Findings presented at the European Respiratory Society(ERS) Annual Congress, being held in Barcelona, Spain (September 7 – 11, 2013), shows that collecting samples of exhaled breath from people at a high risk of lung cancer could be a cheap and non-invasive method of diagnosing the disease, according to new research.

Current tests for lung cancer include blood and urine tests, followed by CT scans and chest radiographs. This new method could see people at a high risk of lung cancer receiving an initial – non-invasive – breath test to quickly assess their symptoms.

We have shown that it is possible to use breath tests to correctly identify lung cancer with a high sensitivity rate

Detecting disease
Previous research has shown that animals are capable of detecting diseases based on breath tests. Scientists have been trying to replicate this in so-called ?electronic nose? technology, which works by detecting different profiles of volatile organic compounds orVOCs in breath samples. This is the most extensive study using the electronic nose to show that the technique could be an accurate method for lung cancer screening.

Researchers have not yet clearly identified which VOCs are linked to different diseases, but this new study suggests it is possible for an ‘electronic nose’ to differentiate lung cancer from different lung conditions and healthy people.

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Study design
Researchers from the University of Latvia collected exhaled breath samples from 252 lung cancer patients, 223 patients with different lung diseases and healthy volunteers and 265 non-smokers and 210 smokers. The researchers found that in non-smokers, the electronic nose correctly identified 128 as having lung cancer and only misdiagnosed 5 people who didn?t have cancer. In the group of smokers, the electronic nose correctly identified 114 people as having lung cancer and misdiagnosing 5 people with lung cancer.

Lead author, Maris Bukovskis, from the University of Latvia, said: ?We have shown that it is possible to use breath tests to correctly identify lung cancer with a high sensitivity rate. The results of our study take us one step further to understanding this important new technology.[1]”

?The major problem with electronic nose technology is that it is individual, and each piece of equipment must be trained to distinguish between odours. This causes a problem of standardizing the practice between different centres. The next step will be to test the practice between different centres to help us think about how we can ensure consistency between all the results, he concluded.?

In a second study from the same research group, scientists looked at how compounds of VOCs were changed by different diseases. The findings shed light on the mechanisms of lung diseases and how a disease develops and affects a person.[2]

Commenting on the results of the second study, lead author, Emmanuel Taivans, from the University of Latvia, noted: ?Our research has shown us why research into VOCs is important and how we could use this to understand more about the way diseases develop and progress.?

Other studies
Results of an unrelated study by Eleanor A. Chapman and colleagues of the Inflammation and Infection Research Centre, School of Medical Sciences, University of New South Wales shows that exhaled breath VOC profiling can accurately distinguish between patients with malignant mesothelioma (MM), other asbestos-related diseases (ARD) and controls using a carbon polymer array (CPA) electronic nose. In this study, the scientists concluded that their method could eventually translate into a screening tool for high-risk populations.[3]

After reviewing the studies presented in Barcelona, H. Jack West, M.D., Medical Director, Thoracic Oncology Program, Swedish Cancer Instituteand President & CEO Global Resources for Advancing Cancer Education, Seattle, Washington (USA) noted: “[While] this concept, is especially appealing as we move toward a new world of lung cancer screening in which the vast majority of lung nodules detected are likely to be benign. This promising work certainly needs to be studied in a much larger setting for additional validation. [Furthermore], if we can use VOCs from exhaled breath to identify which of these patients are more or less likely to have cancer, combining such an analysis with radiographic screening could potentially lead to a much more favorable [diagnostic] sensitivity and specificity.”

For more information
[1] Analysis of exhaled breath with electronic nose and diagnosis of lung cancer by multifactorial logistic regression analysiser
Date and time: Monday 9 September, 12:50-14:40
[2] Volatile organic compounds of exhaled breath in lung cancer and lung inflammatory diseases
Date and time: Monday 9 September, 08:30-10:30
[3] Chapman EA, Thomas PS, Stone E, Lewis C, Yates DH. A breath test for malignant mesothelioma using an electronic nose. Eur Respir J. 2012 Aug;40(2):448-54. doi: 10.1183/09031936.00040911. Epub 2011 Dec 19.[Article][PubMed]

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