Identifying potential breath biomarkers for early diagnosis of papillary thyroid cancer based on solid-phase microextraction gas chromatography-high resolution mass spectrometry with metabolomics

• Published in: Metabolomics 2024-05, Vol.20 (3), p.59, Article 59
• Main Authors: Li, Lan, Wen, Xinxin, Li, Xian, Yan, Yaqi, Wang, Jiayu, Zhao, Xuyang, Tian, Yonghui, Ling, Rui, Duan, Yixiang
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aromatic compounds; Biochemistry; Biomarkers; Biomarkers, Tumor - analysis; Biomarkers, Tumor - metabolism; Biomedical and Life Sciences; Biomedicine; Biopsy; Breath tests; Breath Tests - methods; Cell Biology; Chromatography; Developmental Biology; Diagnosis; Early Detection of Cancer - methods; Esters; Female; Gas chromatography; Gas Chromatography-Mass Spectrometry - methods; Humans; Invasiveness; Life Sciences; Male; Mass spectrometry; Mass spectroscopy; Medical diagnosis; Metabolomics; Metabolomics - methods; Middle Aged; Molecular Medicine; Original Article; Papillary thyroid cancer; Population studies; Sampling; Scientific imaging; Solid phase methods; Solid Phase Microextraction - methods; Thyroid cancer; Thyroid Cancer, Papillary - diagnosis; Thyroid Cancer, Papillary - metabolism; Thyroid Neoplasms - diagnosis; Thyroid Neoplasms - metabolism
• ISSN: 1573-3890; 1573-3882; 1573-3890
• DOI: 10.1007/s11306-024-02119-w

Introduction Thyroid cancer incidence rate has increased substantially worldwide in recent years. Fine needle aspiration biopsy (FNAB) is currently the golden standard of thyroid cancer diagnosis, which however, is invasive and costly. In contrast, breath analysis is a non-invasive, safe and simple sampling method combined with a promising metabolomics approach, which is suitable for early cancer diagnosis in high volume population. Objectives This study aims to achieve a more comprehensive and definitive exhaled breath metabolism profile in papillary thyroid cancer patients (PTCs). Methods We studied both end-tidal and mixed expiratory breath, solid-phase microextraction gas chromatography coupled with high resolution mass spectrometry (SPME-GC-HRMS) was used to analyze the breath samples. Multivariate combined univariate analysis was applied to identify potential breath biomarkers. Results The biomarkers identified in end-tidal and mixed expiratory breath mainly included alkanes, olefins, enols, enones, esters, aromatic compounds, and fluorine and chlorine containing organic compounds. The area under the curve (AUC) values of combined biomarkers were 0.974 (sensitivity: 96.1%, specificity: 90.2%) and 0.909 (sensitivity: 98.0%, specificity: 74.5%), respectively, for the end-tidal and mixed expiratory breath, indicating of reliability of the sampling and analysis method Conclusion This work not only successfully established a standard metabolomic approach for early diagnosis of PTC, but also revealed the necessity of using both the two breath types for comprehensive analysis of the biomarkers.