To assess the feasibility of detecting signature volatile organic compounds in the breath of patients with oral squamous cell carcinoma.
Study Design
Prospective cohort pilot study.
Setting
University hospital.
Subjects and Methods
Using gas chromatography and mass spectrometry, emitted volatile organic compounds in the breath of patients before and after curative surgery (n = 10) were compared with those of healthy subjects (n = 4). It was hypothesized that certain volatile organic compounds disappear after surgical therapy. A characteristic signature of these compounds for diseased patients was compiled and validated.
Results
Breath analyses revealed 125 volatile organic compounds in patients with oral cancer. A signature of 8 compounds that were characteristic for patients with oral cancer could be detected: 3 from this group presented were absent after surgery.
Conclusion
The presented results confirmed the hypothesis of an absence of cancer-associated volatile organic compounds in the breath after therapy. In this pilot study, we proved the feasibility of this test approach. Further studies should be initiated to establish protocols for usage in a clinical setting.
FerlayJSoerjomataramIDikshitRet al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11. Int J Cancer. 2015;136:E359-E386.
2.
DenaroNRussiEGAdamoVMerlanoMC. State-of-the-art and emerging treatment options in the management of head and neck cancer: news from 2013. Oncology. 2014;86:212-229.
3.
GüneriPEpsteinJB. Late stage diagnosis of oral cancer: components and possible solutions. Oral Oncol. 2014;50:1131-1136.
4.
ScottSEGrunfeldEAMainJMcGurkM. Patient delay in oral cancer: a qualitative study of patients’ experiences. Psychooncology. 2006;15:474-485.
5.
MehrotraRGuptaDK. Exciting new advances in oral cancer diagnosis: avenues to early detection. Head Neck Oncol. 2011;3:33.
6.
LonneuxMLawsonGIdeCBausartRRemacleMPauwelsS. Positron emission tomography with fluorodeoxyglucose for suspected head and neck tumor recurrence in the symptomatic patient. Laryngoscope. 2000;110:1493-1497.
7.
PurandareNCRangarajanV. Newer imaging techniques in head and neck cancer. Indian J Surg Oncol. 2010;1:186-193.
8.
WolffK-DFollmannMNastA. The diagnosis and treatment of oral cavity cancer. Dtsch Ärztebl Int. 2012;109:829-835.
9.
SiddiquiFYaoM. Application of fluorodeoxyglucose positron emission tomography in the management of head and neck cancers. World J Radiol. 2014;6:238-251.
10.
GrisantiSAlmiciCConsoliFet al. Circulating tumor cells in patients with recurrent or metastatic head and neck carcinoma: prognostic and predictive significance. PLoS One. 2014;9:e103918.
11.
SchmidtHKulasingheAPerryCNelsonCPunyadeeraC. A liquid biopsy for head and neck cancers. Expert Rev Mol Diagn. 2016;16:165-172.
12.
TinhoferIKonschakRStrombergerCet al. Detection of circulating tumor cells for prediction of recurrence after adjuvant chemoradiation in locally advanced squamous cell carcinoma of the head and neck. Ann Oncol. 2014;25:2042-2047.
13.
WilsonADBaiettoM. Applications and advances in electronic-nose technologies. Sensors. 2009;9:5099-5148.
14.
HaickHBrozaYYMochalskiPRuzsanyiVAmannA. Assessment, origin, and implementation of breath volatile cancer markers. Chem Soc Rev. 2014;43:1423-1449.
15.
SongGQinTLiuHet al. Quantitative breath analysis of volatile organic compounds of lung cancer patients. Lung Cancer Amst Neth. 2010;67:227-231.
16.
BajtarevicAAgerCPienzMet al. Noninvasive detection of lung cancer by analysis of exhaled breath. BMC Cancer. 2009;9:348.
17.
KischkelSMiekischWSawackiAet al. Breath biomarkers for lung cancer detection and assessment of smoking related effects—confounding variables, influence of normalization and statistical algorithms. Clin Chim Acta. 2010;411:1637-1644.
18.
SchmekelBWinquistFVikströmA. Analysis of breath samples for lung cancer survival. Anal Chim Acta. 2014;840:82-86.
WangCLiPLianAet al. Blood volatile compounds as biomarkers for colorectal cancer. Cancer Biol Ther. 2014;15:200-206.
21.
AltomareDFDi LenaMPorcelliFet al. Effects of curative colorectal cancer surgery on exhaled volatile organic compounds and potential implications in clinical follow-up. Ann Surg. 2015;262:862-867.
22.
PhillipsMCataneoRNDitkoffBAet al. Volatile markers of breast cancer in the breath. Breast J. 2003;9:184-191.
23.
WangCSunBGuoLet al. Volatile organic metabolites identify patients with breast cancer, cyclomastopathy, and mammary gland fibroma. Sci Rep. 2014;4:5383.
24.
LavraLCatiniAUlivieriAet al. Investigation of VOCs associated with different characteristics of breast cancer cells. Sci Rep. 2015;5:13246.
25.
QinTLiuHSongQet al. The screening of volatile markers for hepatocellular carcinoma. Cancer Epidemiol Biomarkers Prev. 2010;19:2247-2253.
26.
AmalHDingLLiuBet al. The scent fingerprint of hepatocarcinoma: in-vitro metastasis prediction with volatile organic compounds (VOCs). Int J Nanomedicine. 2012;7:4135-4146.
27.
MochalskiPSponringAKingJUnterkoflerKTroppmairJAmannA. Release and uptake of volatile organic compounds by human hepatocellular carcinoma cells (HepG2) in vitro. Cancer Cell Int. 2013;13:72.
28.
SchmutzhardJRiederJDeiblMet al. Pilot study: volatile organic compounds as a diagnostic marker for head and neck tumors. Head Neck. 2008;30:743-749.
29.
HakimMBillanSTischUet al. Diagnosis of head-and-neck cancer from exhaled breath. Br J Cancer. 2011;104:1649-1655.
30.
LeunisNBoumansM-LKremerBet al. Application of an electronic nose in the diagnosis of head and neck cancer. Laryngoscope. 2014;124:1377-1381.
31.
PeiskerARaschkeGFGuentschALuepkePRoshanghiasKSchultze-MosgauS. Evaluation of a post-treatment follow-up program in patients with oral squamous cell carcinoma. Clin Oral Investig. 2017;21:135-141.
32.
CamisascaDRSilamiMANCHonoratoJDiasFLde FariaPASLourençoS de QC. Oral squamous cell carcinoma: clinicopathological features in patients with and without recurrence. ORL J Otorhinolaryngol Relat Spec. 2011;73:170-176.
33.
EbrahimiAClarkJRZhangWJet al. Lymph node ratio as an independent prognostic factor in oral squamous cell carcinoma. Head Neck. 2011;33:1245-1251.
34.
Brandwein-GenslerMTeixeiraMSLewisCMet al. Oral squamous cell carcinoma: histologic risk assessment, but not margin status, is strongly predictive of local disease-free and overall survival. Am J Surg Pathol. 2005;29:167-178.
35.
AgmonINAbudMLiranOet al. Exhaled breath analysis for monitoring response to treatment in advanced lung cancer. J Thorac Oncol. 2016;11:827-837.
36.
GruberMTischUJeriesRet al. Analysis of exhaled breath for diagnosing head and neck squamous cell carcinoma: a feasibility study. Br J Cancer. 2014;111:790-798.
37.
WilsonAD. Advances in electronic-nose technologies for the detection of volatile biomarker metabolites in the human breath. Metabolites. 2015;5:140-163.
38.
BikovALázárZHorvathI. Established methodological issues in electronic nose research: how far are we from using these instruments in clinical settings of breath analysis?J Breath Res. 2015;9:034001.
39.
SanoDOridateN. The molecular mechanism of human papillomavirus-induced carcinogenesis in head and neck squamous cell carcinoma. Int J Clin Oncol. 2016;21:819-826.
40.
MarcuLG. Future treatment directions for HPV-associated head and neck cancer based on radiobiological rationale and current clinical evidence. Crit Rev Oncol Hematol. 2016;103:27-36.
41.
TinhoferIJöhrensKKeilholzUet al. Contribution of human papilloma virus to the incidence of squamous cell carcinoma of the head and neck in a European population with high smoking prevalence. Eur J Cancer Oxf Engl 1990. 2015;51:514-521.
