Measuring volatile organic compounds (VOCs) by breath analysis is a potent, easy-to-perform technique that can distinguish malignant pleural mesothelioma (MPM) patients from healthy people, according to a report published in the Journal of Breath Research.
The study, “Detection of malignant pleural mesothelioma in exhaled breath by multicapillary column/ion mobility spectrometry (MCC/IMS),” may have important implications for the early diagnosis of MPM.
When it comes to the diagnosis, prognosis, and treatment of pleural mesothelioma patients, an invasive procedure called thoracoscopy is currently the gold standard used. But in the last few years, researchers have made substantial advancements in identifying easily accessible, noninvasive biomarkers that could detect MPM at an earlier stage and improving patient outcomes. However, nothing has come to clinical fruition yet.
VOCs are the end-products of disease-related processes, and can be measured by breath analysis using multicapillary column/ion mobility spectrometry (MCC/IMS). Researchers thought they could also signal the possible start of mesothelioma.
“We hypothesize that the VOC composition in the breath of MPM patients differs from those in the breath of controls and that breath analysis can be used to screen for MPM in an at-risk population,” Kevin Lamote from Ghent University Hospital in Belgium and his colleagues explain in their report.
This multicenter, cross-sectional, case-control study enrolled 23 MPM patients; 22 former asbestos workers who have not been diagnosed with the disease; and a healthy control group of 21 people who did not report asbestos exposure.
The breath analysis allowed the researchers to classify each participant with and without occupational asbestos exposure to the correct group using MCC/IMS. In fact, researchers reported an 87% sensitivity (among 100 people with the disease, 87 will test positive) and 70% specificity (among 100 people without the disease, 70 will test negative) in distinguishing MPM patients from both controls.
Even though the study has its limitations when it comes to the number of participants and the differences in ages and smoking status between the individuals in the three groups, as well as a possible confounding factors that may affect the collection of VOCs, the researchers believe that measuring VOCs can be beneficial in screening chronically asbestos-exposed, asymptomatic older people.
“Results should be further validated in a larger patient population and be compared to other lung diseases before clinical implementation,” the research team wrote in their report.
Malignant pleural mesothelioma is primarily caused by prolonged exposure to asbestos. Even though asbestos use has been outlawed in most of the European Union since 2005, it still insulates buildings in less abundant areas in Russia, China, and India. Long follow-up studies report high numbers of mesothelioma incidence and prevalence, which are not likely to decrease in the next decade due to the average 40-year latency period from initial exposure.
Although the U.S. Environmental Protection Agency (EPA) banned most asbestos-containing products in 1989, the act was overturned by the Fifth Circuit Court of Appeals in 1991, allowing many asbestos products to be legally sold and used in the U.S. Products that have not historically contained asbestos are still banned in the United States.