confirm that we have given due consideration to the protection of intellectual property associated with this work and that there are no impediments to publication, including the timing of publication, with respect to intellectual property. In so doing we confirm that we have followed the regulations of our institutions concerning intellectual property.

Figures

FIGURE 1
FIGURE 1
PRISMA flow chart detailing the process for identifying eligible studies.
FIGURE 2
FIGURE 2
Forest plots of sensitivity and specificity for (a) eNoses and (b) GC–MS in the discrimination of urine headspace gases from patients with PCa and cancer‐free controls.
FIGURE 3
FIGURE 3
QUADAS 2 results for eNose‐ and GC–MS‐based studies.
See this image and copyright information in PMC

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