title: Exhaled breath analysis for lung cancer detection using ion mobility spectrometry.
abstract: BACKGROUND
  Conventional methods for lung cancer detection including computed tomography (CT) and bronchoscopy are expensive and invasive. Thus, there is still a need for an optimal lung cancer detection technique.
  
  
  METHODS
  The exhaled breath of 50 patients with lung cancer histologically proven by bronchoscopic biopsy samples (32 adenocarcinomas, 10 squamous cell carcinomas, 8 small cell carcinomas), were analyzed using ion mobility spectrometry (IMS) and compared with 39 healthy volunteers. As a secondary assessment, we compared adenocarcinoma patients with and without epidermal growth factor receptor (EGFR) mutation.
  
  
  RESULTS
  A decision tree algorithm could separate patients with lung cancer including adenocarcinoma, squamous cell carcinoma and small cell carcinoma. One hundred-fifteen separated volatile organic compound (VOC) peaks were analyzed. Peak-2 noted as n-Dodecane using the IMS database was able to separate values with a sensitivity of 70.0% and a specificity of 89.7%. Incorporating a decision tree algorithm starting with n-Dodecane, a sensitivity of 76% and specificity of 100% was achieved. Comparing VOC peaks between adenocarcinoma and healthy subjects, n-Dodecane was able to separate values with a sensitivity of 81.3% and a specificity of 89.7%. Fourteen patients positive for EGFR mutation displayed a significantly higher n-Dodecane than for the 14 patients negative for EGFR (p<0.01), with a sensitivity of 85.7% and a specificity of 78.6%.
  
  
  CONCLUSIONS
  In this prospective study, VOC peak patterns using a decision tree algorithm were useful in the detection of lung cancer. Moreover, n-Dodecane analysis from adenocarcinoma patients might be useful to discriminate the EGFR mutation.
authors.affiliation: Division of Respiratory and Infectious Diseases, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki-shi, Kanagawa, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Handa
authors.affiliation: Division of Respiratory and Infectious Diseases, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki-shi, Kanagawa, Japan.
authors.forename: Ayano
authors.initials: A
authors.lastname: Usuba
authors.affiliation: B&S Analytik, BioMedicalCenter, Dortmund, Germany.
authors.forename: Sasidhar
authors.initials: S
authors.lastname: Maddula
authors.affiliation: Reutlingen University, Faculty Applied Chemistry, Reutlingen, Germany.
authors.forename: Jörg Ingo
authors.initials: JI
authors.lastname: Baumbach
authors.affiliation: Division of Respiratory and Infectious Diseases, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki-shi, Kanagawa, Japan.
authors.forename: Masamichi
authors.initials: M
authors.lastname: Mineshita
authors.affiliation: Division of Respiratory and Infectious Diseases, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki-shi, Kanagawa, Japan.
authors.forename: Teruomi
authors.initials: T
authors.lastname: Miyazawa
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000235:genetics; D000328:Adult; D000368:Aged; D000473:Alkanes / Q000032:analysis; D001944:Breath Tests / Q000379:methods; D003663:Decision Trees; D066246:ErbB Receptors / Q000235:genetics*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000235:genetics; D008297:Male; D008875:Middle Aged; D009154:Mutation; D012907:Smoking; D013057:Spectrum Analysis / Q000379:methods; D055549:Volatile Organic Compounds / Q000032:analysis*
chemical_list: D000473:Alkanes; D055549:Volatile Organic Compounds; C007548:n-dodecane; D066246:ErbB Receptors