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Urinary Volatile Organic Compound Testing in Fast-Track Patients with Suspected Colorectal Cancer

Boulind, Caroline E.; Gould, Oliver; Costello, Ben de Lacy; Allison, Joanna; White, Paul; Ewings, Paul; Wicaksono, Alfian N.; Curtis, Nathan J.; Pullyblank, Anne; Jayne, David; Covington, James A.; Ratcliffe, Norman; Turner, Claire; Francis, Nader K.

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Authors

Caroline E. Boulind

Joanna Allison

Paul White Paul.White@uwe.ac.uk
Professor in Applied Statistics

Paul Ewings

Alfian N. Wicaksono

Nathan J. Curtis

Anne Pullyblank

David Jayne

James A. Covington

Norman Ratcliffe Norman.Ratcliffe@uwe.ac.uk
Professor in Materials & Sensors Science

Claire Turner

Nader K. Francis



Abstract

Colorectal symptoms are common but only infrequently represent serious pathology, including colorectal cancer (CRC). A large number of invasive tests are presently performed for reassurance. We investigated the feasibility of urinary volatile organic compound (VOC) testing as a potential triage tool in patients fast-tracked for assessment for possible CRC. A prospective, multicenter, observational feasibility study was performed across three sites. Patients referred to NHS fast-track pathways for potential CRC provided a urine sample that underwent Gas Chromatography-Mass Spectrometry (GC-MS), Field Asymmetric Ion Mobility Spectrometry (FAIMS), and Selected Ion Flow Tube Mass Spectrometry (SIFT-MS) analysis. Patients underwent colonoscopy and/or CT colonography and were grouped as either CRC, adenomatous polyp(s), or controls to explore the diagnostic accuracy of VOC output data supported by an artificial neural network (ANN) model. 558 patients participated with 23 (4%) CRC diagnosed. 59% of colonoscopies and 86% of CT colonographies showed no abnormalities. Urinary VOC testing was feasible, acceptable to patients, and applicable within the clinical fast track pathway. GC-MS showed the highest clinical utility for CRC and polyp detection vs. controls (sensitivity = 0.878, specificity = 0.882, AUROC = 0.896) but it is labour intensive. Urinary VOC testing and analysis are feasible within NHS fast-track CRC pathways. Clinically meaningful differences between patients with cancer, polyps, or no pathology were identified suggesting VOC analysis may have future utility as a triage tool.

Citation

Boulind, C. E., Gould, O., Costello, B. D. L., Allison, J., White, P., Ewings, P., …Francis, N. K. (2022). Urinary Volatile Organic Compound Testing in Fast-Track Patients with Suspected Colorectal Cancer. Cancers, 14(9), 2127. https://doi.org/10.3390/cancers14092127

Journal Article Type Article
Acceptance Date Apr 18, 2022
Online Publication Date Apr 24, 2022
Publication Date May 1, 2022
Deposit Date Apr 26, 2022
Publicly Available Date Mar 29, 2024
Journal Cancers
Electronic ISSN 2072-6694
Publisher MDPI
Peer Reviewed Peer Reviewed
Volume 14
Issue 9
Pages 2127
DOI https://doi.org/10.3390/cancers14092127
Keywords Cancer Research; Oncology
Public URL https://uwe-repository.worktribe.com/output/9409398

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