"Electronic nose" will reveal precancerous esophagus
A method of early diagnosis of esophageal cancer by breathing has been developed
Scientists have developed a device they call the "electronic nose", which can diagnose a patient's Barrett syndrome by breathing – a precancerous condition that often leads to esophageal cancer. Passing the test takes only five minutes. The description is given in the Gut journal (Peters et al., Detection of Barrett's oesophagus through exhaled breath using an electronic nose device).
People diagnosed with Barrett's esophagus – a precancerous condition in which the cell cover of the esophagus changes and can grow atypically – are at increased risk of developing a certain type of cancer – esophageal adenocarcinoma. According to the British cancer research charity Cancer Research UK, the risk of esophageal adenocarcinoma in patients with Barrett's esophagus is 11 times higher than in the general population.
Barrett's syndrome has no pronounced symptoms, but is more common in people with long-term acid reflux problems, especially in men over 50 years of age who are overweight or obese. The modern method of diagnosing Barrett's esophagus is based on invasive and expensive endoscopy. Scientists from the Netherlands have developed a device that allows you to determine the risk of esophageal cancer by the smell of breath.
The new device was tested on 402 patients who were prescribed endoscopy. 129 of them were subsequently diagnosed with Barrett's syndrome, 141 with gastroesophageal reflux disease (GERD), the remaining 132 had no health problems.
Before the endoscopy, each patient was asked to breathe into an "electronic nose" – a portable device capable of detecting various volatile molecules. Some of them can serve as signs of certain diseases, reflecting changes in cells or local microbial communities of the body. A specific combination of volatile molecules in a respiratory sample can act as a sign of a precancerous condition.
The "electronic nose" developed by scientists processes the analysis of the sample composition using artificial intelligence to identify such combinations. Prior to the study, the scientists trained the system on control samples, which allowed it to determine patterns among molecules in samples with and without Barrett's esophagus.
Testing of the device showed that it is able to correctly identify patients with Barrett's esophagus in 91 percent of cases, and the absence of this disease in 74 percent of cases. Also, the "electronic nose" was able to distinguish patients with Barrett's syndrome from patients with BBB, however, with less accuracy.
Scientists believe that the presence of a non-invasive method will increase the effectiveness of screening among those at risk of esophageal cancer, and therefore reduce the number of cases of the disease.
"If you have an affordable test that is non–invasive and easily identifies patients at risk of developing esophageal cancer, then, of course, participation rates will be much higher compared to using endoscopy," the head of the study, Professor Peter Siersema, from the University of Nijmegen in the Netherlands, is quoted in a press release.
The authors plan to repeat the test on a group of 1,000 patients, which will increase the accuracy of the system. If everything goes well, in 2-3 years the "electronic nose", which allows detecting esophageal cancer in the early stages, will be available for use.
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