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Urinary volatile organic compounds for colorectal cancer screening:A systematic review and meta-analysis
- Source :
- van Liere, E L S A, van Dijk, L J, Bosch, S, Vermeulen, L, Heymans, M W, Burchell, G L, de Meij, T G J, Ramsoekh, D & de Boer, N K H 2023, ' Urinary volatile organic compounds for colorectal cancer screening : A systematic review and meta-analysis ', European Journal of Cancer, vol. 186, pp. 69-82 . https://doi.org/10.1016/j.ejca.2023.03.002
- Publication Year :
- 2023
-
Abstract
- Background: The faecal immunochemical test (FIT) suffers from suboptimal performance and participation in colorectal cancer (CRC) screening. Urinary volatile organic compounds (VOCs) may be a useful alternative. We aimed to determine the diagnostic potential of urinary VOCs for CRC/adenomas. By relating VOCs to known pathways, we aimed to gain insight into the pathophysiology of colorectal neoplasia. Methods: A systematic search was performed in PubMed, EMBASE and Web of Science. Original studies on urinary VOCs for CRC/adenoma detection with a control group were included. QUADAS-2 tool was used for quality assessment. Meta-analysis was performed by adopting a bivariate model for sensitivity/specificity. Fagan's nomogram estimated the performance of combined FIT-VOC. Neoplasm-associated VOCs were linked to pathways using the KEGG database. Results: Sixteen studies—involving 837 CRC patients and 1618 controls—were included; 11 performed chemical identification and 7 chemical fingerprinting. In all studies, urinary VOCs discriminated CRC from controls. Pooled sensitivity and specificity for CRC based on chemical fingerprinting were 84% (95% CI 73–91%) and 70% (95% CI 63–77%), respectively. The most distinctive individual VOC was butanal (AUC 0.98). The estimated probability of having CRC following negative FIT was 0.38%, whereas 0.09% following negative FIT-VOC. Combined FIT-VOC would detect 33% more CRCs. In total 100 CRC-associated urinary VOCs were identified; particularly hydrocarbons, carboxylic acids, aldehydes/ketones and amino acids, and predominantly involved in TCA-cycle or alanine/aspartate/glutamine/glutamate/phenylalanine/tyrosine/tryptophan metabolism, which is supported by previous research on (colorectal)cancer biology. The potential of urinary VOCs to detect precancerous adenomas or gain insight into their pathophysiology appeared understudied. Conclusion: Urinary VOCs hold potential for non-invasive CRC screening. Multicentre validation studies are needed, especially focusing on adenoma detection. Urinary VOCs elucidate underlying pathophysiologic processes.
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- van Liere, E L S A, van Dijk, L J, Bosch, S, Vermeulen, L, Heymans, M W, Burchell, G L, de Meij, T G J, Ramsoekh, D & de Boer, N K H 2023, ' Urinary volatile organic compounds for colorectal cancer screening : A systematic review and meta-analysis ', European Journal of Cancer, vol. 186, pp. 69-82 . https://doi.org/10.1016/j.ejca.2023.03.002
- Accession number :
- edsair.doi.dedup.....26e0e94a37d6025fa065dfd74784bde4