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Journal of Cancer Research and Clinical Oncology

, Volume 145, Issue 1, pp 223–234 | Cite as

Fecal volatile organic compounds for early detection of colorectal cancer: where are we now?

  • Sofie BoschEmail author
  • Daniel J. Berkhout
  • Ilhame Ben Larbi
  • Tim G. de Meij
  • Nanne K. de Boer
Review – Clinical Oncology

Abstract

Introduction

The fecal volatolome, which is composed of fecal volatile organic compounds (VOCs), seems to hold potential as non-invasive biomarker for the detection of colorectal cancer (CRC) and its precursor lesions advanced adenomas (AA). The potential of the fecal volatolome has been subject of various studies using either chemical analytical or pattern-recognition techniques. The available literature on the potential of the fecal volatolome as CRC and AA biomarker was reviewed.

Methods

A systematic literature search was conducted in PubMed, Embase, the Cochrane Library, Google Scholar and ResearchGate using the following keywords: Colorectal Cancer, Advanced Adenoma, Volatile Organic Compound, Metabolome, Gas Chromatrography–Mass Spectrometry, Selected-Ion Flow-Tube Mass Spectrometry, eNose, and Fecal Biomarkers.

Results

Eighty-eight titles or abstracts were identified from the search, of which 11 papers describing the potential of the fecal volatolome for CRC detection were selected. In these studies, different techniques were used for the headspace analyses of fecal VOCs, limiting the possibility to compare outcomes. Increased levels of amino acids and short chain fatty acids, and decreased levels of bile acids and polyol alcohols in the gas phase of feces were observed repeatedly. All selected papers reported high diagnostic value for the detection of both CRC and AA based on fecal VOCs.

Conclusion

Based on the included studies, fecal VOC analyses seem promising for future screening of CRC and AA, with potentially improved test performances allowing for earlier detection of AA and CRC and consequently earlier initiation of treatment, possibly reducing morbidity and mortality rates next to lower rates of (unnecessary) colonoscopies.

Keywords

Colorectal carcinoma Advanced adenoma Volatile organic compounds Biomarker Screening 

Abbreviations

AA

Advanced adenoma

AUC

Area under the curve

CRC

Colorectal cancer

eNose

Electronic Nose

FIT

Fecal immunochemical testing

FOBT

Fecal occult blood test

GC

Gas chromatography

GC–MS

Gas chromatography–mass spectrometry

GC–MSD

Gas chromatography–mass selective detector

GC–SCD

Gas chromatography–sulfur chemiluminescence detector

GC–TCD

Gas chromatography–thermal conductivity detector

HC

Healthy control

SCFA

Short chain fatty acid

SIFT-MS

Selected ion flow tube linked to mass spectrometry

VOCs

Volatile organic compounds

Notes

Funding

There was no funding required for the performance of this study.

Compliance with ethical standards

Conflict of interest

S. Bosch declares that she has no conflict of interest. D. J. Berkhout declares that he has no conflict of interest. I. Ben Larbi declares that she has no conflict of interest. Tim G. de Meij served in the advisory board of Danone. Nanne K. de Boer has served as a speaker for AbbVie and MDS. He has served as consultant and principal investigator for TEVA Pharma BV and Takeda. He has received a (unrestricted) grant from Dr. Falk and Takeda.

Human and animal rights statement

This article does not contain any studies with human participants or animals performed by any of the authors.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Gastroenterology and HepatologyAmsterdam UMC, Vrije Universiteit Amsterdam, AG&M Research InstituteAmsterdamThe Netherlands
  2. 2.Department of Pediatric Gastroenterology, Amsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
  3. 3.Department of Pediatric Gastroenterology, Amsterdam UMCUniversity of Amsterdam, Emma Children’s HospitalAmsterdamthe Netherlands

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