呼出气中挥发性有机化合物检测在肺癌早期诊断中的应用

Detection of volatile organic compounds in exhaled breath for early diagnosis of lung cancer

目的:探讨呼出气中挥发性有机化合物(volatile organic compounds,VOCs)检测在肺癌早期诊断中的应用价值。方法:采用气相色谱-质谱(gas chromatography-mass spectrometry,GCMS)方法检测肺癌患者与健康对照者呼出气中VOC成分和含量的变化,筛选可用于肺癌早期诊断的挥发性物质。结果:在受试者呼出气中检测到24种VOC,其中肺癌患者呼出气中3-己烯-2-酮和3-羟基-2-丁酮的平均峰面积明显大于对照组(P值均<0.05)。进展期(Ⅲ和Ⅳ期)肺癌患者呼出气中3-己烯-2-酮和3-羟基-2-丁酮的平均峰面积均显著大于早期(Ⅰ和Ⅱ期)肺癌患者(P值均<0.05),2组患者呼出气中3-己烯-2-酮和3-羟基-2-丁酮的平均峰面积均明显大于对照组(P值均<0.05)。小细胞肺癌患者呼出气中3-羟基-2-丁酮的平均峰面积显著大于非小细胞肺癌患者(P <0.05),3-己烯-2-酮的含量在2组间的差异无统计学意义(P> 0.05)。结论:肺癌患者呼出气中3-己烯-2-酮和3-羟基-2-丁酮含量明显增高,提示这2种物质可用于肺癌早期诊断的挥发性指标,呼出气GC-MS检测方法对于肺癌的早期诊断具有良好的应用价值。

Objective： To investigate the application value of detecting volatile organic compounds （VOCs） in exhaled breath for the early diagnosis of lung cancer.Methods： The changes of VOC the patients with lung cancer by gas chromatography-mass markers were screened for the type and content in exhaled breath from and the healthy controls were analyzed spectrometry （GC-MS）, then the volatile early diagnosis of lung cancer.Results： Twenty-four VOCs were identified from the exhaled breath of lung cancer patients, among which the contents （average peak areas） of 3-hexene-2-ketone and 3-hydroxy-2-butanone were significantly higher than those of the healthy control group （both P 〈 0.05）. The average peak areas of these two VOCs in advanced lung cancer patients （stage Ill and ]V （stage I and ]I） control group （al were significantly higher than those in early-stage lung cancer patients all P 〈 0.05）, which both were significantly higher than those in the healthy P 〈 0.05）. Compared to non-small cell lung cancer, the average peak area of 3-hydroxy-2-butanone was significantly higher than that in small cell lung cancer （P 〈 0.05）. There was no significant difference in the content of 3-hexene-2-ketone between the patients with small cell lung cancer and the ones with non-small cell lung cancer. Conclusion： The contents of 3-hexene-2-ketone and 3-hydroxy-2-butanone are significantly increased in the exhaled breath of patients with lung cancer, suggesting that the two VOCs can be applied as volatile markers and the detection of exhaled VOCs by GC-MS may be a promising method for early diagnosis of lung cancer in the future.