title: Investigation of potential breath biomarkers for the early diagnosis of breast cancer using gas chromatography-mass spectrometry.
abstract: BACKGROUND
  Breast cancer (BC) remains the most commonly diagnosed malignancy in women. We investigated 4 straight aldehydes in the exhaled breath as potential early BC diagnostic biomarkers.
  
  
  METHODS
  End-tailed breath were collected by Bio-VOC® sampler and assayed by gas chromatography-mass spectrometry. Kruskal-Wallis one-way analysis of variance test and binary logistic regression were used for data analysis. The diagnostic accuracies were evaluated by receiver operating characteristic curves. A predictive model/equation was generated using the 4 biomarkers and validated by leave-one-out cross-validation.
  
  
  RESULTS
  All four potential biomarkers demonstrated significant differences in concentrations between BC and healthy controls (HC) (p<0.05). The areas under the curves (AUCs) in HC vs BCI-II model using hexanal, heptanal, octanal, and nonanal were 0.816, 0.809, 0.731, and 0.830, respectively. The AUC for their combined use was 0.934 (sensitivity 91.7%, specificity 95.8%) in the early diagnosis of BC. The predictive model/equation exhibited good sensitivity (72.7%) and specificity (91.7%) in distinguishing between HC and BC (cross-validation: sensitivity 68.2% and specificity 91.7%).
  
  
  CONCLUSIONS
  The diagnostic values of 4 exhaled straight aldehydes as early diagnostic biomarkers for BC were successfully verified and the diagnostic accuracy improved in their combined use.
authors.affiliation: Research Center of Analytical Instrumentation, College of Chemistry, Sichuan University, Chengdu China.
authors.forename: Jie
authors.initials: J
authors.lastname: Li
authors.affiliation: Utrasonic Department of China West Hospital of Sichuan University, No 37, Guo Xue Road, Chengdu, China (610041).
authors.forename: Yulan
authors.initials: Y
authors.lastname: Peng
authors.affiliation: Research Center of Analytical Instrumentation, Analytical and Testing Center, Sichuan University, Chengdu, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Research Center of Analytical Instrumentation, Analytical and Testing Center, Sichuan University, Chengdu, China.
authors.forename: Wenwen
authors.initials: W
authors.lastname: Li
authors.affiliation: Utrasonic Department of China West Hospital of Sichuan University, No 37, Guo Xue Road, Chengdu, China (610041).
authors.forename: Ya
authors.initials: Y
authors.lastname: Jin
authors.affiliation: Research Center of Analytical Instrumentation, Analytical and Testing Center, Sichuan University, Chengdu, China.
authors.forename: Zhentao
authors.initials: Z
authors.lastname: Tang
authors.affiliation: Research Center of Analytical Instrumentation, College of Chemistry, Sichuan University, Chengdu China; Research Center of Analytical Instrumentation, College of Life Science, Sichuan University, Chengdu China. Electronic address: yduan@scu.edu.cn.
authors.forename: Yixiang
authors.initials: Y
authors.lastname: Duan
mesh_terms: D000447:Aldehydes / Q000032:analysis*; D014408:Biomarkers, Tumor / Q000032:analysis*; D001943:Breast Neoplasms / Q000175:diagnosis*; D001944:Breath Tests; D016022:Case-Control Studies; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans
chemical_list: D000447:Aldehydes; D014408:Biomarkers, Tumor
keywords: Biomarkers; Breast cancer; Breath analysis; Early diagnosis; Noninvasive diagnosis