Detection of Airway Colonization by Aspergillus fumigatus by Use of Electronic Nose Technology in Patients with Cystic Fibrosis
Detection of Airway Colonization by Aspergillus fumigatus by Use of Electronic Nose Technology in Patients with Cystic Fibrosis
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DOI：
10.1128/jcm.02214-15
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发表时间：
2016-03-01
影响因子：
9.4
通讯作者：
Sterk, P. J.
中科院分区：
文献类型：
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作者：
de Heer, K.;Kok, M. G. M.;Sterk, P. J.
目前，还没有可以可靠诊断早期侵袭性肺曲霉病（IA）的无创测试。电子鼻（eNose）可以通过分析呼出的挥发性有机化合物来区分各种肺部疾病。我们最近发表的一项原理验证研究表明，患有长期化疗引起的中性粒细胞减少症和 IA 的患者具有明显的呼气轮廓（或呼吸纹），可以通过 eNose 进行区分。电子鼻价格便宜且无创，并且可以在几分钟内产生结果。我们确定是否也可以用 eNose 检测囊性纤维化 (CF) 患者中的烟曲霉定植。使用 Cyranose 320 分析了 27 名 CF 患者的呼出气样本。痰样本培养确定了烟曲霉定植状态。主成分减少后，使用典型判别分析对 eNose 数据进行分类。我们的主要结果是交叉验证的准确性，定义为使用留一法正确分类的受试者的百分比。 P 值是通过生成 100,000 个随机替代分类来计算的。 27 名受试者中有 9 名被烟曲霉定殖。总共有 3 名受试者被错误分类，导致 Cyranose 检测 IA 的交叉验证准确度为 89%（P = 0.004；敏感性，78%；特异性，94%）。受试者工作特征 (ROC) 曲线分析显示曲线下面积 (AUC) 为 0.89。结果表明，烟曲霉定植导致 CF 患者出现独特的呼吸纹。目前的概念验证数据值得外部验证和监测研究。
Currently, there is no noninvasive test that can reliably diagnose early invasive pulmonary aspergillosis (IA). An electronic nose (eNose) can discriminate various lung diseases through an analysis of exhaled volatile organic compounds. We recently published a proof-of-principle study showing that patients with prolonged chemotherapy-induced neutropenia and IA have a distinct exhaled breath profile (or breathprint) that can be discriminated with an eNose. An eNose is cheap and noninvasive, and it yields results within minutes. We determined whether Aspergillus fumigatus colonization may also be detected with an eNose in cystic fibrosis (CF) patients. Exhaled breath samples of 27 CF patients were analyzed with a Cyranose 320. Culture of sputum samples defined the A. fumigatus colonization status. eNose data were classified using canonical discriminant analysis after principal component reduction. Our primary outcome was cross-validated accuracy, defined as the percentage of correctly classified subjects using the leave-one-out method. The P value was calculated by the generation of 100,000 random alternative classifications. Nine of the 27 subjects were colonized by A. fumigatus. In total, 3 subjects were misclassified, resulting in a cross-validated accuracy of the Cyranose detecting IA of 89% (P = 0.004; sensitivity, 78%; specificity, 94%). Receiver operating characteristic (ROC) curve analysis showed an area under the curve (AUC) of 0.89. The results indicate that A. fumigatus colonization leads to a distinctive breathprint in CF patients. The present proof-of-concept data merit external validation and monitoring studies.