Lecture: Breathing detection and disease diagnosis

Abstract：Breath analysis is a diagnostic modality with few routine applications in clinical practice. Notable examples include the measurement of ¹³C urea for Helicobacter pylori (H.pylori) bacterium, hydrogen breath testing for small bowel bacterial overgrowth and exhaled nitric oxide in asthma. However, human breath is also a complex gaseous biological sample containing over 250 volatile organic compounds (VOCs). In recent years, the role of VOCs in cancer has been investigated using both innovative and conventional methods. Several studies employing Gas-Chromatography Mass-Spectrometry (GC-MS) or Ion Mobility Mass spectrometry have identified potential VOCs of interest within exhaled breath in cancer.Other technological advances have resulted in the development of novel chemical analytical techniques such as selected ion flow tube mass spectrometry (SIFT-MS), both of which offer real time quantification of VOCs.

Esophageal and gastric malignancies account for 15% of cancer-related deaths globally.¹Eight of ten patients will die in five years even after surgical operations. 50% of esophageal and gastric cancer patients are Chinese.The lack of ‘alarm’ symptoms until the disease is at a more advanced stage contribute to these poor statistics. However, diagnosis of these cancers at a treatable stage is associated with a significant survival benefit. Thus, there remains an important clinical need to develop novel methods for early disease detection in esophageal and gastric cancer.

At St Mary’s hospital, we have conducted the up to date largest exhaled breath analysis for esophageal and gastric cancer patients. A panel of VOCs have been identified as potential biomarkers and a diagnosis prediction model was constructed upon the findings to demonstrate the potential of exhaled breath analysis as a non-invasive tool for the disease diagnosis.

Reporter Introduction： 

　　DrJuzheng Huang was graduated from University College London (UCL) with 1^st Class Honors BSci degree in Chemistry in 2007. He then had been admitted into The Department Of Chemistry, University Of Cambridge for his PhD study. During his PhD, he was specializing in the development of receptor molecules for microcantilevere array sensor for the detection of oganophosphorous gas. After graduated from Cambridge in 2011, Dr Huang jointed Department of Surgery and Cancer, St Mary’s Hospital, Imperial College London to pursue his academic career. His main academic interests are the development of novel analytical methods for clinical applications. Using various mass spectrometric based techniques, such as SIFT-MS, GC-MS and TOF-MS, Dr Huang has conducted investigations of multiple biological surrogates from patients for the diagnosis of cancer and therapeutic monitoring purpose. 

Research areas：

1.       SIFT-MS

2.       GC-MS

3.       Quadrupole orthogonal-acceleration time-of-flight Xevo G-2S mass spectrometer.