External validation of exhaled breath profiling using an electronic nose in the discrimination of asthma with fixed airways obstruction and chronic obstructive pulmonary disease
External validation of exhaled breath profiling using an electronic nose in the discrimination of asthma with fixed airways obstruction and chronic obstructive pulmonary disease
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DOI：
10.1111/j.1365-2222.2011.03800.x
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发表时间：
2011-10-01
影响因子：
6.1
通讯作者：
Sterk, P. J.
中科院分区：
文献类型：
--
作者：
Fens, N.;Roldaan, A. C.;Sterk, P. J.
背景固定气流限制可在哮喘和慢性阻塞性肺疾病（COPD）中发现，对日常诊断构成挑战。目的探讨电子鼻呼出气体代谢组学分析在固定气道阻塞患者中鉴别哮喘和COPD的外部有效性。方法100例患者采用横断面设计：60例哮喘患者，21例为固定气道阻塞（固定哮喘），39例为可逆性气道阻塞（典型哮喘），40例为COPD （GOLD II-III期）。对呼出气体进行标准化采样，并使用电子鼻捕获挥发性有机化合物，从而产生呼吸指纹。新招募患者的外部效度（验证集）使用先前的独立训练集进行测试。采用主成分分析、典型判别分析和受试者工作特征曲线下面积（AUC）对呼吸纹进行分析。结果呼气指纹鉴别固定哮喘和慢性阻塞性肺病的外效度为88% (AUC 0.95, 95% CI 0.84-1.00，灵敏度85%，特异性90%)，鉴别经典哮喘的外效度为83% （AUC 0.93, 95% CI 0.87-1.00，灵敏度91%，特异性90%）
Background Fixed airflow limitation can be found both in asthma and chronic obstructive pulmonary disease (COPD), posing a day-to-day diagnostic challenge.Objective We aimed to determine the external validity of metabolomic analysis of exhaled air by electronic nose for distinguishing asthma and COPD in patients with fixed airways obstruction.Methods One hundred patients were included in a cross-sectional design: 60 asthma patients: 21 with fixed airways obstruction (fixed asthma), 39 with reversible airways obstruction (classic asthma) and 40 COPD patients (GOLD stages II-III). Standardized sampling of exhaled breath was performed and volatile organic compounds were captured using an electronic nose resulting in breathprints. External validity in newly recruited patients (validation sets) was tested using a previous and independent training set. Breathprints were analysed by principal component and canonical discriminant analysis and area under the curve (AUC) of receiver operating characteristic curves.Results External validity of breathprints showed 88% accuracy for distinguishing fixed asthma from COPD (AUC 0.95, 95% CI 0.84-1.00, sensitivity 85%, specificity 90%) and 83% for classic asthma (AUC 0.93, 95% CI 0.87-1.00, sensitivity 91%, specificity 90%) (both P