通过呼气检测癌前胃病变和胃癌。

Detection of precancerous gastric lesions and gastric cancer through exhaled breath.

机构信息

Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa, Israel.

Faculty of Medicine, University of Latvia, Riga, Latvia Department of Research, Riga East University Hospital, Riga, Latvia Digestive Diseases Centre GASTRO, Riga, Latvia.

出版信息

Gut. 2016 Mar;65(3):400-7. doi: 10.1136/gutjnl-2014-308536. Epub 2015 Apr 13.

DOI:10.1136/gutjnl-2014-308536

PMID:25869737

Abstract

OBJECTIVES

Timely detection of gastric cancer (GC) and the related precancerous lesions could provide a tool for decreasing both cancer mortality and incidence.

DESIGN

968 breath samples were collected from 484 patients (including 99 with GC) for two different analyses. The first sample was analysed by gas chromatography linked to mass spectrometry (GCMS) while applying t test with multiple corrections (p value<0.017); the second by cross-reactive nanoarrays combined with pattern recognition. For the latter, 70% of the samples were randomly selected and used in the training set while the remaining 30% constituted the validation set. The operative link on gastric intestinal metaplasia (OLGIM) assessment staging system was used to stratify the presence/absence and risk level of precancerous lesions. Patients with OLGIM stages III-IV were considered to be at high risk.

RESULTS

According to the GCMS results, patients with cancer as well as those at high risk had distinctive breath-print compositions. Eight significant volatile organic compounds (p value<0.017) were detected in exhaled breath in the different comparisons. The nanoarray analysis made it possible to discriminate between the patients with GC and the control group (OLGIM 0-IV) with 73% sensitivity, 98% specificity and 92% accuracy. The classification sensitivity, specificity, and accuracy between the subgroups was as follows: GC versus OLGIM 0-II-97%, 84% and 87%; GC versus OLGIM III-IV-93%, 80% and 90%; but OLGIM I-II versus OLGIM III-IV and dysplasia combined-83%, 60% and 61%, respectively.

CONCLUSIONS

Nanoarray analysis could provide the missing non-invasive screening tool for GC and related precancerous lesions as well as for surveillance of the latter.

TRIAL REGISTRATION NUMBER

Clinical Trials.gov number, NCT01420588 (3/11/2013).

摘要

目的

及时发现胃癌（GC）及相关癌前病变，为降低癌症死亡率和发病率提供工具。

设计

对 484 例患者（包括 99 例 GC 患者）的 968 个呼吸样本进行了两种不同分析。第一份样本采用气相色谱-质谱联用（GCMS）进行分析，并进行了多次校正的 t 检验（p 值<0.017）；第二份样本采用交叉反应纳米阵列结合模式识别进行分析。对于后者，随机选择 70%的样本作为训练集，其余 30%作为验证集。采用操作链接胃肠上皮化生（OLGIM）评估分期系统对癌前病变的存在/缺失和风险水平进行分层。OLGIM 分期 III-IV 的患者被认为处于高风险状态。

结果

根据 GCMS 结果，癌症患者以及高风险患者的呼气特征谱具有明显差异。在不同的比较中，共检测到 8 种具有显著差异的挥发性有机化合物（p 值<0.017）。纳米阵列分析能够区分 GC 患者和对照组（OLGIM 0-IV），其灵敏度为 73%，特异性为 98%，准确性为 92%。亚组间的分类灵敏度、特异性和准确性如下：GC 与 OLGIM 0-II-97%、84%和 87%；GC 与 OLGIM III-IV-93%、80%和 90%；而 OLGIM I-II 与 OLGIM III-IV 以及异型增生合并的灵敏度、特异性和准确性分别为 83%、60%和 61%。