Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Mar 15, 2024; 16(3): 894-906
Published online Mar 15, 2024. doi: 10.4251/wjgo.v16.i3.894
Identification of breath volatile organic compounds to distinguish pancreatic adenocarcinoma, pancreatic cystic neoplasm, and patients without pancreatic lesions
Kasenee Tiankanon, Nuttanit Pungpipattrakul, Thanikan Sukaram, Roongruedee Chaiteerakij, Rungsun Rerknimitr
Kasenee Tiankanon, Nuttanit Pungpipattrakul, Thanikan Sukaram, Roongruedee Chaiteerakij, Rungsun Rerknimitr, Division of Gastroenterology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
Kasenee Tiankanon, Roongruedee Chaiteerakij, Rungsun Rerknimitr, Center of Excellence for Innovation and Endoscopy in Gastrointestinal Oncology, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand
Co-first authors: Kasenee Tiankanon and Nuttanit Pungpipattrakul.
Author contributions: Chaiteerakij R and Tiankanon K are the guarantors and designed the study; Pungpipattrakul N and Sukaram T participated in data acquisition and analysis; Pungpipattrakul N, Tiankanon K, Sukaram T and Chaiteerakij R performed data interpretation; Pungpipattrakul N and Tiankanon K drafted the initial manuscript; Sukaram T, Chaiteerakij R and Rerknimitr R critically revised the article for important intellectual content; All authors approved the final version of the manuscript.
Supported by Ratchadapisek Sompoth Fund, Faculty of Medicine, Chulalongkorn University, No. GA66/12.
Institutional review board statement: The study protocol was reviewed and approved by the Institutional Research Committee, Faculty of Medicine, Chulalongkorn University (No. 0482/65) and registered in the Thai Clinical Trials Registry (TCTR20211109002).
Informed consent statement: All study participants or their legal guardians provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare there are no conflicts of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non-Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Rungsun Rerknimitr, MD, Professor, Division of Gastroenterology, Faculty of Medicine, Chulalongkorn University, 1873 Rama 4 Road, Pathumwan, Bangkok 10330, Thailand. cholangiogram@gmail.com
Received: September 22, 2023
Peer-review started: September 22, 2023
First decision: December 4, 2023
Revised: December 19, 2023
Accepted: January 10, 2024
Article in press: January 10, 2024
Published online: March 15, 2024
Processing time: 171 Days and 18.4 Hours
ARTICLE HIGHLIGHTS
Research background

In various gastrointestinal malignancies, including pancreatic adenocarcinoma, volatile organic compounds (VOC) have demonstrated a good result in distinguishing patients with cancer and those without cancer.

Research motivation

No previous research has been conducted to capture exhaled breath VOCs using thermal desorption-gas chromatography/field-asymmetric ion mobility spectrometry (TD-GC/FAIMS) methods to distinguish pancreatic ductal adenocarcinoma (PDAC). The control population in the previous study was heterogeneous and reduced the validity of the results.

Research objectives

To identify exhale breath VOCs that can distinguish PDAC patients from those with intraductal papillary mucinous neoplasm (IPMN) and those with no pancreatic lesions using TD-GC/FAIMS.

Research methods

Exhaled breath was collected using the ReCIVA® device and VOCs were identified using TD-GC/FAIMS.

Research results

Dimethyl sulfide and acetone dimer were higher in PDAC patients when compared to IPMN and healthy participants. Dimethyl sulfide levels have been linked to PDAC metastasis status. Combining acetone dimer with the CA19-9 biomarker improved PDAC diagnostic accuracy.

Research conclusions

Dimethyl sulfide and acetone dimer were two VOCs that can potentially distinguish PDAC from IPMN and healthy participants.

Research perspectives

Further validation with a larger cohort using a longitudinal approach is needed to confirm these findings.