Steenhuis Eline G M, Asmara Oke D, Kort Sharina, Papenhuijzen Mirell H G, Veeger Nic J G M, Van den Heuvel Michel M, Van Geffen Wouter H
Department of Pulmonology, Isala, Zwolle, The Netherlands.
Department of Pulmonology, Medisch Centrum Leeuwarden, Leeuwarden, The Netherlands.
ERJ Open Res. 2025 May 19;11(3). doi: 10.1183/23120541.00723-2024. eCollection 2025 May.
Lung cancer remains a leading cause of cancer-related deaths. Early-stage detection is pivotal for curative interventions, yet most cases are diagnosed at advanced stages. Noninvasive point-of-care diagnostic strategies are needed to reduce lung cancer mortality rates. We assess the potential of electronic nose (eNose) devices as a tool for lung cancer detection.
All online available databases were searched. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we reviewed studies using eNose for exhaled air analysis in lung cancer patients. Included patients had pathologically confirmed lung cancer, both non-small cell lung cancer and small cell lung cancer, in various stages. Primary outcomes were sensitivity, specificity, negative predictive value and area under the curve. Secondary outcomes evaluated eNose performance in distinguishing non-small cell lung cancer subtypes and small cell lung cancer. Additionally, a subgroup analysis was conducted to evaluate the efficacy of various commonly used sensors in this differentiation. The Quality Assessment of Diagnostic Accuracy Studies 2 tool was used for risk-of-bias assessment.
We included 35 studies, comprising 4483 patients. Pooled sensitivity and specificity were 0.90 (95% CI 0.87-0.93) and 0.89 (95% CI 0.85-0.93), respectively. The median negative predictive value was 0.93 and the median area under the curve was 0.91. Both the likelihood of bias and concerns regarding applicability were minimal.
eNose devices hold promise as noninvasive, point-of-care tools for lung cancer diagnosis. Owing to the high sensitivity and negative predictive values and great ease of use, they could be valuable additions to the diagnostic toolbox. Further research and validation efforts are critical to maximise their impact on early lung cancer detection.
肺癌仍然是癌症相关死亡的主要原因。早期检测对于治愈性干预至关重要，但大多数病例在晚期才被诊断出来。需要非侵入性即时诊断策略来降低肺癌死亡率。我们评估电子鼻（eNose）设备作为肺癌检测工具的潜力。
检索了所有在线可用数据库。遵循系统评价和Meta分析的首选报告项目指南，我们回顾了使用电子鼻对肺癌患者呼出气体进行分析的研究。纳入的患者患有经病理证实的肺癌，包括非小细胞肺癌和小细胞肺癌，处于不同阶段。主要结局指标为敏感性、特异性、阴性预测值和曲线下面积。次要结局指标评估电子鼻在区分非小细胞肺癌亚型和小细胞肺癌方面的性能。此外，进行了亚组分析以评估各种常用传感器在这种区分中的功效。使用诊断准确性研究质量评估2工具进行偏倚风险评估。
我们纳入了35项研究，共4483例患者。合并敏感性和特异性分别为0.90（95%CI 0.87 - 0.93）和0.89（95%CI 0.85 - 0.93）。中位阴性预测值为0.93，中位曲线下面积为0.91。偏倚可能性和适用性方面的担忧均最小。
电子鼻设备有望成为肺癌诊断的非侵入性即时工具。由于其高敏感性、阴性预测值和极大的易用性，它们可能成为诊断工具箱中有价值的补充。进一步的研究和验证工作对于最大限度地发挥其对早期肺癌检测的影响至关重要。
