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Published on: November 5, 2020
Volatile organic compounds in bile can distinguish pancreatic cancer from chronic pancreatitis: a prospective
Udayakumar Navaneethan1, Chad Spencer2, Xiang Zhu3
1Center for Interventional Endoscopy, Orlando, Florida, United States.
Background:
Early and accurate diagnosis of pancreatic cancer is important. Our aim was to identify potential volatile organic compounds (VOCs) in the bile that can help distinguish pancreatic cancer from chronic pancreatitis.
Methods:
In this prospective observational study, bile was aspirated from patients undergoing endoscopic retrograde cholangiopancreatography for chronic pancreatitis and pancreatic cancer, and the gaseous headspace was analyzed using mass spectrometry.
Results:
The study included a discovery cohort of 57 patients (46 pancreatic cancer, 11 chronic pancreatitis) and a validation cohort of 31 patients (19 and 12, respectively). Using logistic regression analysis, the model [0.158 × age + 9.747 × log (ammonia) - 3.994 × log (acetonitrile) + 5.044 × log (trimethylamine) - 30.23] successfully identified patients with pancreatic cancer with a sensitivity of 93.5 % and specificity of 100 % (likelihood ratio 40.9, area under the curve 0.98, 95 % confidence interval 0.95 - 1.00). The diagnostic accuracy of this model was confirmed in the second independent validation cohort.
Conclusion:
The measurement of VOCs in bile helped to accurately distinguish pancreatic cancer from chronic pancreatitis.
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