Montalto Norman J, Wells Wayne O
Acordia National/Wells Fargo, 602 Virginia St. E., Charleston, West Virginia, 25327-1921, USA.
Cancer Epidemiol Biomarkers Prev. 2007 Sep;16(9):1858-62. doi: 10.1158/1055-9965.EPI-07-0189.
This study evaluated the performance characteristics of a novel rapid method for verifying smoking status in individuals by measurement of cotinine, the primary metabolite of nicotine, in saliva samples using an immunochromatographic strip in a "dipstick" format compared with liquid chromatography/mass spectrometry (LC/MS).
A prospective comparison was made of smoking status as determined by measurement of cotinine in urine by LC/MS (the gold standard) and in saliva using a semiquantitative dipstick assay that uses cotinine-specific monoclonal antibodies attached to gold particles and a series of avidity traps to measure cotinine levels (saliva NicAlert). One hundred seventy-two individuals from a family practice/general medical setting agreed to participate after informed consent and institutional review board approval. Saliva NicAlert tests were done by untrained operators who followed written directions.
Comparison of smoking status as determined by urine cotinine measurement by LC/MS (50 ng/mL cutoff) with the saliva strip test results, averaged over the two operators, indicated that the saliva test strip results had a sensitivity of 99% and a specificity of 96%. Saliva NicAlert also identified four smokers who reported being nonsmokers but were confirmed to be smokers by LC/MS.
The saliva NicAlert assay seems to be a valid, highly sensitive, and specific method for validating self-reported smoking status and may have clinical applications in selected medical settings.
本研究评估了一种新型快速方法的性能特征，该方法通过使用免疫层析试纸条以“试纸”形式测量唾液样本中可替宁（尼古丁的主要代谢产物）来验证个体的吸烟状态，并与液相色谱/质谱法（LC/MS）进行比较。
对通过LC/MS（金标准）测量尿液中可替宁以及使用半定量试纸法测量唾液中可替宁所确定的吸烟状态进行前瞻性比较。该试纸法使用附着在金颗粒上的可替宁特异性单克隆抗体和一系列亲和力捕获剂来测量可替宁水平（唾液尼古丁检测试纸）。在获得知情同意并经机构审查委员会批准后，来自家庭医疗/普通医疗环境的172名个体同意参与。唾液尼古丁检测试纸测试由未受过培训的操作人员按照书面说明进行。
将通过LC/MS测量尿液可替宁（截断值为50 ng/mL）所确定的吸烟状态与两名操作人员的唾液试纸测试结果的平均值进行比较，结果表明唾液测试试纸结果的灵敏度为99%，特异性为96%。唾液尼古丁检测试纸还识别出四名自称不吸烟者但经LC/MS确认为吸烟者的人。
唾液尼古丁检测试纸法似乎是一种有效、高度灵敏且特异的方法，可用于验证自我报告的吸烟状态，并且可能在特定医疗环境中有临床应用。
