title: Diagnosis of head-and-neck cancer from exhaled breath.
abstract: BACKGROUND
  Head-and-neck cancer (HNC) is the eighth most common malignancy worldwide. It is often diagnosed late due to a lack of screening methods and overall cure is achieved in <50% of patients. Head-and-neck cancer sufferers often develop a second primary tumour that can affect the entire aero-digestive tract, mostly HNC or lung cancer (LC), making lifelong follow-up necessary.
  
  
  METHODS
  Alveolar breath was collected from 87 volunteers (HNC and LC patients and healthy controls) in a cross-sectional clinical trial. The discriminative power of a tailor-made Nanoscale Artificial Nose (NA-NOSE) based on an array of five gold nanoparticle sensors was tested, using 62 breath samples. The NA-NOSE signals were analysed to detect statistically significant differences between the sub-populations using (i) principal component analysis with ANOVA and Student's t-test and (ii) support vector machines and cross-validation. The identification of NA-NOSE patterns was supported by comparative analysis of the chemical composition of the breath through gas chromatography in conjunction with mass spectrometry (GC-MS), using 40 breath samples.
  
  
  RESULTS
  The NA-NOSE could clearly distinguish between (i) HNC patients and healthy controls, (ii) LC patients and healthy controls, and (iii) HNC and LC patients. The GC-MS analysis showed statistically significant differences in the chemical composition of the breath of the three groups.
  
  
  CONCLUSIONS
  The presented results could lead to the development of a cost-effective, fast, and reliable method for the differential diagnosis of HNC that is based on breath testing with an NA-NOSE, with a future potential as screening tool.
authors.affiliation: The Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa 32000, Israel.
authors.forename: M
authors.initials: M
authors.lastname: Hakim
authors.forename: S
authors.initials: S
authors.lastname: Billan
authors.forename: U
authors.initials: U
authors.lastname: Tisch
authors.forename: G
authors.initials: G
authors.lastname: Peng
authors.forename: I
authors.initials: I
authors.lastname: Dvrokind
authors.forename: O
authors.initials: O
authors.lastname: Marom
authors.forename: R
authors.initials: R
authors.lastname: Abdah-Bortnyak
authors.forename: A
authors.initials: A
authors.lastname: Kuten
authors.forename: H
authors.initials: H
authors.lastname: Haick
mesh_terms: D000328:Adult; D000368:Aged; D001944:Breath Tests / Q000379:methods; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer / Q000379:methods; D045853:Exhalation / Q000502:physiology; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry / Q000379:methods; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult