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Urine as a biological modality for colorectal cancer detection
Published in Expert Review of Molecular Diagnostics, 2020
Subashini Chandrapalan, Ramesh P Arasaradnam
The right colon with its two physiological valves (ileocecal valve and hepatic flexure) acts as a ‘functional bio-chamber’ in which the complex interaction between the gut microbiota, colonocytes, and undigested fiber produces VOCs [42]. This process is heavily influenced by the external factors such as diet, environment, medication, and lifestyle. Any changes to these factors can modify the chemical nature of the volatolome produced [43]. As such, for example, a change in dietary practice or heavy drinking can result in an altered fermentation process and unique volatolome pattern for that individual. This unique volatolome may contain compounds that are carcinogenic in nature. e.g. N nitrosamines. It is noteworthy at this point that the overall chemical nature of this composite volatolome (i.e. the ‘VOC signature’), has greater significance than the impact of their individual chemical components.