The Screening of Volatile Markers for Hepatocellular Carcinoma

Background: Breath analysis became promising for noninvasive diagnoses of cancer with sophisticated spectrometry technology introduced. This study aimed to screen volatile markers for hepatocellular carcinoma (HCC). Methods: Breath samples were collected from 30 HCC patients who were comorbid with type B hepatitis and cirrhosis and from 27 hepatocirrhosis patients and 36 healthy persons, both taken as controls. The volatile organic compounds in the samples were analyzed with gas chromatography/mass spectrometry and the markers were selected by comparing their levels between groups. Each of the markers was evaluated by receiver operating characteristic (ROC) curves and a discriminant function using the markers was established. The relationships of alpha-fetoprotein (AFP) levels and clinical stages with the concentrations of the markers were also investigated. Results: 3-Hydroxy-2-butanone, styrene, and decane were screened as potential markers, among which 3-hydroxy-2-butanone was found to have the best diagnostic value. The diagnostic function using these markers had a sensitivity of 86.7% and a specificity of 91.7% between HCC patients and normal controls and a sensitivity of 83.3% and a specificity of 91.7% by cross-validation. No statistically significance (P > 0.05) was found for the concentration differences of these markers between HCC patients with AFP > 400 or < 400 mu g/L or between stage I-II and stage III-IV patients. Conclusion: These volatile organic compounds could be useful as breath markers of HCC patients, independent of AFP levels or clinical stages. Impact: Breath analysis could be useful for early diagnosis of HCC, especially for AFP-negative HCC. Cancer Epidemiol Biomarkers Prev; 19(9); 2247-53. (C) 2010 AACR.