A review of exhaled breath: a key role in lung cancer diagnosis

This article reviews the literature and summarizes single institution experience of applying different diagnostic algorithms for lung cancer. All diagnostic methods can be divided into three groups: non-invasive; minimally invasive and invasive. The non-invasive methods include clinical examination; imaging methods for anatomical, functional and multimodal visualization; sputum cytological, analysis of the exhaled breath, detection of various blood and sputum markers. Minimally invasive methods include endoscopy, percutaneous fine-needle and core-needle biopsy. Invasive methods include diagnostic thoracoscopy and laparoscopy, mediastinoscopy, parasternal mediastinotomy and diagnostic thoracotomy. While creating an individual diagnostic plan for each patient it is necessary to carefully analyze the effectiveness, safety, sensitivity, specificity and of different methods available among wide range of modern diagnostic techniques. Optimization of lung cancer diagnosis methods, which includes early cancer detection, is one of priority areas of modern oncology. Many aspects of this problem remain unresolved and require further research

Download Full-text

Combined sputum hypermethylation and eNose analysis for lung cancer diagnosis

Journal of Clinical Pathology ◽

10.1136/jclinpath-2014-202414 ◽

2014 ◽

Vol 67 (8) ◽

pp. 707-711 ◽

Cited By ~ 33

Author(s):

A Jasmijn Hubers ◽

Paul Brinkman ◽

Remco J Boksem ◽

Robert J Rhodius ◽

Birgit I Witte ◽

...

Keyword(s):

Lung Cancer ◽

Cancer Patients ◽

Cancer Diagnosis ◽

Breath Analysis ◽

Exhaled Breath ◽

Dna Hypermethylation ◽

Lung Cancer Patients ◽

Lung Cancer Diagnosis ◽

Exhaled Breath Analysis ◽

Validation Set

AimsThe aim of this study is to explore DNA hypermethylation analysis in sputum and exhaled breath analysis for their complementary, non-invasive diagnostic capacity in lung cancer.MethodsSputum samples and exhaled breath were prospectively collected from 20 lung cancer patients and 31 COPD controls (Set 1). An additional 18 lung cancer patients and 8 controls only collected exhaled breath as validation set (Set 2). DNA hypermethylation of biomarkers RASSF1A, cytoglobin, APC, FAM19A4, PHACTR3, 3OST2 and PRDM14 was considered, and breathprints from exhaled breath samples were created using an electronic nose (eNose).ResultsBoth DNA hypermethylation markers in sputum and eNose were independently able to distinguish lung cancer patients from controls. The combination of RASSF1A and 3OST2 hypermethylation had a sensitivity of 85% with a specificity of 74%. eNose had a sensitivity of 80% with a specificity of 48%. Sensitivity for lung cancer diagnosis increased to 100%, when RASSF1A hypermethylation was combined with eNose, with specificity of 42%. Both methods showed to be complementary to each other (p≤0.011). eNose results were reproducible in Set 2.ConclusionsWhen used in concert, RASSF1A hypermethylation in sputum and exhaled breath analysis are complementary for lung cancer diagnosis, with 100% sensitivity in this series. This finding should be further validated.

Download Full-text