Evaluation of N-NOSE as a surveillance tool for recurrence in gastric and esophageal cancers: a prospective cohort study

BMC Cancer. 2024 Dec 18;24(1):1544. doi: 10.1186/s12885-024-13327-x.

Abstract

Objective: Early detection of recurrent gastric and esophageal cancers remains a critical challenge. Innovative and non-invasive cancer screening technologies, such as N-NOSE, can improve early detection. N-NOSE is a urine-based scent test that leverages the olfactory abilities of the nematode C. elegans. For the first time, this prospective study evaluates the efficacy of the N-NOSE chemotaxis index as a novel biomarker for postoperative surveillance and recurrence in patients with upper gastrointestinal cancers.

Methods: A two-year prospective cohort study was conducted at The University of Tokyo Hospital, involving 40 patients with gastric and esophageal cancers. Urine samples were collected pre- and postoperatively and analysed using the N-NOSE technique.

Results: In cases of recurrence with vascular invasion, the chemotaxis index at 100-fold urine dilution was significantly elevated compared to the non-recurrence group.

Conclusion: This study suggests the potential of N-NOSE as an effective follow-up tool for patients with upper gastrointestinal cancer, particularly those with vascular invasion. While N-NOSE has been validated to distinguish between cancer and non-cancer, and its performance compared to traditional markers has been proven, it has not been studied for recurrence. Our data highlights, for the first time, the capability of N-NOSE in the surveillance of cancer recurrence.

Keywords: Caenorhabditis elegans (C. elegans); Gastric cancer; Nematode-nose (N-NOSE); Oesophageal cancer; Urine.

MeSH terms

  • Aged
  • Biomarkers, Tumor / urine
  • Early Detection of Cancer / methods
  • Esophageal Neoplasms* / diagnosis
  • Esophageal Neoplasms* / pathology
  • Esophageal Neoplasms* / urine
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local*
  • Prospective Studies
  • Stomach Neoplasms* / diagnosis
  • Stomach Neoplasms* / pathology
  • Stomach Neoplasms* / urine

Substances

  • Biomarkers, Tumor