Volatile organic compounds in plasma for the diagnosis of esophageal adenocarcinoma: a pilot study

• Published in: Gastrointestinal endoscopy 2016-10, Vol.84 (4), p.597-603
• Main Authors: Bhatt, Amit, MD, Parsi, Mansour A., MD, MPH, Stevens, Tyler, MD, Gabbard, Scott, MD, Kumaravel, Arthi, MD, Jang, Sunguk, MD, Grove, David, PhD, Lopez, Rocio, MS, Murthy, Sudish, MD, Vargo, John J., MD, MPH, Dweik, Raed, MD
• Format: Article
• Language: English
• Subjects: Acetonitriles - blood; Acrylonitrile - blood; Adenocarcinoma - blood; Adenocarcinoma - diagnosis; Adult; Aged; Area Under Curve; Butadienes - blood; Carbon Disulfide - blood; Case-Control Studies; Cross-Sectional Studies; Endoscopy, Digestive System; Esophageal Neoplasms - blood; Esophageal Neoplasms - diagnosis; Ethylamines - blood; Female; Gastroenterology and Hepatology; Gastroesophageal Reflux - blood; Gastroesophageal Reflux - diagnosis; Hemiterpenes - blood; Hexanes - blood; Humans; Hydrogen Sulfide - blood; Logistic Models; Male; Middle Aged; Multivariate Analysis; Pentanes - blood; Pilot Projects; Volatile Organic Compounds - blood
• ISSN: 0016-5107; 1097-6779
• DOI: 10.1016/j.gie.2015.11.031

Background and Aims A noninvasive screening test that can detect esophageal adenocarcinoma (EAC) at an earlier stage could improve the prognosis associated with EAC. The role of plasma volatile organic compounds (VOCs) for the diagnosis of EAC has not been previously studied. Methods Plasma samples were collected from subjects with EAC and GERD before endoscopy. Twenty-two preselected VOCs were analyzed with selected ion flow tube mass spectrometry. Results The headspaces from 39 plasma samples (20 EAC, 19 GERD) were analyzed. The levels of 9 VOCs (acetonitrile, acrylonitrile, carbon disulfide, isoprene, 1-heptene, 3-methylhexane, [E]-2-nonene, hydrogen sulfide, and triethylamine) were significantly altered in EAC patients compared with GERD patients. A multivariable logistic regression analysis was performed to build a model for the prediction of EAC. The model identified patients with EAC with an area under the curve of 0.83 (95% confidence interval, 0.67-0.98). Conclusions Plasma VOCs may be useful in diagnosing EAC. Larger studies are needed to confirm our pilot study observations.