The investigation of volatile organic compounds in diagnosing (early) esophageal squamous cell carcinoma and gastric adenocarcinoma

Purpose The diagnosis of upper gastrointestinal cancer (UGIC) and early UGIC is currently based on endoscopy and histopathology. In this study, we aimed to explore whether intraluminal and exhaled volatile organic compounds (VOCs) could be used to diagnose (early) esophageal squamous cell carcinoma (ESCC) and gastric adenocarcinoma (GC). Methods We prospectively recruited 259 patients and first collected intraluminal gas simples directly from upper GI tract via our designed device after passing endoscopic biopsy channel and collected exhaled gas samples in pairs. Results 509 gas samples were totally collected and VOCs composed by peak compounds detected by gas chromatography–mass spectrometry (GC–MS) were used to train and test Multilayer Perceptron Network (MPN) for discrimination. Intraluminal and exhaled gas had more than 0.95 area under the curve (AUC) to discriminate UGIC (ESCC and GC) and early UGIC from benign control with different VOCs compositions. Conclusion Both intraluminal and exhaled VOCs had cancer-specific compositions to accurately discriminate early UGIC and UGIC, and the ability of intraluminal VOCs was better than that of exhaled VOCs. These suggested the potential role of VOCs in diagnosing and screening early UGIC and UGIC in the future.