呼气的质谱分析用于鉴定食管腺癌和胃腺癌中的挥发性有机化合物生物标志物

Mass Spectrometric Analysis of Exhaled Breath for the Identification of Volatile Organic Compound Biomarkers in Esophageal and Gastric Adenocarcinoma.

作者信息

Kumar Sacheen, Huang Juzheng, Abbassi-Ghadi Nima, Mackenzie Hugh A, Veselkov Kirill A, Hoare Jonathan M, Lovat Laurence B, Španěl Patrik, Smith David, Hanna George B

机构信息

*Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, London, UK †Department of Medicine, Imperial College London, St Mary's Hospital, London, UK ‡Department of Surgery and Interventional Science, National Medical Laser Centre, University College London, London, UK §J. Heyrovsky Institute of Physical Chemistry, Academy of Sciences of the Czech Republic, Prague, Czech Republic ¶Institute for Science and Technology in Medicine, Keele University, Guy Hilton Research Centre, Hartshill, UK.

出版信息

Ann Surg. 2015 Dec;262(6):981-90. doi: 10.1097/SLA.0000000000001101.

DOI:10.1097/SLA.0000000000001101

PMID:25575255

Abstract

OBJECTIVE

The present study assessed whether exhaled breath analysis using Selected Ion Flow Tube Mass Spectrometry could distinguish esophageal and gastric adenocarcinoma from noncancer controls.

BACKGROUND

The majority of patients with upper gastrointestinal cancer present with advanced disease, resulting in poor long-term survival rates. Novel methods are needed to diagnose potentially curable upper gastrointestinal malignancies.

METHODS

A Profile-3 Selected Ion Flow Tube Mass Spectrometry instrument was used for analysis of volatile organic compounds (VOCs) within exhaled breath samples. All study participants had undergone upper gastrointestinal endoscopy on the day of breath sampling. Receiver operating characteristic analysis and a diagnostic risk prediction model were used to assess the discriminatory accuracy of the identified VOCs.

RESULTS

Exhaled breath samples were analyzed from 81 patients with esophageal (N = 48) or gastric adenocarcinoma (N = 33) and 129 controls including Barrett's metaplasia (N = 16), benign upper gastrointestinal diseases (N = 62), or a normal upper gastrointestinal tract (N = 51). Twelve VOCs-pentanoic acid, hexanoic acid, phenol, methyl phenol, ethyl phenol, butanal, pentanal, hexanal, heptanal, octanal, nonanal, and decanal-were present at significantly higher concentrations (P < 0.05) in the cancer groups than in the noncancer controls. The area under the ROC curve using these significant VOCs to discriminate esophageal and gastric adenocarcinoma from those with normal upper gastrointestinal tracts was 0.97 and 0.98, respectively. The area under the ROC curve for the model and validation subsets of the diagnostic prediction model was 0.92 ± 0.01 and 0.87 ± 0.03, respectively.

CONCLUSIONS

Distinct exhaled breath VOC profiles can distinguish patients with esophageal and gastric adenocarcinoma from noncancer controls.

摘要

目的

本研究评估了使用选择离子流管质谱法进行呼出气分析能否区分食管腺癌和胃腺癌与非癌症对照者。

背景

大多数上消化道癌症患者就诊时已处于疾病晚期，导致长期生存率较低。需要新的方法来诊断可能可治愈的上消化道恶性肿瘤。

方法

使用Profile-3选择离子流管质谱仪分析呼出气样本中的挥发性有机化合物（VOCs）。所有研究参与者在呼气采样当天均接受了上消化道内镜检查。采用受试者工作特征分析和诊断风险预测模型来评估所鉴定VOCs的鉴别准确性。

结果

对81例食管腺癌（N = 48）或胃腺癌（N = 33）患者以及129例对照者的呼出气样本进行了分析，对照者包括巴雷特化生（N = 16）、上消化道良性疾病（N = 62）或上消化道正常（N = 51）。癌症组中12种VOCs（戊酸、己酸、苯酚、甲基苯酚、乙基苯酚、丁醛、戊醛、己醛、庚醛、辛醛、壬醛和癸醛）的浓度显著高于非癌症对照者（P < 0.05）。使用这些显著的VOCs区分食管腺癌和胃腺癌与上消化道正常者的受试者工作特征曲线下面积分别为0.97和0.98。诊断预测模型的模型子集和验证子集的受试者工作特征曲线下面积分别为0.92±0.01和0.87±0.03。