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

S. Kort; 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

doi:10.1016/j.lungcan.2018.09.022

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

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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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 language	English
Pages (from-to)	223-229
Number of pages	7
Journal	Lung cancer
Volume	125
DOIs	https://doi.org/10.1016/j.lungcan.2018.09.022
Publication status	Published - 1 Nov 2018

Keywords

UT-Hybrid-D
Electronic nose
Exhaled breath analysis
Lung cancer
Diagnostic test
22/4 OA procedure

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10.1016/j.lungcan.2018.09.022

ArticleFinal published version, 0.99 MBLicence: Taverne

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@article{0df2872e6f82486882aef31cd371c092,

title = "Multi-centre prospective study on diagnosing subtypes of lung cancer by exhaled-breath analysis",

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{\texttrademark} (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{\texttrademark} 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, 22/4 OA procedure",

author = "S. Kort and M.M. Tiggeloven and M. Brusse-Keizer and J.W. Gerritsen and J.H. Schouwink 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.",

note = "Elsevier deal",

year = "2018",

month = nov,

day = "1",

doi = "10.1016/j.lungcan.2018.09.022",

language = "English",

volume = "125",

pages = "223--229",

journal = "Lung cancer",

issn = "0169-5002",

publisher = "Elsevier",

}

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

KW - 22/4 OA procedure

U2 - 10.1016/j.lungcan.2018.09.022

DO - 10.1016/j.lungcan.2018.09.022

M3 - Article

C2 - 30429025

VL - 125

SP - 223

EP - 229

JO - Lung cancer

JF - Lung cancer

SN - 0169-5002

ER -

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

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