Sani Shuaibu Nazifi, Zhou Wei, Ismail Balarabe B, Zhang Yongkui, Chen Zhijun, Zhang Binjie, Bao Changqian, Zhang Houde, Wang Xiaozhi
College of Information Science & Electronic Engineering, Zhejiang University, Hangzhou 310027, China.
Biochemical Analysis Laboratory, Breath (Hangzhou) Technology Co., Ltd., Hangzhou 310000, China.
Cancers (Basel). 2023 Feb 13;15(4):1186. doi: 10.3390/cancers15041186.
(1) Background: lung cancer is the world's deadliest cancer, but early diagnosis helps to improve the cure rate and thus reduce the mortality rate. Annual low-dose computed tomography (LD-CT) screening is an efficient lung cancer-screening program for a high-risk population. However, LD-CT has often been characterized by a higher degree of false-positive results. To meet these challenges, a volatolomic approach, in particular, the breath volatile organic compounds (VOCs) fingerprint analysis, has recently received increased attention for its application in early lung cancer screening thanks to its convenience, non-invasiveness, and being well tolerated by patients. (2) Methods: a LC-MS/MS-based volatolomics analysis was carried out according to P/N 5046800 standard based breath analysis of VOC as novel cancer biomarkers for distinguishing early-stage lung cancer from the healthy control group. The discriminatory accuracy of identified VOCs was assessed using subject work characterization and a random forest risk prediction model. (3) Results: the proposed technique has good performance compared with existing approaches, the differences between the exhaled VOCs of the early lung cancer patients before operation, three to seven days after the operation, as well as four to six weeks after operation under fasting and 1 h after the meal were compared with the healthy controls. The results showed that only 1 h after a meal, the concentration of seven VOCs, including 3-hydroxy-2-butanone (TG-4), glycolaldehyde (TG-7), 2-pentanone (TG-8), acrolein (TG-11), nonaldehyde (TG-19), decanal (TG-20), and crotonaldehyde (TG-22), differ significantly between lung cancer patients and control, with the invasive adenocarcinoma of the lung (IAC) having the most significant difference. (4) Conclusions: this novel, non-invasive approach can improve the detection rate of early lung cancer, and LC-MS/MS-based breath analysis could be a promising method for clinical application.
(1) 背景：肺癌是全球致死率最高的癌症，但早期诊断有助于提高治愈率，从而降低死亡率。年度低剂量计算机断层扫描（LD-CT）筛查是针对高危人群的一种有效的肺癌筛查方案。然而，LD-CT的特点往往是假阳性结果的比例较高。为应对这些挑战，一种挥发性物质组学方法，特别是呼气挥发性有机化合物（VOCs）指纹分析，由于其便利性、非侵入性以及患者耐受性良好，最近在早期肺癌筛查中的应用受到了越来越多的关注。(2) 方法：根据基于P/N 5046800标准的基于气相色谱-质谱联用仪（LC-MS/MS）的挥发性物质组学分析，对VOC进行标准呼吸分析，将其作为区分早期肺癌与健康对照组的新型癌症生物标志物。使用受试者工作特征和随机森林风险预测模型评估已鉴定VOCs的鉴别准确性。(3) 结果：与现有方法相比，所提出的技术具有良好的性能，比较了早期肺癌患者术前、术后三至七天以及术后四至六周空腹状态和进食后1小时呼出的VOCs与健康对照组之间的差异。结果显示，仅在进食后1小时，包括3-羟基-2-丁酮（TG-4）、乙醇醛（TG-7）、2-戊酮（TG-8）、丙烯醛（TG-11）、壬醛（TG-19）、癸醛（TG-20）和巴豆醛（TG-22）在内的七种VOCs的浓度在肺癌患者和对照组之间存在显著差异，其中肺浸润性腺癌（IAC）的差异最为显著。(4) 结论：这种新型的非侵入性方法可以提高早期肺癌的检出率，基于LC-MS/MS的呼气分析可能是一种有前景的临床应用方法。
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