title: An electronic nose distinguishes exhaled breath of patients with Malignant Pleural Mesothelioma from controls.
abstract: BACKGROUND
  Malignant Pleural Mesothelioma (MPM) is a tumour of the surface cells of the pleura that is highly aggressive and mainly caused by asbestos exposure. Electronic noses capture the spectrum of exhaled volatile organic compounds (VOCs) providing a composite biomarker profile (breathprint).
  
  
  OBJECTIVE
  We tested the hypothesis that an electronic nose can discriminate exhaled air of patients with MPM from subjects with a similar long-term professional exposure to asbestos without MPM and from healthy controls.
  
  
  METHODS
  13 patients with a histology confirmed diagnosis of MPM (age 60.9±12.2 year), 13 subjects with certified, long-term professional asbestos exposure (age 67.2±9.8), and 13 healthy subjects without asbestos exposure (age 52.2±16.2) participated in a cross-sectional study. Exhaled breath was collected by a previously described method and sampled by an electronic nose (Cyranose 320). Breathprints were analyzed by canonical discriminant analysis on principal component reduction. Cross-validated accuracy (CVA) was calculated.
  
  
  RESULTS
  Breathprints from patients with MPM were separated from subjects with asbestos exposure (CVA: 80.8%, sensitivity 92.3%, specificity 85.7%). MPM was also distinguished from healthy controls (CVA: 84.6%). Repeated measurements confirmed these results.
  
  
  CONCLUSIONS
  Molecular pattern recognition of exhaled breath can correctly distinguish patients with MPM from subjects with similar occupational asbestos exposure without MPM and from healthy controls. This suggests that breathprints obtained by electronic nose have diagnostic potential for MPM.
authors.affiliation: Department of Respiratory Diseases, University of Bari, Bari, Italy. sdragonieri@hotmail.com
authors.forename: Silvano
authors.initials: S
authors.lastname: Dragonieri
authors.forename: Marc P
authors.initials: MP
authors.lastname: van der Schee
authors.forename: Tommaso
authors.initials: T
authors.lastname: Massaro
authors.forename: Nunzia
authors.initials: N
authors.lastname: Schiavulli
authors.forename: Paul
authors.initials: P
authors.lastname: Brinkman
authors.forename: Armando
authors.initials: A
authors.lastname: Pinca
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Carratú
authors.forename: Antonio
authors.initials: A
authors.lastname: Spanevello
authors.forename: Onofrio
authors.initials: O
authors.lastname: Resta
authors.forename: Marina
authors.initials: M
authors.lastname: Musti
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Sterk
mesh_terms: D000368:Aged; D001194:Asbestos / Q000633:toxicity; D001944:Breath Tests / Q000379:methods*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008654:Mesothelioma / Q000175:diagnosis*; D008875:Middle Aged; D016273:Occupational Exposure; D010997:Pleural Neoplasms / Q000175:diagnosis*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D001194:Asbestos