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目的:通过对非小细胞肺癌患者呼出气体中的挥发性有机化合物进行定量检测,评价挥发性有机化合物对非小细胞肺癌诊断的意义。方法:用Tedlar~采样袋收集43份非小细胞肺癌患者和41份正常人的呼气样品,经固相微萃取浓缩后,用气相色谱/质谱检测呼气中的挥发性有机化合物,结果用外标法定量。通过ROC曲线评价呼气分析诊断非小细胞肺癌的临床价值,对早期和晚期非小细胞肺癌以及肺腺癌和鳞癌之间的呼气分析差异进行统计学分析。结果:在非小细胞肺癌患者呼气中正丁醇和3-羟基-2-丁酮的浓度分别为6.36和8.28ng/L,明显高于正常人呼气中的浓度,P<0.001。正丁醇和3-羟基-2-丁酮作为挥发性标志在Ⅰ～Ⅱ期非小细胞肺癌患者呼气中的浓度和Ⅲ～Ⅳ期进行比较,差异无统计学意义(P>0.05),而它们在肺腺癌患者的呼气中的浓度高于鳞癌患者,P<0.05。结论:正丁醇和3-羟基-2-丁酮可作为肺癌呼气诊断的挥发性标志,可能对非小细胞肺癌的腺、鳞癌鉴别诊断有帮助,但不能作为早晚期肺癌的鉴别指标。
Objective: To evaluate the value of volatile organic compounds in the diagnosis of non-small cell lung cancer by quantitative detection of volatile organic compounds in exhaled breath of patients with non-small cell lung cancer. Methods: 43 samples of non-small cell lung cancer and 41 healthy volunteers were collected by Tedlar ~ sampling bag. After the sample was concentrated by solid-phase microextraction, volatile organic compounds in exhaled breath were detected by gas chromatography / mass spectrometry. Results Quantitative with external standard. The clinical value of breath analysis in the diagnosis of non-small cell lung cancer (ROC) was assessed by ROC curve analysis, and the differences in expiratory analysis between early and advanced non-small cell lung cancer and between lung adenocarcinoma and squamous cell carcinoma were statistically analyzed. Results: The concentrations of n-butanol and 3-hydroxy-2-butanone in patients with non-small cell lung cancer were 6.36 and 8.28 ng / L, respectively, which were significantly higher than those in normal subjects (P <0.001). The concentrations of n-butanol and 3-hydroxy-2-butanone as volatile markers in patients with stage Ⅰ ~ Ⅱ non-small cell lung cancer in exhalation and Ⅲ ~ Ⅳwere no significant difference (P> 0.05) Their concentrations in exhaled lung adenocarcinoma were higher than those in squamous cell carcinoma, P <0.05. CONCLUSION: Butanol and 3-hydroxy-2-butanone can be used as volatile markers in the diagnosis of lung cancer. They may be helpful for the differential diagnosis of adenocarcinoma and squamous cell carcinoma of non-small cell lung cancer, but not for the differential diagnosis of early-advanced lung cancer.