Breath Research Institute of the Austrian Academy of Sciences, Dammstr 22, A-6850 Dornbirn, Austria.
Expert Rev Mol Diagn. 2011 Mar;11(2):207-17. doi: 10.1586/erm.10.112.
Lung cancer is the leading cause of cancer-related mortality worldwide. Methods for early detection of lung cancer, such as computerized tomography scanning technology, often discover a large number of small lung nodules, posing a new problem to radiologists and chest physicians. The vast majority of these nodules will be benign, but there is currently no easy way to determine which nodules represent very early lung cancer. Adjuvant testing with PET imaging and nonsurgical biopsies has a low yield for these small indeterminate nodules, carries potential morbidity and is costly. Indeed, purely morphological criteria seem to be insufficient for distinguishing lung cancer from benign nodules at early stages with sufficient confidence, therefore false positives undergoing surgical resection frequently occur. A molecular approach to the diagnosis of lung cancer through the analysis of exhaled breath could greatly improve the specificity of imaging procedures. A biomarker-driven approach to signs or symptoms possibly due to lung cancer would represent a complementary tool aimed at ruling out (with known error probability) rather than diagnosing lung cancer. Volatile and nonvolatile components of the breath are being studied as biomarkers of lung cancer. Breath testing is noninvasive and potentially inexpensive. There is promise that an accurate lung cancer breath biomarker, capable of being applied clinically, will be developed in the near future. In this article, we summarize some of the rationale for breath biomarker development, review the published literature in this field and provide thoughts regarding future directions.
肺癌是全球癌症相关死亡的主要原因。肺癌的早期检测方法，如计算机断层扫描技术，经常会发现大量的小肺结节，这给放射科医生和胸科医生带来了新的问题。这些结节绝大多数是良性的，但目前还没有一种简单的方法可以确定哪些结节代表非常早期的肺癌。用 PET 成像和非手术活检进行辅助检测，对这些小的不确定结节的阳性率较低，且具有潜在的发病率和昂贵的费用。事实上，单纯的形态学标准似乎不足以在早期阶段有足够的信心区分肺癌和良性结节，因此经常会发生假阳性的手术切除。通过分析呼气来进行肺癌的分子诊断，可以极大地提高成像程序的特异性。通过对可能由于肺癌引起的症状或体征进行基于生物标志物的分析，将是一种互补的工具，旨在排除（已知的错误概率）而不是诊断肺癌。呼气中的挥发性和非挥发性成分被作为肺癌的生物标志物进行研究。呼吸测试是非侵入性的，并且具有潜在的低成本。有望在不久的将来开发出一种准确的、可应用于临床的肺癌呼吸生物标志物。在本文中，我们总结了一些开发呼吸生物标志物的基本原理，回顾了该领域的已发表文献，并对未来的方向进行了思考。
