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Investigation of urinary volatile organic compounds as novel diagnostic and surveillance biomarkers of bladder cancer

Lett, Lauren; George, Michael; Slater, Rachael; De Lacy Costello, Ben; Ratcliffe, Norman; Garc�a-Fi�ana, Marta; Lazarowicz, Henry; Probert, Chris

Investigation of urinary volatile organic compounds as novel diagnostic and surveillance biomarkers of bladder cancer Thumbnail


Authors

Lauren Lett

Michael George

Rachael Slater

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

Marta Garc�a-Fi�ana

Henry Lazarowicz

Chris Probert



Abstract

Background: The diagnosis and surveillance of urothelial bladder cancer (UBC) require cystoscopy. There is a need for biomarkers to reduce the frequency of cystoscopy in surveillance; urinary volatile organic compound (VOC) analysis could fulfil this role. This cross-sectional study compared the VOC profiles of patients with and without UBC, to investigate metabolomic signatures as biomarkers. Methods: Urine samples were collected from haematuria clinic patients undergoing diagnostic cystoscopy and UBC patients undergoing surveillance. Urinary headspace sampling utilised solid-phase microextraction and VOC analysis applied gas chromatography-mass spectrometry; the output underwent metabolomic analysis. Results: The median participant age was 70 years, 66.2% were male. Of the haematuria patients, 21 had a new UBC diagnosis, 125 had no cancer. In the surveillance group, 75 had recurrent UBC, 84 were recurrence-free. A distinctive VOC profile was observed in UBC patients compared with controls. Ten VOCs had statistically significant abundances useful to classify patients (false discovery rate range 1.9 × 10−7–2.8 × 10−2). Two prediction models were evaluated using internal validation. An eight-VOC diagnostic biomarker panel achieved AUROC 0.77 (sensitivity 0.71, specificity 0.72). A six-VOC surveillance biomarker panel obtained AUROC 0.80 (sensitivity 0.71 and specificity 0.80). Conclusions: Urinary VOC analysis could aid the diagnosis and surveillance of UBC.

Journal Article Type Article
Acceptance Date Mar 8, 2022
Online Publication Date Mar 29, 2022
Publication Date Jul 20, 2022
Deposit Date Jul 28, 2022
Publicly Available Date Jul 29, 2022
Journal British Journal of Cancer
Print ISSN 0007-0920
Electronic ISSN 1532-1827
Publisher Springer Nature [academic journals on nature.com]
Peer Reviewed Peer Reviewed
Volume 127
Issue 2
Pages 329-336
DOI https://doi.org/10.1038/s41416-022-01785-8
Keywords Bladder cancer; Diagnostic markers; Molecular medicine; Predictive markers
Public URL https://uwe-repository.worktribe.com/output/9722880
Publisher URL https://www.nature.com/articles/s41416-022-01785-8

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