Exhaled Breath Analysis in Diagnosis of Malignant Pleural Mesothelioma: Systematic Review
呼氣分析在惡性胸膜間皮瘤的診斷：系統評價
Zehra Nur Töreyin 1,*OrcID,Manosij Ghosh 1OrcID,Özlem Göksel 2,Tuncay Göksel 3OrcID andLode Godderis 1,4
1University of Leuven (KU Leuven), Department of Public Health and Primary Care, Centre for Environment and Health, 3000 Leuven, Belgium
2Ege University, Faculty of Medicine, Department of Pulmonary Medicine, Division of Immunology, Allergy and Asthma, Laboratory of Occupational and Environmental Respiratory Diseases, Bornova,Izmir, Turkey
3Ege University, Faculty of Medicine, Department of Pulmonary Medicine, Bornova,Izmir, Turkey
4Idewe, External Service for Prevention and Protection at Work, 3001 Heverlee, Belgium
*Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(3), 1110; https://doi.org/10.3390/ijerph
Abstract
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.
惡性胸膜間皮瘤(MPM)主要與以往接觸石棉有關。在早期檢測MPM的非侵入性生物標記物方面還缺乏信息。人類對癌癥和石棉相關疾病呼氣生物標志物的研究顯示了令人鼓舞的結果。本系統綜述的目的是對目前呼氣分析在多發性肺病診斷中的應用進行綜述。對MEDLINE(PubMed)、EMBASE和Web科學數據庫進行了系統回顧，以確定相關研究。質量評估采用紐卡斯爾-渥太華量表。共鑒定了6項研究，所有研究均顯示了良好的質量，并利用氣相色譜-質譜聯用(GC-MS)、離子遷移光譜-多毛細管柱聯用(IMS-MCC)或模式識別技術探索了基于揮發性有機化合物(VOC)的呼吸剖面。樣本量在39到330之間變化。一些化合物(即環己烷、P3、P5、P50、P71、、*、壬醛、VOC IK 1287)可指示石棉接觸人群中的多發性硬化癥的發展，其診斷準確率高。電子鼻研究報告說，呼吸指紋能夠區分多發性硬化癥和接觸石棉的高敏感度和陰性預測值的個人。小樣本和研究方法的多樣性限制了結果轉化為臨床實踐。應在更大的人群中開展更多具有標準化方法的前瞻性研究
Keywords:malignant pleural mesothelioma; exhaled breath analysis; volatile organic compounds; exhaled breath condensate
關鍵詞：惡性胸膜間皮瘤；呼氣分析；揮發性有機物；呼氣冷凝液
