Breath test for the diagnosis of oesophageal squamous cell carcinoma - - PowerPoint PPT Presentation

Breath test for the diagnosis

• f oesophageal squamous cell carcinoma

Yan Mei Goh

Diagnosis of oesophago-gastric cancer

• Upper GI symptoms account for 3% of consultations

in primary care

• 11,500 diagnosed annually in the UK

Gut 2014; 63:250-61

Diagnostic dilemma in cancer

High incidence non-specific symptoms Low incidence cancer

Triage test Tissue diagnosis

+

1971 Linus Pauling Concentrated breath in a cold trap Analyzed with GC >100 volatile organic compounds (VOCs)

Breath analysis

Biomarker discovery - Exhaled Breath

Multicentre oesophageal validation study

Noninvasive Exhaled Breath Volatile Organic Compound Analysis for the Diagnosis of Oesophagogastric Cancer

Sheraz R. Markar, PhD; Tom Wiggins, PhD; Stefan Antonowicz, PhD; Sung-Tong Chin, PhD; Andrea Romano, PhD; Konstantin Nikolic, PhD; Benjamin Evans, PhD; David Cunningham, PhD; Muntzer Mughal, MD; Jesper Lagergren, PhD; George B. Hanna, PhD

JAMA Oncology | Original Investigation

0.6 0.8 1.0 1.0 0.8

Sensitivity 1 – Specificity

0.6 0.4 0.2 0.4 0.2

Diagnostic accuracy 85%

Colorectal cancer

C o n tr o l C R C a P o s to p R e c u r r e n c e 1 0 2 0 3 0 4 0 5 0

D is e a s e g ro u p

Breath Volatile Organic Compound Profiling of Colorectal Cancer Using Selected Ion Flow-Tube Mass Spectrometry

Sheraz R. Markar, PhD, Sung-Tong Chin, PhD, Andrea Romano, PhD, Tom Wiggins, MRCS, Stefan Antonowicz, MRCS, Paraskevas Paraskeva, PhD, Paul Ziprin, FRCS, Ara Darzi, FRCS, and George B. Hanna, PhD

ORIGINAL ARTICLE

Diagnostic accuracy 83%

Annals of Surgery 2017

Pancreatic cancer

Original article

Profile of exhaled-breath volatile organic compounds to diagnose pancreatic cancer

• S. R. Markar

, B. Brodie, S.-T. Chin, A. Romano, D. Spalding and G. B. Hanna

0·2 0·4 1–specificity

a

0·6 0·8 1·0 0·2 0·4 0·6 Sensitivity 0·8 1·0

Diagnostic accuracy 90%

British Journal of Surgery 2018

Breath collection system

Breath sample

Robust system for transport Stability for 4 weeks

Collection device

Steel tube

GC-MS SIFT-MS PTR-TOF-MS Identification Quantification

Implementation into clinical practice

One breath triage test for multiple cancers

Breath test assisted pathway

Patients with alarming symptoms

Endoscopy / CT

PPI Re-test

Patients with non-specific symptoms

• ve

+ve

Triage Breath test

Plan for squamous cell cancer breath test

Clinical Phenotyping Study Oesophageal SCC n=60 Head and Neck SCC n=60 Healthy Control n=60 Positive Control n=30

Breath collection system

Breath sample

Robust system for transport Stability for 4 weeks

Collection device

Steel tube

GC-MS SIFT-MS PTR-TOF-MS Identification Quantification

Saliva collection system

Saliva sample

Robust system for transport

Collection device GC-MS Identification Quantification

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Nasosorption™ FX·i is a non handle for the ease of nasal sampling. Nasosorption™ FX·i is supplied housed in a cryo ingle-Use Non-Sterile Medical 13485 (Medical Devices). The devi

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• sations. Please see our full Terms and Conditions

Nasosorption™ FX·i device ng nge (device ce dra rawing ngs no not t to to sca cale): asosorption™ FX·i, working length 40mm, swab size 7 x 28mm long, 2 year shelf life. Imperial college

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Nasosorption™ FX·i, working length 39mm, swab size 4.5mm x 27mm long, 2 year shelf life. Imperial col device for children.

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