Volatile organic compounds in breath as markers of lung cancer: a cross-sectional study
Volatile organic compounds in breath as markers of lung cancer: a cross-sectional study
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DOI：
10.1016/s0140-6736(98)07552-7
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发表时间：
1999-06-05
期刊：
影响因子：
168.9
通讯作者：
McVay, WP
中科院分区：
文献类型：
--
作者：
Phillips, M;Gleeson, K;McVay, WP
背景许多挥发性有机化合物（VOCs），主要是烷烃和苯衍生物，已被确定在呼吸肺癌患者。我们调查了挥发性有机化合物的组合是否可以识别这样的患者。我们收集了108例胸片异常的患者的呼吸样本，这些患者计划进行支气管镜检查。样品采用便携式采样器采集，气相色谱-质谱联用分析。计算每次呼吸VOC的肺泡梯度，即呼吸量和空气量之间的差异。前向逐步判别分析用于识别区分肺癌患者和非肺癌患者的VOCs。60例患者经组织学证实为肺癌。22种呼吸VOC的组合，主要是烷烃，烷烃衍生物和苯衍生物，区分了肺癌患者和非肺癌患者，无论分期如何（所有p < 0.0003）。对于1期肺癌，22种VOC的敏感性为100%，特异性为81.3%。交叉验证的组合正确预测71.7%的肺癌患者和66.7%的非肺癌患者的诊断。在胸片异常的患者中，呼吸样本中22种VOC的组合区分了肺癌患者和非肺癌患者。需要进行前瞻性研究来证实呼吸VOCS在普通人群中检测肺癌的有效性。
Background. Many volatile organic compounds (VOCs), principally alkanes and benzene derivatives, have been identified in breath from patients with lung cancer. We investigated whether a combination of VOCs could identify such patients.Methods. We collected breath samples from 108 patients with an abnormal chest radiograph who were scheduled for bronchoscopy. The samples were collected with a portable apparatus, then essayed by gas chromatography and mass spectroscopy. The alveolar gradient of each breath VOC, the difference between the amount in breath and in air, was calculated. Forward stepwise discriminant analysis was used to identify VOCs that discriminated between patients with and without lung cancer.Findings. Lung cancer was confirmed histologically in 60 patients. A combination of 22 breath VOCs, predominantly alkanes, alkane derivatives, and benzene derivatives, discriminated between patients with and without lung cancer, regardless of stage (all p < 0.0003). For stage 1 lung cancer, the 22 VOCs had 100% sensitivity and 81.3% specificity. Cross-validation of the combination correctly predicted the diagnosis in 71.7% patients with lung cancer and 66.7% of those without lung cancer.Interpretation. In patients with an abnormal chest radiograph, a combination of 22 VOCs in breath samples distinguished between patients with and without lung cancer. Prospective studies are needed to confirm the usefulness of breath VOCS for detecting lung cancer in the general population.