Summary
The object of this study was to explore the use of fecal skatole and indole and breath methane and hydrogen as metabolic markers of the anaerobic colonic flora in patients with unresected large bowel cancer or polyps. Patients with descending or sigmoid colon cancer were more likely to be breath methane excretors than control subjects, patients with proximal colon cancer, and patients with rectal cancer. Control subjects excreting breath methane excreted less fecal skatole than breath methane excretors in the following groups: patients with adenomatous polyps, all patients with colorectal cancer, patients with proximal colon cancer, patients with descending and sigmoid colon cancer, and patients with rectal cancer. These data suggest that fecal skatole excretion equal to or greater than 100 μg/g feces might be useful to discriminate colorectal cancer patients from control subjects. Twenty-nine percent (8 of 28) of the cancer patients had both “high” skatole levels and breath methane excretion compared with only 2% (1 of 41) of the control subjects (P<0.01).
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References
American Cancer Society., Cancer Facts and Figures 1984. New York: American Cancer Society (1984)
Bjorneklett A, Jenssen E (1982). Relationship between hydrogen (H2) and methane (CH4) production in man. Scan J Gastroenterol 17:985–992
Bond JH, Engel RR, Levitt MD (1971) Factors influencing pulmonary methane excretion in man. J Exptl Med 133:572–588
Bond JH, Levitt MD (1975) Factors affecting the concentration of combustible gases in the colon during colonoscopy. Gastroenterology 68:1445–1448
Calloway DH (1966) Respiratory hydrogen and methane as affected by consumption of gas-forming foods. Gastroenterology 51:383–389
Chung KT, Fulk GE, Slein MW (1975) Tryptophanase of fecal flora as a possible factor in the etiology of colon cancer. J Natl Cancer Inst 54:1073–1078
DeWys W, Costa G, Henkin R (1981) Clinical parameters related to anorexia. Cancer Treat Rep: 65 (suppl 5):49–51
Elsden SR, Hilton MG, Waller JM (1976) The end products of the metabolism of aromatic amino acids by clostridia. Arch Microbiol 107:283–288
Gilat T, Ben Hur H, Gelman-Malachi E, Terdiman R, Peled Y (1978) Alterations of the colonic flora and their effect on the hydrogen breath test. Gut 19:602–605
Haines A, Metz G, Dilawari J, Blendis L, Wiggins H (1977) Breath-methane in patients with cancer of the large bowel. Lancet 2:481–483
Herter CA (1908) The occurence of skatol in the human intestine. J Biol Chem 4:101–109
Hill MJ, Drasar BS, Williams REO, Meade TW, Cox AG, Simpson JEP, Morson BC (1975) Fecal bile acids, clostridia and the etiology of cancer of the large bowel: A case-comparison study. Lancet 1:535–539
Hill MJ, Morson BC, Bussey HJR (1978) Aetiology of adenoma-carcinoma sequence in large bowel. Lancet 1:245–247
Karlin DA, Jones RD, Stroehlein JR, Mastromarino AJ, Potter GD (1982) Breath methane excretion in patients with unresected colorectal cancer. J Natl Cancer Inst 69:573–576
Levitt MD, Ingelfinger FJ (1968) Hydrogen and methane production in man. Ann New York Acad Sci 150:75–81
Mackenzie A (1977) Determination of indole and 3-methylindole in plasma and rumen fluid from cattle with fog fever or after L-tryptophan administration. Res Veterinary Science 23:47–50
Mastromarino A, Reddy BS, Wynder EL (1976) Metabolic epidemiology of colon cancer: Enzymic activity of fecal flora. Am J Clin Nutr 29:1455–1460
Metz G, Jenkins DJA, Peters TJ, Newman A, Blendis LM (1975) Breath hydrogen as a diagnostic method for hypolactasia. Lancet 1:1155–1157
Michael AF, Drummond KN, Doeden D, Anderson JA, Good RA (1964) Tryptophan metabolism in man. J Clin Invest 43:1730–1746
Miller TL, Wolin MJ (1983) Oxidation of hydrogen and reduction of methanol to methane is the sole energy source for a methanogen-isolated from human feces. J Bacteriol 153:1051–1055
Reddy BS, Mastromarino A, Wynder EL (1977a) Diet and metabolism: Large bowel cancer. Cancer 39:1815–1819
Reddy BS, Wynder EL (1977b) Metabolic epidemiology of colon cancer: Fecal bile acids and neutral sterols in colon cancer patients and patients with adenomatous polyps. Cancer 39:2523–2539
Sherlock P, Lipkin M, Winawer SJ (1980) The prevention of colon cancer. Am J Med 68:917–931
Winawer SJ, Andrews M, Flehinger B, Sherlock P, Schottenfeld D, Miller DC (1980) Progress report on controlled trial of fecal occult blood testing for the detection of colorectal neoplasia. Cancer 45:2959–2964
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Supported by Public Health Service Grant CA-29056 from the National Cancer Institute
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Karlin, D.A., Mastromarino, A.J., Jones, R.D. et al. Fecal skatole and indole and breath methane and hydrogen in patients with large bowel polyps or cancer. J Cancer Res Clin Oncol 109, 135–141 (1985). https://doi.org/10.1007/BF00391888
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DOI: https://doi.org/10.1007/BF00391888