Exhaled breath analysis for the early detection of lung cancer: recent developments and future prospects

In lung cancer, the prognosis and treatment options depend directly on tumor size and its spread at the time of diagnosis. There is therefore a constant search for methods that will allow early detection of cancerous lung nodules. With advancing imaging technology and implantation of screening routines in high-risk populations by low-dose computerized tomography, a significant increase in the number of diagnosed small peripheral lesions can be expected. While early detection of small cancerous lesions carries the benefit of wider treatment options and better prognosis, the process of obtaining a biopsy to confirm a cancerous tissue is not free of complications and bears inconveniences and stress to the patient. This review discusses the potential use of exhaled breath analysis as a simple, noninvasive tool for early detection of lung cancer and characterization of suspicious lung nodules.

[1]  Giorgio Pennazza,et al.  Volatile signature for the early diagnosis of lung cancer , 2016, Journal of breath research.

[2]  R. Cataneo,et al.  Volatile organic compounds in breath as markers of lung cancer: a cross-sectional study , 1999, The Lancet.

[3]  Hossam Haick,et al.  Exhaled Breath Analysis for Monitoring Response to Treatment in Advanced Lung Cancer , 2016, Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer.

[4]  A. Amann,et al.  Suitability of different polymer bags for storage of volatile sulphur compounds relevant to breath analysis. , 2009, Journal of chromatography. B, Analytical technologies in the biomedical and life sciences.

[5]  J. Austin,et al.  Prediction of lung cancer using volatile biomarkers in breath. , 2007, Cancer biomarkers : section A of Disease markers.

[6]  T. Walles,et al.  Comparison of volatile organic compounds from lung cancer patients and healthy controls—challenges and limitations of an observational study , 2016, Journal of breath research.

[7]  N. Peled,et al.  Screening for Lung Cancer: What Comes Next? , 2015, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[8]  Matthew B Schabath,et al.  Lung cancer screening, version 1.2015: featured updates to the NCCN guidelines. , 2015, Journal of the National Comprehensive Cancer Network : JNCCN.

[9]  W. Miekisch,et al.  Diagnostic potential of breath analysis--focus on volatile organic compounds. , 2004, Clinica chimica acta; international journal of clinical chemistry.

[10]  P. Mazzone,et al.  Detection of lung cancer by sensor array analyses of exhaled breath. , 2005, American journal of respiratory and critical care medicine.

[11]  C Di Natale,et al.  In situ detection of lung cancer volatile fingerprints using bronchoscopic air-sampling. , 2012, Lung cancer.

[12]  M. Fiegl,et al.  Noninvasive detection of lung cancer by analysis of exhaled breath , 2009, BMC Cancer.

[13]  Hossam Haick,et al.  Nanoscale Sensor Technologies for Disease Detection via Volatolomics. , 2015, Small.

[14]  G. Sun,et al.  Quantitative breath analysis of volatile organic compounds of lung cancer patients. , 2010, Lung cancer.

[15]  J. Beauchamp,et al.  On the use of Tedlar® bags for breath-gas sampling and analysis , 2008, Journal of breath research.

[16]  J. Crowley,et al.  The IASLC Lung Cancer Staging Project: Proposals for the Revision of the TNM Stage Groupings in the Forthcoming (Seventh) Edition of the TNM Classification of Malignant Tumours , 2007, Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer.

[17]  B. Buszewski,et al.  The application of statistical methods using VOCs to identify patients with lung cancer , 2011, Journal of breath research.

[18]  Tarek Mekhail,et al.  Exhaled Breath Analysis with a Colorimetric Sensor Array for the Identification and Characterization of Lung Cancer , 2012, Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer.

[19]  J. Austin,et al.  Detection of lung cancer using weighted digital analysis of breath biomarkers. , 2008, Clinica chimica acta; international journal of clinical chemistry.

[20]  C. Dolea,et al.  World Health Organization , 1949, International Organization.

[21]  E. Martinelli,et al.  Lung cancer identification by the analysis of breath by means of an array of non-selective gas sensors. , 2003, Biosensors & bioelectronics.

[22]  H. Haick,et al.  Detection of lung, breast, colorectal, and prostate cancers from exhaled breath using a single array of nanosensors , 2010, British Journal of Cancer.

[23]  Hossam Haick,et al.  Volatile organic compounds of lung cancer and possible biochemical pathways. , 2012, Chemical reviews.

[24]  Hossam Haick,et al.  Detection of cancer through exhaled breath: a systematic review , 2015, Oncotarget.

[25]  Magdalena Ligor,et al.  Determination of volatile organic compounds in exhaled breath of patients with lung cancer using solid phase microextraction and gas chromatography mass spectrometry , 2009, Clinical chemistry and laboratory medicine.

[26]  H. J. O’neill,et al.  Volatile organic compounds in exhaled air from patients with lung cancer. , 1985, Clinical chemistry.

[27]  Ping Wang,et al.  The analysis of volatile organic compounds biomarkers for lung cancer in exhaled breath, tissues and cell lines. , 2012, Cancer biomarkers : section A of Disease markers.

[28]  Julian King,et al.  Stability of selected volatile breath constituents in Tedlar, Kynar and Flexfilm sampling bags. , 2013, The Analyst.

[29]  Kevin Gleeson,et al.  Detection of lung cancer with volatile markers in the breath. , 2003, Chest.

[30]  W. Miekisch,et al.  Breath gas aldehydes as biomarkers of lung cancer , 2009, International journal of cancer.

[31]  Radu Ionescu,et al.  Volatile fingerprints of cancer specific genetic mutations. , 2013, Nanomedicine : nanotechnology, biology, and medicine.

[32]  Hossam Haick,et al.  Sniffing the unique "odor print" of non-small-cell lung cancer with gold nanoparticles. , 2009, Small.

[33]  Giorgio Pennazza,et al.  The lung cancer breath signature: a comparative analysis of exhaled breath and air sampled from inside the lungs , 2015, Scientific Reports.

[34]  W. Miekisch,et al.  Breath biomarkers for lung cancer detection and assessment of smoking related effects--confounding variables, influence of normalization and statistical algorithms. , 2010, Clinica chimica acta; international journal of clinical chemistry.

[35]  Marc Quirynen,et al.  Differences between alveolar air and mouth air. , 2007, Analytical chemistry.

[36]  H. Haick,et al.  Non-invasive Breath Analysis of Pulmonary Nodules , 2012, Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer.

[37]  C. Gatsonis,et al.  Reduced Lung-Cancer Mortality with Low-Dose Computed Tomographic Screening , 2012 .

[38]  A. Onn,et al.  Screening for lung cancer: time for large-scale screening by chest computed tomography , 2014, European Respiratory Journal.

[39]  Marcus Wolff,et al.  VOC breath biomarkers in lung cancer. , 2016, Clinica chimica acta; international journal of clinical chemistry.

[40]  Onofrio Resta,et al.  An electronic nose in the discrimination of patients with non-small cell lung cancer and COPD. , 2009, Lung cancer.

[41]  Ulrike Tisch,et al.  A nanomaterial-based breath test for short-term follow-up after lung tumor resection. , 2013, Nanomedicine : nanotechnology, biology, and medicine.

[42]  Ulrike Tisch,et al.  Classification of lung cancer histology by gold nanoparticle sensors. , 2012, Nanomedicine : nanotechnology, biology, and medicine.

[43]  Calum E. MacAulay,et al.  Sex and Smoking Status Effects on the Early Detection of Early Lung Cancer in High-Risk Smokers Using an Electronic Nose , 2015, IEEE Transactions on Biomedical Engineering.

[44]  Giorgio Pennazza,et al.  An investigation on electronic nose diagnosis of lung cancer. , 2010, Lung cancer.

[45]  Hossam Haick,et al.  Assessment, origin, and implementation of breath volatile cancer markers. , 2014, Chemical Society reviews.

[46]  John C. Cancilla,et al.  Silicon Nanowire Sensors Enable Diagnosis of Patients via Exhaled Breath. , 2016, ACS nano.

[47]  John C. Cancilla,et al.  Cancerous glucose metabolism in lung cancer—evidence from exhaled breath analysis , 2016, Journal of breath research.

[48]  M. Phillips,et al.  Blinded Validation of Breath Biomarkers of Lung Cancer, a Potential Ancillary to Chest CT Screening , 2015, PloS one.

[49]  Massimo Corradi,et al.  Determination of aldehydes in exhaled breath of patients with lung cancer by means of on-fiber-derivatisation SPME-GC/MS. , 2010, Journal of chromatography. B, Analytical technologies in the biomedical and life sciences.

[50]  A. Zwinderman,et al.  Combined sputum hypermethylation and eNose analysis for lung cancer diagnosis , 2014, Journal of Clinical Pathology.

[51]  William Hazelton,et al.  Benefits and Harms of Computed Tomography Lung Cancer Screening Strategies: A Comparative Modeling Study for the U.S. Preventive Services Task Force , 2014, Annals of Internal Medicine.

[52]  L. Bianchi,et al.  Exhaled volatile organic compounds in patients with non-small cell lung cancer: cross sectional and nested short-term follow-up study , 2005, Respiratory research.

[53]  H. Haick,et al.  Diagnosis and Classification of 17 Diseases from 1404 Subjects via Pattern Analysis of Exhaled Molecules , 2016, ACS nano.

[54]  Giorgio Pennazza,et al.  Interpretation of exhaled volatile organic compounds , 2010 .

[55]  Q. Jöbsis,et al.  Clinical use of exhaled volatile organic compounds in pulmonary diseases: a systematic review , 2012, Respiratory Research.

[56]  Tarek Mekhail,et al.  Diagnosis of lung cancer by the analysis of exhaled breath with a colorimetric sensor array , 2007, Thorax.