The screening of volatile markers for hepatocellular carcinoma.
BACKGROUND
Breath analysis became promising for noninvasive diagnoses of cancer with sophisticated spectrometry technology introduced. This study aimed to screen volatile markers for hepatocellular carcinoma (HCC).


METHODS
Breath samples were collected from 30 HCC patients who were comorbid with type B hepatitis and cirrhosis and from 27 hepatocirrhosis patients and 36 healthy persons, both taken as controls. The volatile organic compounds in the samples were analyzed with gas chromatography/mass spectrometry and the markers were selected by comparing their levels between groups. Each of the markers was evaluated by receiver operating characteristic (ROC) curves and a discriminant function using the markers was established. The relationships of alpha-fetoprotein (AFP) levels and clinical stages with the concentrations of the markers were also investigated.


RESULTS
3-Hydroxy-2-butanone, styrene, and decane were screened as potential markers, among which 3-hydroxy-2-butanone was found to have the best diagnostic value. The diagnostic function using these markers had a sensitivity of 86.7% and a specificity of 91.7% between HCC patients and normal controls and a sensitivity of 83.3% and a specificity of 91.7% by cross-validation. No statistically significance (P > 0.05) was found for the concentration differences of these markers between HCC patients with AFP >400 or <400 microg/L or between stage I-II and stage III-IV patients.


CONCLUSIONS
These volatile organic compounds could be useful as breath markers of HCC patients, independent of AFP levels or clinical stages.


CONCLUSIONS
Breath analysis could be useful for early diagnosis of HCC, especially for AFP-negative HCC.
Qin
Tao
T
Department of Oncology, The First Affiliated Hospital of Anhui Medical University and 2Center of Medical Physics and Technology, Hefei Institutes of Physical Science, Chinese Academy of Science, Hefei, China.
Liu
Hu
H
Song
Qi
Q
Song
Geng
G
Wang
Hong-zhi
HZ
Pan
Yue-yin
YY
Xiong
Fu-xing
FX
Gu
Kang-sheng
KS
Sun
Guo-ping
GP
Chen
Zhen-dong
ZD
D000093:Acetoin / Q000032:analysis / Q000378:metabolism; D000473:Alkanes / Q000032:analysis / Q000378:metabolism; D014408:Biomarkers, Tumor / Q000032:analysis / Q000378:metabolism*; D001944:Breath Tests; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000378:metabolism* / Q000473:pathology; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry / Q000379:methods; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000378:metabolism* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012189:Retrospective Studies; D020058:Styrene / Q000032:analysis / Q000378:metabolism; D055549:Volatile Organic Compounds / Q000032:analysis / Q000378:metabolism*
D000473:Alkanes; D014408:Biomarkers, Tumor; D055549:Volatile Organic Compounds; D020058:Styrene; D000093:Acetoin; C012867:decane