Multi-centre prospective study on diagnosing subtypes of lung cancer by exhaled-breath analysis

S. Kort (Corresponding Author), M. M. Tiggeloven, M. Brusse-Keizer, J. W. Gerritsen, J. H. Schouwink, E. Citgez, F. H.C. de Jongh, S. Samii, J. van der Maten, M. van den Bogart, J. van der Palen

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Abstract

Objectives: Lung cancer is a leading cause of mortality. Exhaled-breath analysis of volatile organic compounds (VOC's) might detect lung cancer early in the course of the disease, which may improve outcomes. Subtyping lung cancers could be helpful in further clinical decisions. Materials and methods: In a prospective, multi-centre study, using 10 electronic nose devices, 144 subjects diagnosed with NSCLC and 146 healthy subjects, including subjects considered negative for NSCLC after investigation, breathed into the Aeonose™ (The eNose Company, Zutphen, Netherlands). Also, analyses into subtypes of NSCLC, such as adenocarcinoma (AC) and squamous cell carcinoma (SCC), and analyses of patients with small cell lung cancer (SCLC) were performed. Results: Choosing a cut-off point to predominantly rule out cancer resulted for NSCLC in a sensitivity of 94.4%, a specificity of 32.9%, a positive predictive value of 58.1%, a negative predictive value (NPV) of 85.7%, and an area under the curve (AUC) of 0.76. For AC sensitivity, PPV, NPV, and AUC were 81.5%, 56.4%, 79.5%, and 0.74, respectively, while for SCC these numbers were 80.8%, 45.7%, 93.0%, and 0.77, respectively. SCLC could be ruled out with a sensitivity of 88.9% and an NPV of 96.8% with an AUC of 0.86. Conclusion: Electronic nose technology with the Aeonose™ can play an important role in rapidly excluding lung cancer due to the high negative predictive value for various, but not all types of lung cancer. Patients showing positive breath tests should still be subjected to further diagnostic testing.
Original languageEnglish
Pages (from-to)223-229
Number of pages7
JournalLung cancer
Volume125
DOIs
Publication statusPublished - 1 Nov 2018

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Lung Neoplasms
Prospective Studies
Electronic Nose
Area Under Curve
Small Cell Lung Carcinoma
Squamous Cell Carcinoma
Adenocarcinoma
Volatile Organic Compounds
Breath Tests
Netherlands
Healthy Volunteers
Cell Count
Technology
Equipment and Supplies
Mortality
Neoplasms

Keywords

  • UT-Hybrid-D
  • Electronic nose
  • Exhaled breath analysis
  • Lung cancer
  • Diagnostic test

Cite this

Kort, S. ; Tiggeloven, M. M. ; Brusse-Keizer, M. ; Gerritsen, J. W. ; Schouwink, J. H. ; Citgez, E. ; de Jongh, F. H.C. ; Samii, S. ; van der Maten, J. ; van den Bogart, M. ; van der Palen, J. / Multi-centre prospective study on diagnosing subtypes of lung cancer by exhaled-breath analysis. In: Lung cancer. 2018 ; Vol. 125. pp. 223-229.
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abstract = "Objectives: Lung cancer is a leading cause of mortality. Exhaled-breath analysis of volatile organic compounds (VOC's) might detect lung cancer early in the course of the disease, which may improve outcomes. Subtyping lung cancers could be helpful in further clinical decisions. Materials and methods: In a prospective, multi-centre study, using 10 electronic nose devices, 144 subjects diagnosed with NSCLC and 146 healthy subjects, including subjects considered negative for NSCLC after investigation, breathed into the Aeonose™ (The eNose Company, Zutphen, Netherlands). Also, analyses into subtypes of NSCLC, such as adenocarcinoma (AC) and squamous cell carcinoma (SCC), and analyses of patients with small cell lung cancer (SCLC) were performed. Results: Choosing a cut-off point to predominantly rule out cancer resulted for NSCLC in a sensitivity of 94.4{\%}, a specificity of 32.9{\%}, a positive predictive value of 58.1{\%}, a negative predictive value (NPV) of 85.7{\%}, and an area under the curve (AUC) of 0.76. For AC sensitivity, PPV, NPV, and AUC were 81.5{\%}, 56.4{\%}, 79.5{\%}, and 0.74, respectively, while for SCC these numbers were 80.8{\%}, 45.7{\%}, 93.0{\%}, and 0.77, respectively. SCLC could be ruled out with a sensitivity of 88.9{\%} and an NPV of 96.8{\%} with an AUC of 0.86. Conclusion: Electronic nose technology with the Aeonose™ can play an important role in rapidly excluding lung cancer due to the high negative predictive value for various, but not all types of lung cancer. Patients showing positive breath tests should still be subjected to further diagnostic testing.",
keywords = "UT-Hybrid-D, Electronic nose, Exhaled breath analysis, Lung cancer, Diagnostic test",
author = "S. Kort and Tiggeloven, {M. M.} and M. Brusse-Keizer and Gerritsen, {J. W.} and Schouwink, {J. H.} and E. Citgez and {de Jongh}, {F. H.C.} and S. Samii and {van der Maten}, J. and {van den Bogart}, M. and {van der Palen}, J.",
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Kort, S, Tiggeloven, MM, Brusse-Keizer, M, Gerritsen, JW, Schouwink, JH, Citgez, E, de Jongh, FHC, Samii, S, van der Maten, J, van den Bogart, M & van der Palen, J 2018, 'Multi-centre prospective study on diagnosing subtypes of lung cancer by exhaled-breath analysis' Lung cancer, vol. 125, pp. 223-229. https://doi.org/10.1016/j.lungcan.2018.09.022

Multi-centre prospective study on diagnosing subtypes of lung cancer by exhaled-breath analysis. / Kort, S. (Corresponding Author); Tiggeloven, M. M.; Brusse-Keizer, M.; Gerritsen, J. W.; Schouwink, J. H.; Citgez, E.; de Jongh, F. H.C.; Samii, S.; van der Maten, J.; van den Bogart, M.; van der Palen, J.

In: Lung cancer, Vol. 125, 01.11.2018, p. 223-229.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Multi-centre prospective study on diagnosing subtypes of lung cancer by exhaled-breath analysis

AU - Kort, S.

AU - Tiggeloven, M. M.

AU - Brusse-Keizer, M.

AU - Gerritsen, J. W.

AU - Schouwink, J. H.

AU - Citgez, E.

AU - de Jongh, F. H.C.

AU - Samii, S.

AU - van der Maten, J.

AU - van den Bogart, M.

AU - van der Palen, J.

N1 - Elsevier deal

PY - 2018/11/1

Y1 - 2018/11/1

N2 - Objectives: Lung cancer is a leading cause of mortality. Exhaled-breath analysis of volatile organic compounds (VOC's) might detect lung cancer early in the course of the disease, which may improve outcomes. Subtyping lung cancers could be helpful in further clinical decisions. Materials and methods: In a prospective, multi-centre study, using 10 electronic nose devices, 144 subjects diagnosed with NSCLC and 146 healthy subjects, including subjects considered negative for NSCLC after investigation, breathed into the Aeonose™ (The eNose Company, Zutphen, Netherlands). Also, analyses into subtypes of NSCLC, such as adenocarcinoma (AC) and squamous cell carcinoma (SCC), and analyses of patients with small cell lung cancer (SCLC) were performed. Results: Choosing a cut-off point to predominantly rule out cancer resulted for NSCLC in a sensitivity of 94.4%, a specificity of 32.9%, a positive predictive value of 58.1%, a negative predictive value (NPV) of 85.7%, and an area under the curve (AUC) of 0.76. For AC sensitivity, PPV, NPV, and AUC were 81.5%, 56.4%, 79.5%, and 0.74, respectively, while for SCC these numbers were 80.8%, 45.7%, 93.0%, and 0.77, respectively. SCLC could be ruled out with a sensitivity of 88.9% and an NPV of 96.8% with an AUC of 0.86. Conclusion: Electronic nose technology with the Aeonose™ can play an important role in rapidly excluding lung cancer due to the high negative predictive value for various, but not all types of lung cancer. Patients showing positive breath tests should still be subjected to further diagnostic testing.

AB - Objectives: Lung cancer is a leading cause of mortality. Exhaled-breath analysis of volatile organic compounds (VOC's) might detect lung cancer early in the course of the disease, which may improve outcomes. Subtyping lung cancers could be helpful in further clinical decisions. Materials and methods: In a prospective, multi-centre study, using 10 electronic nose devices, 144 subjects diagnosed with NSCLC and 146 healthy subjects, including subjects considered negative for NSCLC after investigation, breathed into the Aeonose™ (The eNose Company, Zutphen, Netherlands). Also, analyses into subtypes of NSCLC, such as adenocarcinoma (AC) and squamous cell carcinoma (SCC), and analyses of patients with small cell lung cancer (SCLC) were performed. Results: Choosing a cut-off point to predominantly rule out cancer resulted for NSCLC in a sensitivity of 94.4%, a specificity of 32.9%, a positive predictive value of 58.1%, a negative predictive value (NPV) of 85.7%, and an area under the curve (AUC) of 0.76. For AC sensitivity, PPV, NPV, and AUC were 81.5%, 56.4%, 79.5%, and 0.74, respectively, while for SCC these numbers were 80.8%, 45.7%, 93.0%, and 0.77, respectively. SCLC could be ruled out with a sensitivity of 88.9% and an NPV of 96.8% with an AUC of 0.86. Conclusion: Electronic nose technology with the Aeonose™ can play an important role in rapidly excluding lung cancer due to the high negative predictive value for various, but not all types of lung cancer. Patients showing positive breath tests should still be subjected to further diagnostic testing.

KW - UT-Hybrid-D

KW - Electronic nose

KW - Exhaled breath analysis

KW - Lung cancer

KW - Diagnostic test

U2 - 10.1016/j.lungcan.2018.09.022

DO - 10.1016/j.lungcan.2018.09.022

M3 - Article

VL - 125

SP - 223

EP - 229

JO - Lung cancer

JF - Lung cancer

SN - 0169-5002

ER -