Lamote Kevin, Vynck Matthijs, Van Cleemput Joris, Thas Olivier, Nackaerts Kristiaan, van Meerbeeck Jan P
Department of Respiratory Medicine, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium. Department of Internal Medicine, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium. Author to whom any correspondence should be addressed. Department of Respiratory Medicine, Ghent University Hospital, De Pintelaan 185-building 7K12IE, 9000 Ghent, Belgium.
J Breath Res. 2016 Sep 26;10(4):046001. doi: 10.1088/1752-7155/10/4/046001.
Malignant pleural mesothelioma (MPM) is predominantly caused by previous asbestos exposure. Diagnosis often happens in advanced stages restricting any therapeutic perspectives. Early stage detection via breath analysis was explored using multicapillary column/ion mobility spectrometry (MCC/IMS) to detect volatile organic compounds (VOCs) in the exhaled breath of MPM patients in comparison to former occupational asbestos-exposed and non-exposed controls. Breath and background samples of 23 MPM patients, 22 asymptomatic former asbestos (AEx) workers and 21 healthy non-asbestos exposed persons were taken for analysis. After background correction, we performed a logistic least absolute shrinkage and selection operator (lasso) regression to select the most important VOCs, followed by receiver operating characteristic (ROC) analysis. MPM patients were discriminated from both controls with 87% sensitivity, 70% specificity and respective positive and negative predictive values of 61% and 91%. The overall accuracy was 76% and the area under the ROC-curve was 0.81. AEx individuals could be discriminated from MPM patients with 87% sensitivity, 86% specificity and respective positive and negative predictive values of 87% and 86%. The overall accuracy was 87% with an area under the ROC-curve of 0.86. Breath analysis by MCC/IMS allows MPM patients to be discriminated from controls and holds promise for further investigation as a screening tool for former asbestos-exposed persons at risk of developing MPM.
恶性胸膜间皮瘤（MPM）主要由既往接触石棉所致。诊断通常在晚期进行，这限制了任何治疗前景。通过多毛细管柱/离子迁移谱（MCC/IMS）对呼气进行分析，探索早期检测方法，以检测MPM患者呼出气体中的挥发性有机化合物（VOCs），并与既往职业性接触石棉者和未接触石棉者进行对照。采集了23例MPM患者、22例无症状既往石棉接触者（AEx）工人和21例健康未接触石棉者的呼气和背景样本进行分析。在进行背景校正后，我们进行了逻辑最小绝对收缩和选择算子（lasso）回归以选择最重要的VOCs，随后进行了受试者工作特征（ROC）分析。MPM患者与两组对照的鉴别灵敏度为87%，特异度为70%，阳性预测值和阴性预测值分别为61%和91%。总体准确率为76%，ROC曲线下面积为0.81。AEx个体与MPM患者的鉴别灵敏度为87%，特异度为86%，阳性预测值和阴性预测值分别为87%和86%。总体准确率为87%，ROC曲线下面积为0.86。通过MCC/IMS进行呼气分析能够鉴别MPM患者与对照，有望作为一种筛查工具对有患MPM风险的既往石棉接触者作进一步研究。
