Volatile markers of breast cancer in the breath.
Volatile markers of breast cancer in the breath.
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DOI：
10.1046/j.1524-4741.2003.09309.x
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发表时间：
2003-05-01
期刊：
影响因子：
--
通讯作者：
Wong, Cynthia
中科院分区：
文献类型：
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作者：
Phillips, Michael;Cataneo, Renee N;Wong, Cynthia
乳腺癌伴随着氧化应激的增加和多态性细胞色素P-450混合氧化酶（CYP 450 mixed oxidase enzymes，CYP 450 mixed oxidase enzymes，CYP 450）的诱导。这两个过程都会影响呼吸中挥发性有机化合物（VOC）的丰度，因为氧化应激会导致膜中多不饱和脂肪酸的脂质过氧化，产生烷烃和甲基烷烃，这些烷烃和甲基烷烃被氧化物分解代谢。我们对呼吸中的挥发性有机化合物进行了一项初步研究，这是乳腺癌女性疾病的一种潜在的新标志物。这是一项结合病例对照和横断面研究，研究对象为计划进行乳腺活检的乳房X线检查异常的女性。通过气相色谱法和质谱法分析呼吸样本，以确定呼吸甲基化烷烃轮廓（BMAC），这是C4-C20烷烃和单甲基化烷烃的肺泡梯度（呼吸中的丰度减去室内空气中的丰度）的三维显示。采用前向逐步判别分析比较了乳腺癌和非乳腺癌妇女的BMAC。从两名病理学家阅读的异常乳房X线照片和活检的妇女中获得201个呼吸样本。在198例一致性活检中，有51例乳腺癌。呼气试验区分乳腺癌患者和健康志愿者的敏感性为94.1%（48/51），特异性为73.8%（31/42）（交叉验证敏感性为88.2%（45/51），特异性为73.8%（31/42））。与乳腺X线检查异常且活检时无癌症的女性相比，呼吸试验识别乳腺癌的敏感性为62.7%（32/51），特异性为84.0%（42/50）（交叉验证敏感性为60.8%（31/51），特异性为82.0%（41/50））。乳腺癌筛查呼气试验的阴性预测值（NPV）上级优于筛查乳房X线摄影（99.93% vs 99.89%）;筛查乳房X线摄影的阳性预测值（PPV）上级优于筛查呼气试验（4.63% vs 1.29%）。呼吸测试的氧化应激标志物准确地确定妇女与乳腺癌，与NPV上级筛查乳房X光片。这种呼吸测试可能被用作乳腺癌的主要筛查。需要在更大的群体中进行验证性研究。
Breast cancer is accompanied by increased oxidative stress and induction of polymorphic cytochrome P-450 mixed oxidase enzymes (CYP). Both processes affect the abundance of volatile organic compounds (VOCs) in the breath because oxidative stress causes lipid peroxidation of polyunsaturated fatty acids in membranes, producing alkanes and methylalkanes which are catabolized by CYP. We performed a pilot study of breath VOCs, a potential new marker of disease in women with breast cancer. This was a combined case-control and cross-sectional study of women with abnormal mammograms scheduled for a breast biopsy. Breath samples were analyzed by gas chromatography and mass spectroscopy in order to determine the breath methylated alkane contour (BMAC), a three-dimensional display of the alveolar gradients (abundance in breath minus abundance in room air) of C4-C20 alkanes and monomethylated alkanes. BMACs in women with and without breast cancer were compared using forward stepwise discriminant analysis. Two hundred one breath samples were obtained from women with abnormal mammograms and biopsies read by two pathologists. There were 51 cases of breast cancer in 198 concordant biopsies. The breath test distinguished between women with breast cancer and healthy volunteers with a sensitivity of 94.1% (48/51) and a specificity of 73.8% (31/42) (cross-validated sensitivity 88.2% (45/51), specificity 73.8% (31/42)). Compared to women with abnormal mammograms and no cancer on biopsy, the breath test identified breast cancer with a sensitivity of 62.7% (32/51) and a specificity of 84.0% (42/50) (cross-validated sensitivity of 60.8% (31/51), specificity of 82.0% (41/50)). The negative predictive value (NPV) of a screening breath test for breast cancer was superior to a screening mammogram (99.93% versus 99.89%); the positive predictive value (PPV) of a screening mammogram was superior to a screening breath test (4.63% versus 1.29%). A breath test for markers of oxidative stress accurately identified women with breast cancer, with an NPV superior to a screening mammogram. This breath test could potentially be employed as a primary screen for breast cancer. Confirmatory studies in larger groups are required.