A Systematic Review and Meta-Analysis: Volatile Organic Compound Analysis in the Detection of Hepatobiliary and Pancreatic Cancers

Background: Hepatobiliary cancers are notoriously difficult to detect, frequently leading to diagnosis in later stages of disease when curative treatment is not an option. The currently used biomarkers such as AFP (alpha-fetoprotein) and CA19.9 lack sensitivity and specificity. Hence, there is an unmet need for an alternative biomarker. Aim: To evaluate the diagnostic accuracy of volatile organic compounds (VOCs) for the detection of hepatobiliary and pancreatic cancers. Methods: A systematic review of VOCs’ use in the detection of hepatobiliary and pancreatic cancers was performed. A meta-analysis was performed using the software R. Heterogeneity was explored through meta-regression analysis. Results: A total of 18 studies looking at 2296 patients were evaluated. Pooled sensitivity and specificity of VOCs for the detection of hepatobiliary and pancreatic cancer were 0.79 (95% CI, 0.72−0.85) and 0.81 (97.5% CI, 0.76−0.85), respectively. The area under the curve was 0.86. Meta-regression analysis showed that the sample media used contributed to heterogeneity. Bile-based VOCs showed the highest precision values, although urine and breath are preferred for their feasibility. Conclusions: Volatile organic compounds have the potential to be used as an adjunct tool to aid in the early diagnosis of hepatobiliary cancers

Salivary Volatile Organic Compound Analysis: An Optimised Methodology and Longitudinal Assessment Using Direct Injection Mass Spectrometry

Analysis of salivary volatile organic compounds (VOCs) may offer a novel noninvasive modality for disease detection. This study aims to optimise saliva headspace VOC analysis and assess longitudinal variation of salivary VOCs. Whole saliva from healthy participants was acquired in order to assess four methodological parameters: saliva collection, volume, dilution, and acidification. Saliva VOCs were analysed using untargeted proton transfer reaction time-of-flight mass spectrometry. Using the optimised method, five saliva samples collected over 3 weeks assessed the longitudinal VOC variability and reproducibility with targeted selected ion flow tube-mass spectrometry analysis. The method of saliva collection influenced VOC detection and was a source of contamination. An amount of 500 µL of whole saliva by passive drool yielded optimal VOCs. Longitudinal variation was negligible with target short chain fatty acids and aldehydes. However, certain compounds showed variability suggesting the influence of potential exogenous factors. Overall, there was an acceptable range of inter- and intraindividual VOC variability. Standardisation with morning sampling after a 6 h fast is recommended demonstrating minimal intersubject variability. Future studies should seek to establish salivary VOC levels in healthy and diseased populations

Abstracts of the 4th Annual Graduate Entry Research in Medicine Conference

This book contains the abstracts of the papers presented at The 4th Annual Graduate Entry Research in Medicine Conference (GERMCON 2021) Organized by Warwick Medical School, University of Warwick in collaboration with Swansea University Medical School, Swansea University, Wales, UK held on 11th September 2021. This event has been designed with the intention of supporting students to develop their interests and skills within academic medicine. This was especially important for Graduate Entry Medical (GEM) students, who have less opportunity and time to engage in research due to their accelerated medical degree. Conference Title: 4th Annual Graduate Entry Research in Medicine ConferenceConference Acronym: GERMCON 2021Conference Date: 11 September 2021Conference Location: Scarman Conference Centre, The University of Warwick, England, CV4 7SH, UK.Conference Organizer: Warwick Medical School, University of Warwick, UKCo-organizer: Swansea University Medical School, Swansea University, Wales, UK Other Abstract Book of GERMCON: Abstracts of the 3rd Annual Graduate Entry Research in Medicine Conferenc