Breath analysis by ion mobility spectrometry allows to discriminate COPD from lung cancer patients.

Breath analysis by ion mobility spectrometry allows to discriminate COPD from lung cancer patients.

Janssens, E (1) (presenting author); Lamote, K (1,2); van Meerbeeck, J P (1,2,3)

(1) Laboratory of Experimental Medicine and Pediatrics, Antwerp University, Antwerp, Belgium. 
(2) Department of Internal Medicine, Ghent University, Ghent, Belgium.
(3) Department of Pulmonology & Thoracic Oncology, Antwerp University Hospital, Edegem, Belgium.


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Background: Both COPD and lung cancer are major health concerns caused by tobacco smoking. Although most smokers will not develop either COPD or LC, they are closely related where COPD patients are at risk for developing LC. Both pulmonary diseases are characterised by inflammatory reactions that trigger oxidative stress, liberating volatile organic compounds (VOCs) in breath. Hence, breath analysis could hold promise for the diagnosis of LC in at risk COPD patients.  Aim: We investigated the use of breath analysis to discriminate between healthy smokers (HS), and patients with either COPD, lung cancer (LC) or asthma.   Methods: Breath samples from 28 COPD patients, 56 LC patients, 6 asthma patients and 17 HS were obtained for VOC analysis by Multicapillary Column/Ion Mobility Spectrometer (MCC/IMS), as previously described (Lamote et al, 2017, Eur Respir J).  Results: Good discrimination was achieved using MCC/IMS between COPD patients and HS with 0.844 accuracy, 0.821 sensitivity, 0.882 specificity, 0.920 PPV and 0.750 NPV. The AUCroc was 0.889. Discrimination between COPD and LC patients was also clear, showing 0.798 accuracy, 0.768 sensitivity, 0.857 specificity, 0.915 PPV and 0.649 NPV. The AUCroc was 0.853. With an AUCroc of 0.429 and accuracy of 0.521, discrimination of COPD from asthma patients was not possible.   
Conclusion: The accuracy, sensitivity and NPV of the diagnostic model for COPD vs HS and LC confirms previous research and suggests the possibility to use breath analysis by MCC/IMS to diagnose COPD in smokers and LC in COPD patients. Further research should validate these findings.




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