早期肺癌患者呼出气特征性挥发性有机化合物及其诊断价值研究

Identification and diagnostic value of characteristic volatile organic compounds in exhaled breath of patients with early stage lung cancer

目的研究早期肺癌患者呼出气特征性挥发性有机化合物(volatile organic compounds,VOCs)及其诊断价值。方法应用固相微萃取联合气相色谱质谱技术分析117例早期肺癌患者[男54例、女63例,年龄(61.9±6.8)岁]和130例健康受试者[男79例、女51例,年龄(63.3±6.6)岁]呼出气中VOCs,筛选早期肺癌特征性VOCs,建立诊断模型。结果筛选出乙酸、正丁醇、二甲基硅醇、甲苯、2,3,4-三甲基庚烷、3,4-二甲基苯甲酸、5-甲基-3-己烯-2-酮、正己醇、2-氧代戊二酸甲酯和4-甲氧基苯酚共10种早期肺癌特征性VOCs。将性别及10种早期肺癌特征性VOCs纳入诊断模型,其敏感性为83.8%,特异性为96.2%。结论呼出气VOCs有望成为早期肺癌的潜在诊断方式之一。

Objective To investigate the characteristic volatile organic compounds(VOCs)in exhaled breath and their diagnostic value in patients with early stage lung cancer.Methods Solid-phase micro-extraction combined with gas chromatography mass spectrometry was used to analyze exhaled breath VOCs of 117 patients with early stage lung cancer(54 males and 63 females,with an average age of 61.9±6.8 years)and 130 healthy subjects(79 males and 51 females,with an average age of 63.3±6.6 years.The characteristic VOCs of early stage lung cancer were identified,and a diagnostic model was established.Results Ten characteristic VOCs of early stage lung cancer were identified,including acetic acid,n-butanol,dimethylsilanol,toluene,2,3,4-trimethylheptane,3,4-dimethylbenzoic acid,5-methyl-3-hexene-2-ketone,nhexanol,methyl 2-oxoglutarate and 4-methoxyphenol.Gender and the 10 characteristic VOCs were included in the diagnostic model,with a sensitivity of 83.8%and a specificity of 96.2%.Conclusion Analysis of exhaled breath VOCs is expected to be one of the potential methods used for early stage lung cancer diagnosis.