Volatile organic compounds (VOCs) for the non-invasive detection of pancreatic cancer from urine.

Abstract

Pancreatic ductal adenocarcinoma (PDAC) is a particularly challenging cancer, with very low 5-year survival rates. This low survival rate is linked to late stage diagnosis, associated with the lack of approved biomarkers. One approach that is receiving considerable attention is the use of volatile organic compounds (VOCs) that emanate from biological waste as biomarkers for disease. In this study, we used urine as our biological matrix and two VOC analysis platforms: gas chromatography - ion mobility spectrometry (GC-IMS) and GC time-of-flight mass spectrometry (GC-TOF-MS). We measured the urinary headspace of samples from patients with PDAC, chronic pancreatitis (CP) and healthy controls. In total, 123 samples were tested from these groups. Results indicate that both GC-IMS and GC-TOF-MS were able to discriminate PDAC from healthy controls with high confidence and an AUC (area under the curve) in excess of 0.85. However, both methods struggled to separate CP from PDAC, with the best result of AUC 0.58. This indicates that both conditions produce similar biomarkers in the urinary headspace. Chemical identification suggests that 2,6-dimethyl-octane, nonanal, 4-ethyl-1,2-dimethyl-benzene and 2-pentanone play an important role in separating these groups. Therefore, both techniques validate this approach in identifying subjects for further investigation in a clinical setting.