Department of Anaesthesiology and Intensive Care Medicine, University Rostock, Schillingallee 35, 18057 Rostock, Germany.
Eur Respir J. 2012 Sep;40(3):706-13. doi: 10.1183/09031936.00125411. Epub 2012 Jan 20.
Noninvasive breath analysis may provide valuable information for cancer recognition if disease-specific volatile biomarkers could be identified. In order to compare nondiseased and diseased tissue in vivo, this study took advantage of the special circumstances of one-lung ventilation (OLV) during lung-surgery. 15 cancer patients undergoing lung resection with OLV were enrolled. From each patient, alveolar breath samples were taken separately from healthy and diseased lungs before and after tumour resection. Volatile substances were pre-concentrated by means of solid-phase microextraction, and were separated, identified and quantified by means of gas chromatography-mass spectrometry. Different classes of volatile substances could be identified according to their concentration profiles. Due to prolonged fasting and activation of lipolysis, concentrations of endogenous acetone significantly increased during surgery. Exogenous substances, such as benzene or cyclohexanone, showed typical washout exhalation kinetics. Exhaled concentrations of potentially tumour associated substances, such as butane or pentane, were different for nondiseased and diseased lungs and decreased significantly after surgery. Separate analysis of volatile substances exhaled from healthy and diseased lungs in the same patient, together with thorough consideration of substance origins and exhalation kinetics offers unique opportunities of biomarker recognition and evaluation.
如果能够确定与疾病相关的挥发性生物标志物，那么无创呼吸分析可能为癌症识别提供有价值的信息。为了比较体内非病变组织和病变组织，本研究利用了单肺通气（OLV）在肺手术中的特殊情况。本研究共纳入了 15 名接受肺切除术和 OLV 的肺癌患者。在肿瘤切除前后，分别从每个患者的健康和患病肺中采集肺泡呼吸样本。采用固相微萃取法对挥发性物质进行预浓缩，然后通过气相色谱-质谱联用进行分离、鉴定和定量。根据浓度曲线可以识别不同类别的挥发性物质。由于长时间禁食和脂解作用的激活，手术过程中内源性丙酮的浓度显著增加。外源性物质，如苯或环己酮，表现出典型的洗脱呼气动力学。与非病变肺相比，潜在与肿瘤相关的物质（如丁烷或戊烷）的呼出浓度在病变肺中有所不同，并且在手术后显著降低。对同一患者健康和患病肺呼出的挥发性物质进行单独分析，并结合对物质来源和呼气动力学的深入考虑，为生物标志物的识别和评估提供了独特的机会。
