Investigation of urinary volatile organic compounds as novel diagnostic and surveillance biomarkers of bladder cancer

Lett, Lauren ORCID: 0000-0002-3623-0321, George, Michael ORCID: 0000-0002-5388-4634, Slater, rachel, Costello, Ben De Lacy, Ratcliffe, norman, Garcia-Finana, Marta ORCID: 0000-0003-4939-0575, Lazarowicz, henry and Probert, Chris ORCID: 0000-0003-4550-0239 (2022) Investigation of urinary volatile organic compounds as novel diagnostic and surveillance biomarkers of bladder cancer. British Journal of Cancer, 127 (2). pp. 329-336.

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Official URL: http://dx.doi.org/10.1038/s41416-022-01785-8

Abstract

<h4>Background</h4>The diagnosis and surveillance of urothelial bladder cancer (UBC) require cystoscopy. There is a need for biomarkers to reduce the frequency of cystoscopy in surveillance; urinary volatile organic compound (VOC) analysis could fulfil this role. This cross-sectional study compared the VOC profiles of patients with and without UBC, to investigate metabolomic signatures as biomarkers.<h4>Methods</h4>Urine samples were collected from haematuria clinic patients undergoing diagnostic cystoscopy and UBC patients undergoing surveillance. Urinary headspace sampling utilised solid-phase microextraction and VOC analysis applied gas chromatography-mass spectrometry; the output underwent metabolomic analysis.<h4>Results</h4>The median participant age was 70 years, 66.2% were male. Of the haematuria patients, 21 had a new UBC diagnosis, 125 had no cancer. In the surveillance group, 75 had recurrent UBC, 84 were recurrence-free. A distinctive VOC profile was observed in UBC patients compared with controls. Ten VOCs had statistically significant abundances useful to classify patients (false discovery rate range 1.9 × 10<sup>-7</sup>-2.8 × 10<sup>-2</sup>). Two prediction models were evaluated using internal validation. An eight-VOC diagnostic biomarker panel achieved AUROC 0.77 (sensitivity 0.71, specificity 0.72). A six-VOC surveillance biomarker panel obtained AUROC 0.80 (sensitivity 0.71 and specificity 0.80).<h4>Conclusions</h4>Urinary VOC analysis could aid the diagnosis and surveillance of UBC.

Item Type:	Article
Uncontrolled Keywords:	Humans, Carcinoma, Transitional Cell, Neoplasm Recurrence, Local, Hematuria, Cross-Sectional Studies, Aged, Female, Male, Urinary Bladder Neoplasms, Volatile Organic Compounds, Biomarkers, Biomarkers, Tumor
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Clinical Directorate Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences Faculty of Health and Life Sciences > Institute of Population Health
Depositing User:	Symplectic Admin
Date Deposited:	22 Feb 2022 08:51
Last Modified:	18 Jan 2023 21:12
DOI:	10.1038/s41416-022-01785-8
Open Access URL:	https://doi.org/10.1038/s41416-022-01785-8
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3149356