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MFMMMMMMMMMMMFMFF1234567891011121314151617a SCC, esophageal squamous cell carcinoma b Ce, cervical esophagus; Ut, upper thoracic esophagus; Mt, middle thoracic esophagus; Lt, lower thoracic esophagus; Ae, abdominal esophagusc WD, well differentiated; MD, moderately differentiated; PD, poorly differentiated Fisher Scientific Inc., MA, USA), the Fisher Ratio was calculated against individual frames and signif-icant peaks were extracted to find candidate for biomarkers which discriminated 2 groups14). VOCs were identified by comparing EI mass spectra of each peak with that of the NIST Mass Spectral Library Version 2.0f using NIST MS Search 2.0. The area of selected ion peak in each candidate was applied to principal component analysis (PCA). And those of them that were significantly higher in the patient group than in the healthy volunteer group were used to generate receiver-operating characteristics (ROC) curves using the free ROC analysis software (WROCFIT). Statistical analysis was performed using t-test. The differentially expressed compounds with p-values of < 0.05 were considered statistically significant. Receiver-oper-ating characteristics (ROC) curve was used to evaluate the discriminatory power of selected VOCs for differentiation of patients and controls. Study population The clinical characteristics of the patient group Patient no.SexAgeSmoking4066706655556766815562706565688380YesNoYesYesNoYesYesYesYesYesYesYesYesYesYesYesNoTable 1　Clinical characteristics of esophageal carcinoma patients in this studyFamily history of cancerHistologyaMain location of the lesionbNoNoNoYesYesYesYesYesNoYesYesYesYesNoNoNoYesSCCSCCSCCSCCSCCSCCSCCSCCSCCSCCSCCSCCSCCSCCSCCSCCSCCare summarized in Table 1. Seventeen esophageal carcinoma patients and 9 volunteer control subjects were enrolled in this study. All subjects in the patient group had been pathologically diagnosed with advanced ESCC.VOCs profiling of samplesRepresentative GC/MS total ion chromatograms of samples from the patient group and the control group were showed in Figure 1. Statistical analysis of the obtained peaks revealed that 15 VOCs containing 4 VOCs, i.e. acetonitrile, acetic acid, acetone, 2-butanone, of which were significantly higher in the patient group than in the healthy volunteer group.Figure 2 showed differences of peak area for 4 VOCs in two groups. These differences were found to be significant (acetonitrile, p = 0.0037; acetic acid, p = 0.0024; acetone, p = 0.0024; 2-butanone, p = 0.0037).ROC curves were drawn for acetonitrile, acetic acid, acetone, and 2-butanone. The results for the area-under-the-curve (AUC) of the combination of these 4 VOCs indicated that ESCC patients can be Depth of tumor invasionLymph node metastasisWDMDPDMDMDMDMDPDMDPDMDMDMDMDMDMDMDT3T3T3T3T4bT3T3T2T4bT2T3T3T4bT3T3T4bT3Distant metastasisStageN2N2N3N0N2N2N2N2N3N2N1N3N3N3N2N2N1NoNoNolungNoNoNoNoNoNoNoNoNoNoNoNoNoⅢBⅢBⅢCⅣⅢBⅢBⅢBⅢBⅢCⅢBⅢAⅢCⅢCⅢCⅢBⅢCⅢA501Size(mm)DifferentiationcCeUtLtCeLtMtUtMtCeUtMtMtUtUtLtAeCeUtCeUtLtMtMtLtCeMt5070454442365039663045806076602025Results