Pleil Joachim, Giese Roger
National Exposure Research Laboratory, US Environmental Protection Agency, Research Triangle Park, NC, United States of America.
J Breath Res. 2017 Sep 7;11(3):032001. doi: 10.1088/1752-7163/aa79bc.
Dogs have been studied for many years as a medical diagnostic tool to detect a pre-clinical disease state by sniffing emissions directly from a human or an in vitro biological sample. Some of the studies report high sensitivity and specificity in blinded case-control studies. However, in these studies it is completely unknown as to which suites of chemicals the dogs detect and how they ultimately interpret this information amidst confounding background odors. Herein, we consider the advantages and challenges of canine olfaction for early (meaningful) detection of cancer, and propose an experimental concept to narrow the molecular signals used by the dog for sample classification to laboratory-based instrumental analysis. This serves two purposes; first, in contrast to dogs, analytical methods could be quickly up-scaled for high throughput sampling. Second, the knowledge gained from identifying probative chemicals could be helpful in learning more about biochemical pathways and disease progression. We focus on exhaled breath aerosol, arguing that the semi-volatile fraction should be given more attention. Ultimately, we conclude that the interaction between dog-based and instrument-based research will be mutually beneficial and accelerate progress towards early detection of cancer by breath analysis.
多年来，狗一直被用作医学诊断工具，通过直接嗅闻人类或体外生物样本的排放物来检测临床前疾病状态。一些研究报告称在盲法病例对照研究中具有高灵敏度和特异性。然而，在这些研究中，完全不清楚狗检测到的是哪些化学物质组合，以及它们在混杂的背景气味中最终如何解读这些信息。在此，我们考虑犬嗅觉在早期（有意义的）癌症检测中的优势和挑战，并提出一个实验概念，将狗用于样本分类的分子信号缩小到基于实验室的仪器分析。这有两个目的；第一，与狗不同，分析方法可以快速扩大规模以进行高通量采样。第二，从鉴定有证明力的化学物质中获得的知识有助于更多地了解生化途径和疾病进展。我们专注于呼出的气息气溶胶，认为半挥发性部分应得到更多关注。最终，我们得出结论，基于狗的研究和基于仪器的研究之间的相互作用将是互利的，并将加速通过呼吸分析实现癌症早期检测的进展。
