Exhaled volatile organic compounds identify patients with colorectal cancer

  • Author: D. F. Altomare, M. Di Lena, F. Porcelli, L. Trizio, E. Travaglio, M. Tutino, S. Dragonieri, V. Memeo, G. de Gennaro

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We thank Dr Matuchansky for his interest in our study and for the letter underlying the possible evolution of this technique for the cancer screening.

Of course we know the paper of Sonoda on the dog sniffer and it is a further element in favour of the presence of specific volatile compounds in the exhaled breath of cancer patients which are not detectable by human olfactory mucosa. In this regard our paper explores this difference trying to identify these compounds using sophisticated technology and statistical analysis. The development of a reliable qualitative analysis using the electronic nose is a field of intensive research in several international research centers for its obvious advantages for screening purposes; however its clinical application is still a far to be adopted.

One of the arms of this study in our laboratory is in fact the correlation of the CG-MS outcome with the output from the electronic nose.

Donato F Altomare
Department of Emergency and Organ Transplantation
University Aldo Moro of Bari

  • Commentor: Donato F Altomare - University Aldo Moro of Bari
  • Date: Feb 26, 2013

I read with great interest this article showing that breath volatile organic compounds (VOCs) pattern analysis by gas chromatography-mass spectrometry has potential clinical application in human colorectal cancer (CRC) screening with an accuracy to discriminate patients with CRC of over 75%. These preliminary results provided by a 'chemical nose' may prove of paramount importance, but the authors appropriately emphasize, as does the commentary (1), that the methodology could be improved by the use of an electronic nose (2).

The authors omitted to quote a recently published important work using a dog 'natural nose' for human CRC screening in exhaled breath (3) The results strongly support their own conclusions from a 'chemical nose'. Indeed, it was shown that CRC can be screened with odour material by canine scent detection, using a specially trained Labrador retriever: the sensitivity and specificity of detection in 33 breath samples compared with colonoscopy diagnosis were 0.91 and 0.99, respectively, and detection accuracy was not confounded by current smoking, colorectal benign polyps or inflammation (3). Similar figures were obtained using canine scent detection in 37 watery stool samples (3). The nose performance of dogs is linked to their approximately 200 million olfactory receptors related to up of 6% of their genome, to be compared with the 5 million and up to 2% of the genome in humans (4,5).

C. Matuchansky
Lariboisiere St-Louis Faculty of Medicine
Denis Diderot-Paris 7 University
29 rue Médéric
Paris 75017

1.Zbar A. Exhaled volatile organic compounds identify patients with colorectal cancer. Br J Surg 2013;100:151.
2.Arasaradnam RP, Quraishi N, Kyrou I, Nwokolo CU, Joseph M, Kumar S et al. Insights into 'fermentonomics': evaluation of volatile organic compounds (VOCs) in human disease using an electronic 'e-nose'. J Med EngTechnol 2011;35:87-91.
3.Sonoda H, Kohnoe S, Yamazato T, Satoh Y, Morizono G, Shikata K et al. Colorectal cancer screening with odour material by canine scent detection. Gut 2011;60:814-819.
4.Arasaradnam RP, Nwokolo CU, Bardhan KD, Covington JA. Electronic nose versus canine nose: clash of the titans. Gut 2011;60:1768.
5.Quignon P, Kirkness E, Cadieu E, Touleimat N, Guvon R, Renier C et al. Comparison of the canine and human olfactory receptor gene repertoires. Genome Biol 2003;4:R80.

  • Commentor: Matuchansky - Denis Diderot-Paris 7 University, Paris, France
  • Date: Jan 14, 2013

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