Diagnostic accuracy of breath tests for pneumoconiosis using an electronic nose
電子鼻用于塵肺病呼吸分析試驗準確性研究
Pau-Chung Chen1,2,3,4, Hsin-Yi Peng1, Che-Jui Chang1, and Hsiao-Yu Yang1,2,3*
1 Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan
2 Department of Public Health, National Taiwan University College of Public Health, Taipei, Taiwan
3 Department of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei, Taiwan
4 Department of Environmental and Occupational Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
Abstract
Breath analyses have attracted substantial attention as screens for occupational environmental lung disease. The objective of this study was to develop breath tests for pneumoconiosis by analysing volatile organic compounds using an electronic nose. A case-control study was designed. We screened 102 subjects from a cohort of stone workers. After excluding three subjects with poorly controlled diabetes mellitus and one subject with asthma, 98 subjects were enrolled, including 34 subjects with pneumoconiosis and 64 healthy controls. We analysed the subjects’ breath using an electronic nose (Cyranose 320)with 32 nanocomposite sensors. Data were randomly split into 80% for model building and 20% for validation. Using a linear discriminate analysis, the sensitivity, specificity, accuracy, and area under the receiver operating characteristic curve (AUROC) were 67.9%, 88.0%, 80.8%, and 0.91, respectively, in the training set and 66.7%, 71.4%, 70.0%, and 0.86, respectively, in the test set. In subgroup analysis divided by smoking status, the AUROCs for current smokers, former smokers, and subjects who never smoked were 0.94, 0.93, and 0.99, respectively. In subgroup analysis divided by gender, the AUROCs for males and females were 0.95 and 0.99, respectively. Breath tests may have potential as a screen for pneumoconiosis. A multi-centre study is warranted, and the procedures must be standardized before clinical application.
呼吸分析作為職業性環境肺病的篩查手段，已引起人們的廣泛關注。本研究的目的是通過使用電子鼻分析揮發性有機化合物開發塵肺呼吸測試。設計了一個病例對照研究。我們從一組石工中篩選了102名受試者。排除3例糖尿病控制不良和1例哮喘患者后，入選98例，其中塵肺34例，健康對照64例。我們用一個裝有32個納米復合傳感器的電子鼻(Cyranose 320)來分析受試者的呼吸。數據被隨機分成80%用于模型構建和20%用于驗證。采用線性判別分析，受試者操作特征曲線(AUROC)下的靈敏度、特異性、準確性和面積在訓練集分別為67.9%、88.0%、80.8%和0.91，在測試集分別為66.7%、71.4%、70.0%和0.86。根據吸煙狀況分組分析，當前吸煙者、前吸煙者和從未吸煙的受試者的極光分別為0.94、0.93和0.99。在按性別劃分的亞組分析中，男性和女性的極光分別為0.95和0.99。呼吸測試有可能作為塵肺的篩查手段。多中心研究是有必要的，并且在臨床應用之前必須對程序進行標準化。
Keywords: breath testing, volatile organic compounds, pneumoconiosis, sensitivity, specificity
關鍵詞：呼吸測試；揮發性有機化合物；塵肺；敏感性；特異性
