title: Detection of lung cancer by sensor array analyses of exhaled breath.
abstract: BACKGROUND
  Electronic noses are successfully used in commercial applications, including detection and analysis of volatile organic compounds in the food industry.
  
  
  OBJECTIVE
  We hypothesized that the electronic nose could identify and discriminate between lung diseases, especially bronchogenic carcinoma.
  
  
  METHODS
  In a discovery and training phase, exhaled breath of 14 individuals with bronchogenic carcinoma and 45 healthy control subjects or control subjects without cancer was analyzed. Principal components and canonic discriminant analysis of the sensor data was used to determine whether exhaled gases could discriminate between cancer and noncancer. Discrimination between classes was performed using Mahalanobis distance. Support vector machine analysis was used to create and apply a cancer prediction model prospectively in a separate group of 76 individuals, 14 with and 62 without cancer.
  
  
  RESULTS
  Principal components and canonic discriminant analysis demonstrated discrimination between samples from patients with lung cancer and those from other groups. In the validation study, the electronic nose had 71.4% sensitivity and 91.9% specificity for detecting lung cancer; positive and negative predictive values were 66.6 and 93.4%, respectively. In this population with a lung cancer prevalence of 18%, positive and negative predictive values were 66.6 and 94.5%, respectively.
  
  
  CONCLUSIONS
  The exhaled breath of patients with lung cancer has distinct characteristics that can be identified with an electronic nose. The results provide feasibility to the concept of using the electronic nose for managing and detecting lung cancer.
authors.affiliation: Department of Pathobiology, Lerner Research Institute, Cleveland, OH, USA.
authors.forename: Roberto F
authors.initials: RF
authors.lastname: Machado
authors.forename: Daniel
authors.initials: D
authors.lastname: Laskowski
authors.forename: Olivia
authors.initials: O
authors.lastname: Deffenderfer
authors.forename: Timothy
authors.initials: T
authors.lastname: Burch
authors.forename: Shuo
authors.initials: S
authors.lastname: Zheng
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Mazzone
authors.forename: Tarek
authors.initials: T
authors.lastname: Mekhail
authors.forename: Constance
authors.initials: C
authors.lastname: Jennings
authors.forename: James K
authors.initials: JK
authors.lastname: Stoller
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Pyle
authors.forename: Jennifer
authors.initials: J
authors.lastname: Duncan
authors.forename: Raed A
authors.initials: RA
authors.lastname: Dweik
authors.forename: Serpil C
authors.initials: SC
authors.lastname: Erzurum
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001944:Breath Tests / Q000379:methods*; D002849:Chromatography, Gas; D003430:Cross-Sectional Studies; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis*; D008297:Male; D013058:Mass Spectrometry; D008875:Middle Aged; D025341:Principal Component Analysis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity