a review of exhaled breath: a key role in lung cancer diagnosis.
呼出气体:在肺癌诊断中的关键作用
marzorati d1, mainardi l, sedda g, gasparri r, spaggiari l, cerveri p.
1department of electronics, information and bioengineering, politecnico di milano, milan, italy. department of thoracic surgery-ieo, european institute of oncology irccs, milan, italy.
abstract
one of the main causes of the high mortality rate in lung cancer is the late-stage tumor detection. early diagnosis is therefore essential to increase the chances of obtaining an effective treatment quickly thus increasing the survival rate. current screening techniques are based on imaging, with low-dose computed tomography (ldct) as the pivotal approach. even if ldct has high accuracy, its invasiveness and high false positive rate limit its application to high-risk population screening. a non-invasive, cost-efficient, and easy-to-use test should instead be designed as an alternative. exhaled breath contains thousands of volatile organic compounds (vocs). since ancient times, it has been understood that changes in the vocs' mixture may be directly related to the presence of a disease, and recent studies have quantified the change in the compounds' concentration. analyzing exhaled breath to achieve lung cancer early diagnosis represents a non-invasive, low-cost, and user-friendly approach, thus being a promising candidate for high-risk lung cancer population screening. this review discusses technological solutions that have been proposed in the literature as tools to analyze exhaled breath for lung cancer diagnosis, together with factors that potentially affect the outcome of the analysis. even if research on this topic started many years ago, and many different technological approaches have since been adopted, there is still no validated clinical application of this technique. standard guidelines and protocols should be defined by the medical community in order to translate exhaled breath analysis to clinical practice.
肺癌死亡率高的主要原因之一是晚期肿瘤的发现。因此,早期诊断对于增加迅速获得有效治疗的机会从而提高生存率至关重要。目前的筛查技术是以影像学为基础,以低剂量计算机断层扫描(ldct)为关键手段。即使ldct具有较高的准确性,但其侵袭性和高假阳性率限制了其在高危人群筛查中的应用。一个非侵入性的,经济有效的,易于使用的测试应该被设计成一个替代品。呼出的空气中含有数千种挥发性有机化合物。自古以来,人们就知道vocs混合物的变化可能与疾病的存在直接相关,近的研究已经量化了化合物浓度的变化。通过分析呼出气来实现肺癌的早期诊断,是一种无创、低成本、用户友好的方法,是高危肺癌人群筛查的一个有前途的候选方法。本综述讨论了文献中提出的技术解决方案,作为肺癌诊断的呼气分析工具,以及可能影响分析结果的因素。即使这方面的研究早在很多年前就开始了,并且已经采用了许多不同的技术方法,但这项技术仍然没有得到有效的临床应用。为了将呼气分析转化为临床实践,医学界应制定标准指南和规程。
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