Department of Public Health and Primary Care, Centre for Environment and Health, University of Leuven (KU Leuven), 3000 Leuven, Belgium.
Laboratory of Occupational and Environmental Respiratory Diseases, Division of Immunology, Allergy and Asthma, Department of Pulmonary Medicine, Faculty of Medicine, Ege University, Bornova, 35100 Izmir, Turkey.
Int J Environ Res Public Health. 2020 Feb 10;17(3):1110. doi: 10.3390/ijerph17031110.
Malignant pleural mesothelioma (MPM) is mainly related to previous asbestos exposure. There is still dearth of information on non-invasive biomarkers to detect MPM at early stages. Human studies on exhaled breath biomarkers of cancer and asbestos-related diseases show encouraging results. The aim of this systematic review was to provide an overview on the current knowledge about exhaled breath analysis in MPM diagnosis. A systematic review was conducted on MEDLINE (PubMed), EMBASE and Web of Science databases to identify relevant studies. Quality assessment was done by the Newcastle-Ottawa Scale. Six studies were identified, all of which showed fair quality and explored volatile organic compounds (VOC) based breath profile using Gas Chromatography Coupled to Mass Spectrometry (GC-MS), Ion Mobility Spectrometry Coupled to Multi-capillary Columns (IMS-MCC) or pattern-recognition technologies. Sample sizes varied between 39 and 330. Some compounds (i.e, cyclohexane, P3, P5, P50, P71, diethyl ether, limonene, nonanal, VOC IK 1287) that can be indicative of MPM development in asbestos exposed population were identified with high diagnostic accuracy rates. E-nose studies reported breathprints being able to distinguish MPM from asbestos exposed individuals with high sensitivity and a negative predictive value. Small sample sizes and methodological diversities among studies limit the translation of results into clinical practice. More prospective studies with standardized methodologies should be conducted on larger populations.
恶性胸膜间皮瘤（MPM）主要与先前的石棉暴露有关。目前仍然缺乏用于在早期检测 MPM 的非侵入性生物标志物的信息。关于癌症和与石棉相关疾病的呼气生物标志物的人体研究显示出了令人鼓舞的结果。本系统评价的目的是提供关于 MPM 诊断中呼气分析的当前知识概述。在 MEDLINE（PubMed）、EMBASE 和 Web of Science 数据库中进行了系统评价，以确定相关研究。使用纽卡斯尔-渥太华量表进行了质量评估。确定了六项研究，所有研究的质量均为中等，均探索了使用气相色谱-质谱联用（GC-MS）、离子迁移谱-多毛细管柱联用（IMS-MCC）或模式识别技术的基于挥发性有机化合物（VOC）的呼气特征。样本量在 39 到 330 之间不等。一些化合物（例如环己烷、P3、P5、P50、P71、二乙醚、柠檬烯、壬醛、VOC IK 1287）可以指示石棉暴露人群中 MPM 的发展，具有较高的诊断准确率。电子鼻研究报告称，呼吸特征能够以较高的灵敏度和阴性预测值区分 MPM 和石棉暴露个体。研究之间的样本量小和方法多样性限制了将结果转化为临床实践。应该在更大的人群中进行更多具有标准化方法的前瞻性研究。
