GC-MS Techniques Investigating Potential Biomarkers of Dying in the Last Weeks with Lung Cancer
Predicting when a patient with advanced cancer is dying is a challenge and currently no prognostic test is available. We hypothesised that a dying process from cancer is associated with metabolic changes and specifically with changes in volatile organic compounds (VOCs). We analysed urine from patie...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-01-01
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| Series: | International Journal of Molecular Sciences |
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| Online Access: | https://www.mdpi.com/1422-0067/24/2/1591 |
| _version_ | 1797441170351063040 |
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| author | Elinor A. Chapman James Baker Prashant Aggarwal David M. Hughes Amara C. Nwosu Mark T. Boyd Catriona R. Mayland Stephen Mason John Ellershaw Chris S. Probert Séamus Coyle |
| author_facet | Elinor A. Chapman James Baker Prashant Aggarwal David M. Hughes Amara C. Nwosu Mark T. Boyd Catriona R. Mayland Stephen Mason John Ellershaw Chris S. Probert Séamus Coyle |
| author_sort | Elinor A. Chapman |
| collection | DOAJ |
| description | Predicting when a patient with advanced cancer is dying is a challenge and currently no prognostic test is available. We hypothesised that a dying process from cancer is associated with metabolic changes and specifically with changes in volatile organic compounds (VOCs). We analysed urine from patients with lung cancer in the last weeks of life by headspace gas chromatography mass spectrometry. Urine was acidified or alkalinised before analysis. VOC changes in the last weeks of life were identified using univariate, multivariate and linear regression analysis; 12 VOCs increased (11 from the acid dataset, 2 from the alkali dataset) and 25 VOCs decreased (23 from the acid dataset and 3 from the alkali dataset). A Cox Lasso prediction model using 8 VOCs predicted dying with an AUC of 0.77, 0.78 and 0.85 at 30, 20 and 10 days and stratified patients into a low (median 10 days), medium (median 50 days) or high risk of survival. Our data supports the hypothesis there are specific metabolic changes associated with the dying. The VOCs identified are potential biomarkers of dying in lung cancer and could be used as a tool to provide additional prognostic information to inform expert clinician judgement and subsequent decision making. |
| first_indexed | 2024-03-09T12:19:08Z |
| format | Article |
| id | doaj.art-b5806f459bb947deb4d78b7b2197aa5e |
| institution | Directory Open Access Journal |
| issn | 1661-6596 1422-0067 |
| language | English |
| last_indexed | 2024-03-09T12:19:08Z |
| publishDate | 2023-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | International Journal of Molecular Sciences |
| spelling | doaj.art-b5806f459bb947deb4d78b7b2197aa5e2023-11-30T22:42:44ZengMDPI AGInternational Journal of Molecular Sciences1661-65961422-00672023-01-01242159110.3390/ijms24021591GC-MS Techniques Investigating Potential Biomarkers of Dying in the Last Weeks with Lung CancerElinor A. Chapman0James Baker1Prashant Aggarwal2David M. Hughes3Amara C. Nwosu4Mark T. Boyd5Catriona R. Mayland6Stephen Mason7John Ellershaw8Chris S. Probert9Séamus Coyle10School of Medical and Health Sciences, Bangor University, Bangor LL57 2DG, UKInstitute of Systems Medicine and Integrative Biology, University of Liverpool, Liverpool L69 7BE, UKInstitute of Systems Medicine and Integrative Biology, University of Liverpool, Liverpool L69 7BE, UKDepartment of Health Data Science, University of Liverpool, Liverpool L69 3GF, UKAcademic Palliative & End of Life Care Department, Liverpool University Hospitals NHS Foundation Trust, Liverpool L7 8XP, UKInstitute of Systems Medicine and Integrative Biology, University of Liverpool, Liverpool L69 7BE, UKDepartment of Oncology and Metabolism, University of Sheffield, Sheffield S10 2RX, UKPalliative Care Unit, Institute of Life Course & Medical Sciences, University of Liverpool, Liverpool L7 8TX, UKAcademic Palliative & End of Life Care Department, Liverpool University Hospitals NHS Foundation Trust, Liverpool L7 8XP, UKInstitute of Systems Medicine and Integrative Biology, University of Liverpool, Liverpool L69 7BE, UKLiverpool Head and Neck Cancer Centre, University of Liverpool, Liverpool L69 3BX, UKPredicting when a patient with advanced cancer is dying is a challenge and currently no prognostic test is available. We hypothesised that a dying process from cancer is associated with metabolic changes and specifically with changes in volatile organic compounds (VOCs). We analysed urine from patients with lung cancer in the last weeks of life by headspace gas chromatography mass spectrometry. Urine was acidified or alkalinised before analysis. VOC changes in the last weeks of life were identified using univariate, multivariate and linear regression analysis; 12 VOCs increased (11 from the acid dataset, 2 from the alkali dataset) and 25 VOCs decreased (23 from the acid dataset and 3 from the alkali dataset). A Cox Lasso prediction model using 8 VOCs predicted dying with an AUC of 0.77, 0.78 and 0.85 at 30, 20 and 10 days and stratified patients into a low (median 10 days), medium (median 50 days) or high risk of survival. Our data supports the hypothesis there are specific metabolic changes associated with the dying. The VOCs identified are potential biomarkers of dying in lung cancer and could be used as a tool to provide additional prognostic information to inform expert clinician judgement and subsequent decision making.https://www.mdpi.com/1422-0067/24/2/1591GC-MSlung cancerdyingurineVOCsvolatile |
| spellingShingle | Elinor A. Chapman James Baker Prashant Aggarwal David M. Hughes Amara C. Nwosu Mark T. Boyd Catriona R. Mayland Stephen Mason John Ellershaw Chris S. Probert Séamus Coyle GC-MS Techniques Investigating Potential Biomarkers of Dying in the Last Weeks with Lung Cancer International Journal of Molecular Sciences GC-MS lung cancer dying urine VOCs volatile |
| title | GC-MS Techniques Investigating Potential Biomarkers of Dying in the Last Weeks with Lung Cancer |
| title_full | GC-MS Techniques Investigating Potential Biomarkers of Dying in the Last Weeks with Lung Cancer |
| title_fullStr | GC-MS Techniques Investigating Potential Biomarkers of Dying in the Last Weeks with Lung Cancer |
| title_full_unstemmed | GC-MS Techniques Investigating Potential Biomarkers of Dying in the Last Weeks with Lung Cancer |
| title_short | GC-MS Techniques Investigating Potential Biomarkers of Dying in the Last Weeks with Lung Cancer |
| title_sort | gc ms techniques investigating potential biomarkers of dying in the last weeks with lung cancer |
| topic | GC-MS lung cancer dying urine VOCs volatile |
| url | https://www.mdpi.com/1422-0067/24/2/1591 |
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