Feb 28, 2020 07:00:00

An electronic nose will be developed that can detect `` people who are prone to esophageal cancer '' just by analyzing human breath

It has been known from past studies that dogs with excellent smell can ``

discriminate the presence or absence of cancer '' , but it is not possible to bring an actually trained dog to the clinic and treat it It Is difficult. So, a research team of Peter Siersema et al. Who researches gastrointestinal cancer at the Radboud University Health Science Institute in the Netherlands said, `` Electronic nose that analyzes patients' breaths and finds people who are prone to esophageal cancer '' Developed.

Detection of Barrett's oesophagus through exhaled breath using an electronic nose device | Gut
https://gut.bmj.com/content/early/2020/01/07/gutjnl-2019-320273

'Electronic nose' could smell breath to warn about higher risk of oesophageal cancer | Science | The Guardian
https://www.theguardian.com/science/2020/feb/25/electronic-nose-could-sniff-out-pre-cancerous-condition-in-food-pipe-oesophageal-cancer-barrett-oesophagus

It is said that the risk of developing esophageal cancer is increased by smoking and drinking habits. In Japan, the incidence rate of males is almost four times higher than that of females. In addition, it has been pointed out that the characteristics of people who are susceptible to esophageal cancer are '

Barrett's esophagus ', in which the mucous membrane below the esophagus is continuously replaced by a columnar shape from the stomach.

Barrett's esophagus may have patients complaining of subjective symptoms such as heartburn and chest pain, but they often have no symptoms. Although the cause is not clear, it is believed that the gastric acid repeatedly flows back into the esophagus, resulting in repeated inflammation of the mucous membranes and Barrett's esophagus. Also, obese men over 50 years old are more likely to have Barrett's esophagus.

According to the British Royal Cancer Research Fund , people diagnosed with Barrett's esophagus are 11 times more likely to develop esophageal cancer than normal people. It has also been pointed out that 3 to 13% of people with Barrett's esophagus will eventually develop esophageal cancer. Therefore, determining whether it is Barrett's esophagus is important in knowing the risk of esophageal cancer.

At the time of writing, the method of diagnosing Barrett's esophagus relies on endoscopy, which is expensive and burdensome on the patient's body. Therefore, the research team has developed an 'electronic nose' that can determine the presence or absence of Barrett's esophagus simply by analyzing the patient's breath.

The electronic nose developed by the research team is a device that can detect volatile molecules contained in samples, and it also has artificial intelligence that analyzes molecules contained in the breath of patients and identifies patterns. Molecules in human breath are produced by the body, and some molecules are associated with certain diseases or abnormalities in the microbial environment in the body. As a result, certain molecular compositions in breath may help detect disease.

`` If there is a test method that is non-invasive and can easily detect the risk of developing esophageal cancer, the test rate of patients will be much higher than when there is only an upper endoscopy method, '' said Siersema. I believe that knowing the risk of esophageal cancer in advance can reduce the incidence of esophageal cancer. Also, a test using an electronic nose seems to take only 5 minutes at a time, and it seems that the price is lower than when using an endoscope.

The research team tested the developed electronic nose on 402 patients scheduled for endoscopy. First, the research team trained artificial intelligence in the electronic nose based on breath samples taken from 90% of patients and the results of later endoscopy. Endoscopy revealed that 129 of 402 people were diagnosed with Barrett's esophagus, 141 were diagnosed with gastroesophageal reflux disease , but not Barrett's esophagus, and 132 were diagnosed with no abnormalities.

The team then used a trained electronic nose to examine samples taken from the remaining 10%. As a result, the electronic nose identified patients with Barrett's esophagus with 91% accuracy, and the accuracy of diagnosing asymptomatic patients as asymptomatic was 74%. When asymptomatic patients were removed from the target population and were restricted to patients with Barrett's esophagus and patients with gastroesophageal reflux disease, they were still able to identify patients, albeit with reduced accuracy.

Siersema plans to experiment with the electronic nose in a group of 1,000 people in the future, arguing that the electronic nose could be put into practical use in as early as a few years. `` The newly developed electronic nose is an interesting technology that addresses the important clinical issue of early detection of esophageal cancer, '' said Rebecca Fitzgerald , a researcher of esophageal cancer at Cambridge University. He pointed out that the false positive rate at which people were diagnosed as 'Barrett's esophagus' was high. 'Further improvements and validation are needed, but these initial data are promising,' Fitzgerald said.