Urinary volatile organic compounds for colorectal cancer screening: A systematic review and meta-analysis

Liere, Elsa L S A van; Dijk, Laura J. van; Bosch, Sofie; Vermeulen, Louis; Heymans, Martijn W.; Burchell, George L.; Meij, Tim G. J. de; Ramsoekh, Dewkoemar; Boer, Nanne K H de

doi:10.1016/j.ejca.2023.03.002

Cited by 7 publications

(4 citation statements)

References 67 publications

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“…The visually assessed SROC curves indicated clinical accuracy, with VOC analysis and e-nose having SROC curves of approximately 0.93 and 0.90, respectively, both close to 1, signifying superior accuracy and diagnostic efficacy in CRC diagnosis. These findings align with prior reviews ( 22 , 59 , 60 ), but the notable heterogeneity between studies and the identified high risk of bias warrant cautious interpretation. The heterogeneity was largely due to the sample media and the analytical methods used.…”

Section: Discussionsupporting

confidence: 87%

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Diagnostic performance of volatile organic compounds analysis and electronic noses for detecting colorectal cancer: a systematic review and meta-analysis

Wang,

Fang,

Tan

et al. 2024

Front. Oncol.

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IntroductionThe detection of Volatile Organic Compounds (VOCs) could provide a potential diagnostic modality for the early detection and surveillance of colorectal cancers. However, the overall diagnostic accuracy of the proposed tests remains uncertain.ObjectiveThis systematic review is to ascertain the diagnostic accuracy of using VOC analysis techniques and electronic noses (e-noses) as noninvasive diagnostic methods for colorectal cancer within the realm of clinical practice.MethodsA systematic search was undertaken on PubMed, EMBASE, Web of Science, and the Cochrane Library to scrutinize pertinent studies published from their inception to September 1, 2023. Only studies conducted on human subjects were included. Meta-analysis was performed using a bivariate model to obtain summary estimates of sensitivity, specificity, and positive and negative likelihood ratios. The Quality Assessment of Diagnostic Accuracy Studies 2 tool was deployed for quality assessment. The protocol for this systematic review was registered in PROSPERO, and PRISMA guidelines were used for the identification, screening, eligibility, and selection process.ResultsThis review encompassed 32 studies, 22 studies for VOC analysis and 9 studies for e-nose, one for both, with a total of 4688 subjects in the analysis. The pooled sensitivity and specificity of VOC analysis for CRC detection were 0.88 (95% CI, 0.83-0.92) and 0.85 (95% CI, 0.78-0.90), respectively. In the case of e-nose, the pooled sensitivity was 0.87 (95% CI, 0.83-0.90), and the pooled specificity was 0.78 (95% CI, 0.62-0.88). The area under the receiver operating characteristic analysis (ROC) curve for VOC analysis and e-noses were 0.93 (95% CI, 0.90-0.95) and 0.90 (95% CI, 0.87-0.92), respectively.ConclusionThe outcomes of this review substantiate the commendable accuracy of VOC analysis and e-nose technology in detecting CRC. VOC analysis has a higher specificity than e-nose for the diagnosis of CRC and a sensitivity comparable to that of e-nose. However, numerous limitations, including a modest sample size, absence of standardized collection methods, lack of external validation, and a notable risk of bias, were identified. Consequently, there exists an imperative need for expansive, multi-center clinical studies to elucidate the applicability and reproducibility of VOC analysis or e-nose in the noninvasive diagnosis of colorectal cancer.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/#recordDetails, identifier CRD42023398465.

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Section: Discussionsupporting

confidence: 87%

“…Recent meta-analysis evaluated the performance of the combined FIT and urinary. The findings revealed that the combined FIT-VOC approach could detect 33% more cases of colorectal cancers ( 60 ). Chandrapalan S et al.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic performance of volatile organic compounds analysis and electronic noses for detecting colorectal cancer: a systematic review and meta-analysis

Wang,

Fang,

Tan

et al. 2024

Front. Oncol.

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“…Together with others 10,11,[28][29][30] , our present exploratory work further expands the application of the new concept of VOCs in medicine and tests the possibility in perioperative monitoring. We also provide new insights into the thorny issue of perioperative traumatic stress monitoring, a necessary measure to prevent multiple complications in perioperative patients.…”

Section: Discussionmentioning

confidence: 60%

Association of Exhaled Breath Volatile Organic Compounds with Surgical Traumatic Stress during General Anaesthesia: An Exploratory Study

Wang,

Zhao,

et al. 2024

Preprint

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Surgical procedures can induce traumatic stress responses, which are associated with postoperative complications. Therefore, a perioperative monitor is needed to identify patients with a higher degree of stress responses. We explored the relationship between breath volatile organic compounds (VOCs), a non-invasive method widely explored in disease diagnosis, and surgical traumatic stress. Exhaled breath and blood samples were collected from 105 patients under general anaesthesia at three time points: prior to incision (Pre-op), 2h after incision (Intra-op), and prior to extubation (End-op). Differential VOCs between these time points were screened. Blood metabolomics analysis, traumatic stress-related biomarkers detection, and correlation analysis between VOCs and stress biomarkers were performed. We found that both the abundance of VOCs and blood metabolites changed significantly between these time points. Norepinephrine, epinephrine and cortisol all increased significantly in Intra-op and then reduced significantly in End-op. Correlation analysis showed both Comp_6 and Comp_23 were negatively correlated with norepinephrine in group comparison between Intra-op and End-op, the same trend as that in group comparison between Pre-op and Intra-op. We conclude that surgical traumatic stress resulting from surgical procedures may change the exhaled breath VOC profile in perioperative patients, providing preliminary evidence for VOC use in future monitoring.

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“…Whereas most research into VOCs as biomarkers of gastrointestinal disease is oriented towards the diagnosis of upper and lower gastrointestinal cancer, 25 , 26 there have also been case-control studies and cohort studies of faecal, breath, and urinary VOCs in inflammatory bowel disease. In this study, we aim to provide an up to date review of the available literature on studies of diagnostic accuracy of VOCs in inflammatory bowel disease, and to calculate pooled sensitivity and specificity data.…”

Section: Introductionmentioning

confidence: 99%

The Diagnostic Utility of Volatile Organic Compounds in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

Krishnamoorthy

Chandrapalan

Ahmed

et al. 2023

Journal of Crohn's and Colitis

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Background Volatile organic compounds (VOCs) show promise as potential biomarkers of for ulcerative colitis and Crohn’s disease, two chronic idiopathic gastrointestinal disorders with diagnostic and management challenges. Non-invasive biomarkers aid early diagnosis and management. In this study we review studies of diagnostic accuracy of VOCs in inflammatory bowel disease. Methods A systematic search was carried out on the Pubmed and Scopus databases; with sixteen studies reviewed and meta-analysis carried out on ten. Results Meta analysis of 696 IBD cases against 605 controls revealed a pooled sensitivity and specificity of 87% (95% CI, 0.79 - 0.92) and 83% (95% CI, 0.73 - 0.90) respectively. AUC was 0.92. Conclusion VOCs perform very well as non-invasive biomarkers of IBD; with much scope for future improvement and research.

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Urinary volatile organic compounds for colorectal cancer screening: A systematic review and meta-analysis

Cited by 7 publications

References 67 publications

Diagnostic performance of volatile organic compounds analysis and electronic noses for detecting colorectal cancer: a systematic review and meta-analysis

Diagnostic performance of volatile organic compounds analysis and electronic noses for detecting colorectal cancer: a systematic review and meta-analysis

Association of Exhaled Breath Volatile Organic Compounds with Surgical Traumatic Stress during General Anaesthesia: An Exploratory Study

The Diagnostic Utility of Volatile Organic Compounds in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

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