TY - JOUR T1 - Volatile organic compounds increase the likelihood of detecting malignant pleural mesothelioma JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.congress-2015.OA5002 VL - 46 IS - suppl 59 SP - OA5002 AU - Kevin Lamote AU - Matthijs Vynck AU - Joris Van Cleemput AU - Olivier Thas AU - Kristiaan Nackaerts AU - Jan P. Van Meerbeeck Y1 - 2015/09/01 UR - http://erj.ersjournals.com/content/46/suppl_59/OA5002.abstract N2 - Background: Globally, 125 million people are still exposed to asbestos and at risk for developing malignant pleural mesothelioma (MPM). Since MPM is diagnosed at advanced stage due to non-specific symptoms and investigations, it is thought that only an early diagnosis will improve patient's outcome (van Meerbeeck et al, 2011).Breathomics has emerged as a new research field, allowing to detect breath volatile organic compounds (VOCs) which can be used as non-invasive markers for MPM (Lamote et al, 2014).Aim: We investigated the effect of breath analysis added to clinical variables for MPM diagnosis.Methods: Alveolar air was sampled from 23 MPM patients, 10 healthy asbestos-exposed individuals and 12 healthy non-exposed persons after fasting for 2 hours using the BioScout Multicapillary Column/Ion Mobility Spectrometer (MCC/IMS, B&S Analytik, Germany). VOCs were visually selected and their analysis was done by LASSO regression in R. The added value of these VOCs on the diagnostic performance of clinical variables for MPM was compared by ROC-analysis.Results: Modeling smoking status, asbestos exposure and gender did not result in discriminating MPM patients from controls. Adding VOCs to the model increased the AUCROC from 0.52 to 0.71, the diagnostic accuracy from 58% to 71%, the sensitivity from 65% to 87% and the specificity from 50% to 55%. Positive (PPV) and negative predictive values (NPV) increased from 0.58 to 0.67 and from 0.58 to 0.80 respectively.Conclusion: The large increase in accuracy, sensitivity and NPV of the diagnostic model when including VOCs suggests the possibility to use breath analysis as a step up tool in order to rule out MPM. ER -