Objective:

To compare the diagnostic performance of electronic nose (eNose) and gas chromatography-mass spectrometry (GC-MS) technologies in differentiating advanced hepatocellular carcinoma (HCC) from healthy controls, emphasizing the significance of volatolomic analysis in improving diagnostic accuracy.

Key Findings:

• Halogenated and aromatic VOCs are significant in HCC diagnosis due to their association with metabolic disturbances in hepatocarcinogenesis, indicating their potential role in clinical practice.
• The study found that eNose and GC-MS can detect VOCs in exhaled breath and biological matrices of HCC patients, suggesting their viability as non-invasive biomarkers.
• The patterns and concentrations of VOCs in HCC patients differ from those in other liver diseases, underscoring their diagnostic relevance.

Interpretation:

The findings suggest that both eNose and GC-MS technologies can effectively differentiate advanced HCC from healthy controls through the analysis of specific VOCs, supporting their use as non-invasive diagnostic tools that could enhance early detection strategies.

Limitations:

• Absolute specificity of VOCs for HCC has not been fully established, and there may be overlap with VOC signatures in other hepatic and systemic diseases, which could introduce biases in sample selection.
• The study's sample size and demographic limitations may affect the generalizability of the results.

Conclusion:

The study demonstrates the potential of eNose and GC-MS in the early detection and differentiation of advanced HCC, warranting further research to validate these findings in larger, diverse populations and to explore specific areas for future investigation.