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M. Brown



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    P3.06 - Poster Session/ Screening and Early Detection (ID 220)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Screening and Early Detection
    • Presentations: 1
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      P3.06-013 - VOC Breath Testing in Squamous Cell Carcinoma (SCC) of Lung and Larynx Shows Distinct Profiles Each of Which Relate to Tumour Burden (ID 1733)

      09:30 - 09:30  |  Author(s): M. Brown

      • Abstract

      Background:
      Early studies of volatile organic compound (VOC) testing in lung cancer suggested similar profiles for all stages of lung cancer, raising the possibility that in-situ cancer might be detectable by VOC profiling. It was hypothesized that a metabolic predisposition to cancer was being detected in VOC profiles, rather than VOCs arising from tumour bulk. In situ SCC can be detected in lung as well as the larynx allowing VOC profiles to be compared to advanced cancer. Because many lung cancer patients can develop Larynx cancer (and vice versa) profiling to determine the possibility of VOC testing in post treatment surveillance could provide useful data.

      Methods:
      Prospective pilot study. Breath samples were collected using the E-Nose Cyranose ®per established protocols prior to biopsy. Data were reduced to principal components for canonical discriminant analysis to determine differences between groups. Accuracy (CVV) was calculated using leave one out cross validation. All cases and controls had autofluorescence or Narrow Band Imaging bronchoscopy or microlaryngoscopy as well as CT chest. Histological confirmation was obtained. Control patients had negative larynx and bronchus on scopes. All patients had a smoking history.

      Results:
      Patients were as follows:

      Bronchus Larynx
      N Age M/F Current smokers N Age M/F Current smokers
      In situ 8 67±9 6/2 0 10 61±10 9/1 4
      Advanced 10 71±6 7/3 5 10 65±9 10/0 4
      Control 10 63±9 7/3 2 10 62±10 9/1 4
      Factor analysis p values for advanced cancer compared to control were 0.05 for larynx and 0.08, NS for bronchus. Values for in situ for both sites compared to control were NS, but were significant when compared to advanced cancer (0.04 and 0.009 respectively). Advanced cancer of larynx compared to bronchus showed p=0.001, CVV 80%.

      Conclusion:
      These results suggest that VOC signal as measured by eNose relates to tumour bulk as opposed to a systemic metabolic predisposition to cancer, (which might have allowed in situ cancer to be detected). Whilst the inability to detect in situ SCC was disappointing, the clear differences between VOC profiles for advanced cancer suggest the Squamous cell carcinoma has different metabolic profiles in the 2 sites, and further study may allow development of VOC breath testing for surveillance of bronchial SCC after larynx cancer. It suggests that whereas SCC arises in the aerodigestive tract “field” there are different inputs into the tumour development at each site.