Background: An effective screening tool for colorectal cancer is still lacking. Analysis of the volatile organic compounds (VOCs) linked to cancer is a new frontier in cancer screening, as tumour growth involves several metabolic changes leading to the production of specific compounds that can be detected in exhaled breath. This study investigated whether patients with colorectal cancer have a specific VOC pattern compared with the healthy population.Methods: Exhaled breath was collected in an inert bag (Tedlar ) from patients with colorectal cancer and healthy controls (negative at colonoscopy), and processed offline by thermal-desorber gas chromatography-mass spectrometry to evaluate the VOC profile. During the trial phase VOCs of interest were identified and selected, and VOC patterns able to discriminate patients from controls were set up; in the validation phase their discriminant performance was tested on blinded samples. A probabilistic neural network (PNN) validated by the leave-one-out method was used to identify the pattern of VOCs that better discriminated between the two groups.
In recent years, the use of synthetic materials in\ud building and furnishing, the adoption of new lifestyles, the\ud extensive use of products for environmental cleaning and\ud personal hygiene have contributed to the deterioration of\ud indoor air quality and introduced new sources of risk to\ud humans. Indoor environments include home, workplaces\ud such as offices, public buildings such as hospitals, schools,\ud kindergartens, sports halls, libraries, restaurants and bars,\ud theaters and cinemas and finally cabins of vehicles. Indoor\ud environments in schools have been of particular public\ud concern. According to recent studies, children aged\ud between 3 and 14 spend 90 % of the day indoors both in\ud winter and summer. Moreover, children have greater susceptibility\ud to some environmental pollutants than adults,\ud because they breathe higher volumes of air relative to their\ud body weights, and their tissues and organs are actively\ud growing. In this review, the authors explore the methodological\ud approaches used for the assessment of air quality in schools: monitoring strategies, sampling and analysis\ud techniques and summarizing an overview of main findings\ud from scientific literature concerning the most common\ud pollutants found in school environments
Analysis of the volatile part of the metabolome (volatile organic compounds, VOC) present in the gas phase of excreted materials is a promising new screening tool for several cancers, including colorectal cancer (CRC). The VOC signature can reflect health status, like a 'fingerprint', and can be modified in several diseases. Technical difficulties still limit the widespread use of VOC analysis in the clinical setting, but this approach has already been applied successfully in the diagnosis of CRC. The present study reviews the available data on VOC present in the headspace (the gaseous constituents of a closed space above a liquid or solid) of blood, urine, faeces and breath as a potential screening tool for CRC. A systematic electronic literature search was conducted in PubMed, Scirus and Google using the following keywords: Metabolomic, Volatile Organic Compounds (VOC), Electronic-nose and Colorectal Cancer. Only articles published in English between 2000 and 2015 were selected and these were independently checked by two of the authors. Ten papers describing the reliability of VOC analysis in breath and faeces, blood and urine were selected; all indicated good reliability in detecting CRC. The use of different substrates and different analytical platforms has led to the identification of different patterns of VOC. The reliability of a metabolomic approach as a noninvasive biomarker for use in CRC screening is supported by this review despite several limitations due to the number of patients included in each study, the different analytical platforms and biological materials used and different VOC identified.
Exhaled VOCs pattern from CRC patients is modified by cancer removal confirming the tight relationship between tumor metabolism and exhaled VOCs. PNN analysis provides a high discriminatory tool to identify patients disease-free after curative surgery suggesting potential implications in CRC screening and secondary prevention.
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