University of Liverpool Scientists Report New Urine Test To Detect Potential Biomarkers of Prostate Cancer

University of Liverpool Scientists Report New Urine Test To Detect Potential Biomarkers of Prostate Cancer

Reporter: Stephen J. Williams, PhD

Source: http://www.mdtmag.com/news/2016/02/new-milestone-device-can-smell-prostate-cancer#.Vr1gn47ai64.mailto

A research team from the University of Liverpool has reached an important milestone towards creating a urine diagnostic test for prostate cancer that could mean that invasive diagnostic procedures that men currently undergo eventually become a thing of the past.

‘The use of a gas chromatography (GC)-sensor system combined with advanced statistical methods towards the diagnosis of urological malignancies’, published today in the Journal of Breath Research, describes a diagnostic test using a special tool to ‘smell’ the cancer in men’s urine.

Working in collaboration with the University of the West of England’s (UWE Bristol) Urological Institute team at Southmead Hospital and Bristol Royal Infirmary, the pilot study included 155 men presenting to urology clinics. Of this group, 58 were diagnosed with prostate cancer, 24 with bladder cancer and 73 with haematuria or poor stream without cancer. The results of the pilot study using the GC sensor system indicate that it is able to successfully identify different patterns of volatile compounds that allow classification of urine samples from patients with urological cancers.

Urgent need for earlier diagnosis

Professor Chris Probert from the University of Liverpool’s Institute of Translational Medicine began work on this project with UWE Bristol when he was working in Bristol as a gastroenterologist with clinical and research interest in inflammatory bowel disease.

The research team used a gas chromatography sensor system called Odoreader that was developed by a team led by Professor Probert and Professor Norman Ratcliffe at UWE Bristol. The test involves inserting urine samples into the Odoreader that are then measured using algorithms developed by the research team at the University of Liverpool and UWE Bristol.

Professor Probert said: “There is an urgent need to identify these cancers at an earlier stage when they are more treatable as the earlier a person is diagnosed the better. After further sample testing the next step is to take this technology and put it into a user friendly format. With help from industry partners we will be able to further develop the Odoreader, which will enable it to be used where it is needed most; at a patient’s bedside, in a doctor’s surgery, in a clinic or Walk In Centre, providing fast, inexpensive, accurate results.”

Like an electronic nose

Professor Norman Ratcliffe said, “There is currently no accurate test for prostate cancer, the vagaries of the PSA test indicators can sometimes result in unnecessary biopsies, resulting in psychological toll, risk of infection from the procedure and even sometimes missing cancer cases. Our aim is to create a test that avoids this procedure at initial diagnosis by detecting cancer in a non-invasive way by smelling the disease in men’s urine. A few years ago we did similar work to detect bladder cancer following a discovery that dogs could sniff out cancer. We have been using the Odoreader, which is like an electronic nose to sense the cancer.”

“The Odoreader has a 30 metre column that enables the compounds in the urine to travel through at different rates thus breaking the sample into a readable format. This is then translated into an algorithm enabling detection of cancer by reading the patterns presented. The positioning of the prostate gland which is very close to the bladder gives the urine profile a different algorithm if the man has cancer.”

Mr Raj Prasad, Consultant Urologist at Southmead Hospital, North Bristol NHS Trust, said: “If this test succeeds at full medical trial it will revolutionise diagnostics. Even with detailed template biopsies there is a risk that we may fail to detect prostate cancer in some cases. Currently indicators such as diagnosed prostatomegaly (enlarged prostate) and unusually high PSA levels can lead to recommendations for biopsy if there is a concern that cancer may be prevalent. An accurate urine test would mean that many men who currently undergo prostate biopsy may not need to do so.”

A link to the research article in the Journal of Breath Research is given below:

The use of a gas chromatography-sensor system combined with advanced statistical methods, towards the diagnosis of urological malignancies

Raphael B M Aggio1, Ben de Lacy Costello2, Paul White3, Tanzeela Khalid1,4, Norman M Ratcliffe2,Raj Persad5 and Chris S J Probert1

Published 11 February 2016© 2016 IOP Publishing Ltd Journal of Breath Research, Volume 10, Number 1


Prostate cancer is one of the most common cancers. Serum prostate-specific antigen (PSA) is used to aid the selection of men undergoing biopsies. Its use remains controversial. We propose a GC-sensor algorithm system for classifying urine samples from patients with urological symptoms. This pilot study includes 155 men presenting to urology clinics, 58 were diagnosed with prostate cancer, 24 with bladder cancer and 73 with haematuria and or poor stream, without cancer. Principal component analysis (PCA) was applied to assess the discrimination achieved, while linear discriminant analysis (LDA) and support vector machine (SVM) were used as statistical models for sample classification. Leave-one-out cross-validation (LOOCV), repeated 10-fold cross-validation (10FoldCV), repeated double cross-validation (DoubleCV) and Monte Carlo permutations were applied to assess performance.

Significant separation was found between prostate cancer and control samples, bladder cancer and controls and between bladder and prostate cancer samples. For prostate cancer diagnosis, the GC/SVM system classified samples with 95% sensitivity and 96% specificity after LOOCV. For bladder cancer diagnosis, the SVM reported 96% sensitivity and 100% specificity after LOOCV, while the DoubleCV reported 87% sensitivity and 99% specificity, with SVM showing 78% and 98% sensitivity between prostate and bladder cancer samples. Evaluation of the results of the Monte Carlo permutation of class labels obtained chance-like accuracy values around 50% suggesting the observed results for bladder cancer and prostate cancer detection are not due to over fitting.

The results of the pilot study presented here indicate that the GC system is able to successfully identify patterns that allow classification of urine samples from patients with urological cancers. An accurate diagnosis based on urine samples would reduce the number of negative prostate biopsies performed, and the frequency of surveillance cystoscopy for bladder cancer patients. Larger cohort studies are planned to investigate the potential of this system. Future work may lead to non-invasive breath analyses for diagnosing urological conditions.

Other articles in this Open Access Journal related to Cancer Detection Systems include:

Identifying Melanoma by Scent

Recent Breakthroughs in Cancer Research at the Technion-Israel Institute of Technology- 2015

Early Detection of Prostate Cancer: American Urological Association (AUA) Guideline

Who and when should we screen for prostate cancer?

Populations with Low Cancer Risk, Implications for Early Detection Research

Combining Nanotube Technology and Genetically Engineered Antibodies to Detect Prostate Cancer Biomarkers


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