VOCs from Exhaled Breath for the Diagnosis of Hepatocellular Carcinoma
Background: Volatile organic compound (VOC) profiles as biomarkers for hepatocellular carcinoma (HCC) are understudied. We aimed to identify VOCs from the exhaled breath for HCC diagnosis and compare the performance of VOCs to alpha-fetoprotein (AFP). The performance of VOCs for predicting treatment...
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MDPI AG
2023-01-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/13/2/257 |
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| author | Thanikan Sukaram Terapap Apiparakoon Thodsawit Tiyarattanachai Darlene Ariyaskul Kittipat Kulkraisri Sanparith Marukatat Rungsun Rerknimitr Roongruedee Chaiteerakij |
| author_facet | Thanikan Sukaram Terapap Apiparakoon Thodsawit Tiyarattanachai Darlene Ariyaskul Kittipat Kulkraisri Sanparith Marukatat Rungsun Rerknimitr Roongruedee Chaiteerakij |
| author_sort | Thanikan Sukaram |
| collection | DOAJ |
| description | Background: Volatile organic compound (VOC) profiles as biomarkers for hepatocellular carcinoma (HCC) are understudied. We aimed to identify VOCs from the exhaled breath for HCC diagnosis and compare the performance of VOCs to alpha-fetoprotein (AFP). The performance of VOCs for predicting treatment response and the association between VOCs level and survival of HCC patients were also determined. Methods: VOCs from 124 HCC patients and 219 controls were identified using the XGBoost algorithm. ROC analysis was used to determine VOCs performance in differentiating HCC patients from controls and in discriminating treatment responders from non-responders. The association between VOCs and the survival of HCC patients was analyzed using Cox proportional hazard analysis. Results: The combination of 9 VOCs yielded 70.0% sensitivity, 88.6% specificity, and 75.0% accuracy for HCC diagnosis. When differentiating early HCC from cirrhotic patients, acetone dimer had a significantly higher AUC than AFP, i.e., 0.775 vs. 0.714, respectively, <i>p</i> = 0.001. Acetone dimer classified HCC patients into treatment responders and non-responders, with 95.7% sensitivity, 73.3% specificity, and 86.8% accuracy. Isopropyl alcohol was independently associated with the survival of HCC patients, with an adjusted hazard ratio of 7.23 (95%CI: 1.36–38.54), <i>p</i> = 0.020. Conclusions: Analysis of VOCs is a feasible noninvasive test for diagnosing and monitoring HCC treatment response. |
| first_indexed | 2024-03-09T13:02:30Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-09T13:02:30Z |
| publishDate | 2023-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-2e35811f2267438aaade82b42bf9ae1d2023-11-30T21:52:12ZengMDPI AGDiagnostics2075-44182023-01-0113225710.3390/diagnostics13020257VOCs from Exhaled Breath for the Diagnosis of Hepatocellular CarcinomaThanikan Sukaram0Terapap Apiparakoon1Thodsawit Tiyarattanachai2Darlene Ariyaskul3Kittipat Kulkraisri4Sanparith Marukatat5Rungsun Rerknimitr6Roongruedee Chaiteerakij7Program in Medical Sciences, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, ThailandDepartment of Computer Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok 10330, ThailandFaculty of Medicine, Chulalongkorn University, Bangkok 10330, ThailandFaculty of Medicine, Chulalongkorn University, Bangkok 10330, ThailandFaculty of Medicine, Chulalongkorn University, Bangkok 10330, ThailandImage Processing and Understanding Team, Artificial Intelligence Research Group, National Electronics and Computer Technology Center (NECTEC), Pathum Thani 12120, ThailandDivision of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, ThailandDivision of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, ThailandBackground: Volatile organic compound (VOC) profiles as biomarkers for hepatocellular carcinoma (HCC) are understudied. We aimed to identify VOCs from the exhaled breath for HCC diagnosis and compare the performance of VOCs to alpha-fetoprotein (AFP). The performance of VOCs for predicting treatment response and the association between VOCs level and survival of HCC patients were also determined. Methods: VOCs from 124 HCC patients and 219 controls were identified using the XGBoost algorithm. ROC analysis was used to determine VOCs performance in differentiating HCC patients from controls and in discriminating treatment responders from non-responders. The association between VOCs and the survival of HCC patients was analyzed using Cox proportional hazard analysis. Results: The combination of 9 VOCs yielded 70.0% sensitivity, 88.6% specificity, and 75.0% accuracy for HCC diagnosis. When differentiating early HCC from cirrhotic patients, acetone dimer had a significantly higher AUC than AFP, i.e., 0.775 vs. 0.714, respectively, <i>p</i> = 0.001. Acetone dimer classified HCC patients into treatment responders and non-responders, with 95.7% sensitivity, 73.3% specificity, and 86.8% accuracy. Isopropyl alcohol was independently associated with the survival of HCC patients, with an adjusted hazard ratio of 7.23 (95%CI: 1.36–38.54), <i>p</i> = 0.020. Conclusions: Analysis of VOCs is a feasible noninvasive test for diagnosing and monitoring HCC treatment response.https://www.mdpi.com/2075-4418/13/2/257volatile organic compounds (VOCs)biomarkerscancer diagnosisbreath samplesmachine learningField Asymmetric Ion Mobility Spectrometry (FAIMS) |
| spellingShingle | Thanikan Sukaram Terapap Apiparakoon Thodsawit Tiyarattanachai Darlene Ariyaskul Kittipat Kulkraisri Sanparith Marukatat Rungsun Rerknimitr Roongruedee Chaiteerakij VOCs from Exhaled Breath for the Diagnosis of Hepatocellular Carcinoma Diagnostics volatile organic compounds (VOCs) biomarkers cancer diagnosis breath samples machine learning Field Asymmetric Ion Mobility Spectrometry (FAIMS) |
| title | VOCs from Exhaled Breath for the Diagnosis of Hepatocellular Carcinoma |
| title_full | VOCs from Exhaled Breath for the Diagnosis of Hepatocellular Carcinoma |
| title_fullStr | VOCs from Exhaled Breath for the Diagnosis of Hepatocellular Carcinoma |
| title_full_unstemmed | VOCs from Exhaled Breath for the Diagnosis of Hepatocellular Carcinoma |
| title_short | VOCs from Exhaled Breath for the Diagnosis of Hepatocellular Carcinoma |
| title_sort | vocs from exhaled breath for the diagnosis of hepatocellular carcinoma |
| topic | volatile organic compounds (VOCs) biomarkers cancer diagnosis breath samples machine learning Field Asymmetric Ion Mobility Spectrometry (FAIMS) |
| url | https://www.mdpi.com/2075-4418/13/2/257 |
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