A breath test for malignant mesothelioma using an electronic nose

Abstract

Malignant mesothelioma (MM) is a rare tumour usually caused by asbestos exposure. MM is difficult to diagnose in its early stages and is invariably fatal. Earlier detection of MM could potentially improve survival. Exhaled breath sampling of volatile organic compounds (VOCs) using a carbon polymer array (CPA) electronic nose recognises specific breath profiles characteristic of different diseases. VOC breath profiling can distinguish between patients with lung cancer and controls, but there is only one prior report in MM, and the potential confounding effect of other asbestos-related diseases was not highlighted.

A CPA electronic nose will distinguish patients with MM from those with benign asbestos-related diseases (ARDs) and normal subjects with high sensitivity and specificity.

Eighty patients (MM n=20, ARDs n=18, controls n=42) participated in a cross-sectional, case control study. Breath samples were analysed using the Cyranose 320, using canonical discriminant analysis and principal component reduction. Repeatability was assessed by evaluating the samples in duplicate.

20 MM, 18 ARDs and 42 control subjects could be distinguished by their breath profiles. 10 MM subjects created the training set. Smellprints from 10 new MM patients were distinguished from control subjects with an accuracy of 95%. Patients with MM, ARDs and control subjects were correctly identified in 88% of cases.

Exhaled breath VOC profiling can accurately distinguish between patients with MM, ARDs and healthy controls. The CPA eNOSE is a novel method for distinguishing patients with MM. This could eventually translate into a screening tool for high risk populations.