Catino Annamaria, de Gennaro Gianluigi, Di Gilio Alessia, Facchini Laura, Galetta Domenico, Palmisani Jolanda, Porcelli Francesca, Varesano Niccolò
Thoracic Oncology Unit, Clinical Cancer Centre "Giovanni Paolo II", 70124 Bari, Italy.
Department of Biology, University of Bari, 70125 Bari, Italy.
Cancers (Basel). 2019 Jun 14;11(6):831. doi: 10.3390/cancers11060831.
Malignant pleural mesothelioma (MPM) is a rare neoplasm related to asbestos exposure and with high mortality rate. The management of patients with MPM is complex and controversial, particularly with regard to early diagnosis. In the last few years, breath analysis has been greatly implemented with this aim. In this review the strengths of breath analysis and preliminary results in searching breath biomarkers of MPM are highlighted and discussed, respectively. Through a systematic electronic literature search, collecting papers published from 2000 until December 2018, fifteen relevant scientific papers were selected. All papers considered were prospective, comparative, observational case-control studies although every single one pilot and based on a relatively small number of samples. The identification of diagnostic VOCs pattern, through breath sample characterization and the statistical data treatment, allows to obtain a strategic information for clinical diagnostics. To date the collected data provide just preliminary information and, despite the promising results and diagnostic accuracy, conclusions cannot be generalized due to the limited number of individuals included in each cohort study. Furthermore none of studies was externally validated, although validation process is a necessary step towards clinical implementation. Breathomics-based biomarker approach should be further explored to confirm and validate preliminary findings and to evaluate its potential role in monitoring the therapeutic response.
恶性胸膜间皮瘤（MPM）是一种与石棉暴露相关的罕见肿瘤，死亡率很高。MPM患者的管理复杂且存在争议，尤其是在早期诊断方面。在过去几年中，为实现这一目标，呼气分析得到了广泛应用。在这篇综述中，分别强调并讨论了呼气分析的优势以及在寻找MPM呼气生物标志物方面的初步结果。通过系统的电子文献检索，收集了2000年至2018年12月发表的论文，共筛选出15篇相关科学论文。所有纳入的论文均为前瞻性、比较性、观察性病例对照研究，不过每一篇都是初步研究且基于相对少量的样本。通过呼气样本特征分析和统计数据处理来识别诊断性挥发性有机化合物（VOC）模式，可为临床诊断提供关键信息。迄今为止，所收集的数据仅提供了初步信息，尽管结果很有前景且诊断准确性较高，但由于每个队列研究纳入的个体数量有限，结论无法推广。此外，尽管验证过程是临床应用的必要步骤，但没有一项研究进行了外部验证。基于呼吸组学的生物标志物方法应进一步探索，以确认和验证初步发现，并评估其在监测治疗反应中的潜在作用。
