Stomach Diseases Clinical Trial
Official title:
Study of the Exhaled Breath and Salivary Metabolites of Patients With Malignant or Benign Gasctric Lesions
The investigators study the feasibility of a novel method in oncology based on breath
analysis with a nanosensors array for identifying gastric diseases. Alveolar exhaled breath
samples collected from volunteers referred for upper endoscopy or surgery are analyzed using
a custom-designed array of chemical nanosensors based on organically functionalized gold
nanoparticles and carbon nanotubes. Predictive models are built employing discriminant factor
analysis (DFA) pattern recognition method. Classification accuracy, sensitivity and
specificity are determined using leave-one-out cross-validation or an independent blind test
set. The chemical composition of the breath samples is studied using gas chromatography
coupled with mass spectrometry (GC-MS).
A pilot study is conducted first (enlistment of 160 subjects at the Department of Oncology,
The First Affiliated Hospital of Anhui Medical University, The First Affiliated Hospital of
Anhui Medical University, Hefei, Anhui, China.)
The pilot study is followed by a large-scale clinical trial to confirm the preliminary
results of the Chinese pilot study (enlistment of 800 subjects at the Digestive Diseases
Centre GASTRO, Riga East University Hospital, 6 Linezera iela, LV1006 Riga, Latvia). 25% of
the samples are used as independent blind test set. The samples are blinded by the medical
team and are not disclosed until prediction of blind sample identity is complete.
To further prove the diagnosis of GC from exhaled breath and seek the interrelationship among
Breathomics, metabolomics and transcriptomics, saliva samples from about 200 patients are
collected from volunteers referred for upper endoscopy or surgery are analyzed using
Ultra-high-performance liquid chromatography-mass spectrometry (UHPLC-MS). Simultaneously,
RNA sequencing are preformed on gastric cancer tissue samples and paracancerous tissue
samples collected from same group of volunteers. The data of salivary metabonomics and
transcriptomics were integrated and analyzed on the on Kyoto Encyclopedia of Genes and
Genomes to confirm the diagnostic validity of salivary metabonomics.
Number of patients that will have a definitive diagnosis and Alveolar exhaled breath samples
collected from individuals with Tedlar® bags (Keika Ventures, LLC) after endoscopy.. Two
breath samples were collected from each person tested.
Two-bed sorption tubes filled with the following sorbents were used as traps for sample
collection with simultaneous preconcentration: 100mg matrix Tenax TA and 50mg matrix Tenax TA
(35-60 mesh; purchased from Supelo, Bellefonte, PA). Sorbents were separated by glass wool.
The samples were collected at a total flow through sorption trap of 200ml/min.
One sample was used for analysis with the nanosensors array, and the other sample was used
for Gas Chromatography coupled with Mass Spectrometry (GC-MS) analysis.
Cancer tissue and paracancerous tissue samples were collected in the process of surgical
resection. After collection in the operating room, the samples were immediately placed in - 5
℃ dry ice and transferred to the laboratory. Then, the samples were frozen in liquid nitrogen
for 30 minutes, and then placed in - 80℃ freezer for cold storage. After that, the samples
were divided into several batches and transported in dry ice for subsequent transcriptome
analysis. All the saliva samples were collected using 2ml cryopreservation tube during early
morning before surgery or endoscopic resection. The patient had been told not to eat after 22
o'clock the night, and not to drink water, smoke, brush teeth or exercise violently one hour
before the collection. The saliva samples were sealed in the -80 C refrigerator after
collection and then transported in a foam box equipped with dry ice, followed by UHPLC-MS
analysis.
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