Increased number of volatile organic compounds over malignant glottic lesions.
Electronic noses can identify diseases, including head and neck squamous cell carcinoma (SCC) by the fingerprint of volatile organic compounds (VOCs) in exhaled air. However, whether these VOCs originated from the malignant lesion itself remains unclear. The objective was to test for the presence and properties of VOCs directly over the vocal folds in malignant and benign lesions, as a potential tool for noninvasive screening.



Prospective observational case control study.



Samples of mucus directly covering vocal fold lesions were analyzed using gas chromatography mass spectrometry for detection of VOCs, and evaluation of the properties and quantity of VOCs in the samples. Additionally, samples of oropharyngeal mucus were analyzed to exclude VOCs found also in the vicinity of the lesion. Benign and malignant lesion groups were compared using a nonparametric (Mann-Whitney) test.



We studied 14 patients, six with SCC and eight with benign pathology. We found an increased number of discrete VOC types in patients with SCC both above the lesion (SCC = 4.333 ± 2.5, benign = 0.875 ± 0.6; Z=3, P < .001) and directly above the lesion with exclusion of its vicinity (SCC = 3.167 ± 1.9, benign = 0.5 ± 0.5; Z = 2.8, P < .003). VOCs detected in SCCs but not in benign samples included the straight-chain fatty acids: butyric acid, pentanoic acid, hexanoic acid, and heptanoic acid.



Compared with benign vocal fold lesions, the environment of vocal folds in SCC is enriched with VOCs. These preliminary findings highlight a unique pattern that may contribute to the development of a future minimally invasive technology for screening vocal fold lesions for malignancy.



NA Laryngoscope, 126:1606-1611, 2016.
Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel.|Department of Otolaryngology-Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel, affiliated with the Hebrew University Jerusalem, Israel.
Hagit
H
Shoffel-Havakuk
Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel.
Idan
I
Frumin
Department of Otolaryngology-Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel, affiliated with the Hebrew University Jerusalem, Israel.
Yonatan
Y
Lahav
Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel.
Lior
L
Haviv
Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel.
Noam
N
Sobel
Department of Otolaryngology-Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel, affiliated with the Hebrew University Jerusalem, Israel.
Doron
D
Halperin
D000368:Aged; D002278:Carcinoma in Situ / Q000737:chemistry*; D002294:Carcinoma, Squamous Cell / Q000737:chemistry*; D016022:Case-Control Studies; D062609:Electronic Nose; D005260:Female; D005931:Glottis; D006801:Humans; D007822:Laryngeal Neoplasms / Q000737:chemistry*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055549:Volatile Organic Compounds / Q000032:analysis*
D055549:Volatile Organic Compounds
Laryngeal carcinoma; chromatography; electronic nose; glottis; vocal folds; volatile organic compounds