Predictive value of volatile organic compounds in exhaled breath on pulmonary nodule in people aged less than 50 years_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

XIE Shaohua ^1,2 , DAI Wei ² , LIU Mingxin ² , XIANG Run ² , XIE Tianpeng ² , YANG Xiaojun ² , HU Bin ² , ZHUANG Xiang ² , YANG Xiaozun ² , TIAN Bo ² , LI Wenwen ³ , DUAN Yixiang ⁴ ,  LI Qiang ²

1. Graduate School, Chengdu Medical College, Chengdu, 610500, P.R.China;
2. Department of Thoracic Surgery, Sichuan Cancer Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, P.R.China;
3. West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, P.R.China;
4. Research Center of Analytical Instrumentation, The College of Life Sciences, Sichuan University, Chengdu, 610064, P.R.China;

Corresponding author：

LI Qiang, Email: liqiang@sichuancancer.org

Keywords：

Exhaled breath; volatile organic compounds; young and middle-aged; pulmonary nodule; prediction model

DOI：

10.7507/1007-4848.202002125

Video：

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Objective To investigate the predictive value of volatile organic compounds (VOCs) on pulmonary nodules in people aged less than 50 years.Methods The 147 patients with pulmonary nodules and aged less than 50 years who were treated in the Department of Thoracic Surgery of Sichuan Cancer Hospital from August 1, 2019 to January 15, 2020 were divided into a lung cancer group and a lung benign disease group. The lung cancer group included 36 males and 68 females, with the age of 27-49 (43.54±5.73) years. The benign lung disease group included 23 males and 20 females, with the age of 22-49 (42.49±6.83) years. Clinical data and exhaled breath samples were collected prospectively from the two groups. Exhaled breath VOCs were analyzed by gas chromatography mass spectrometry. Binary logistic regression analysis was used to select variables and establish a prediction model. The sensitivity, specificity, and area under the receiver operating characteristic (ROC) curve of the prediction model were calculated.Results There were statistically significant differences in sex (P=0.034), smoking history (P=0.047), cyclopentane (P=0.002), 3-methyl pentane (P=0.043) and ethylbenzene (P=0.009) between the two groups. The sensitivity, specificity and area under the ROC curve of the prediction model with gender, cyclopentane, 3-methyl pentane, ethylbenzene and N,N-dimethylformamide as variables were 80.8%, 60.5% and 0.781, respectively.Conclusion The combination of VOCs and clinical characteristics has a certain predictive value for the benign and malignant pulmonary nodules in people aged less than 50 years.

Citation： XIE Shaohua, DAI Wei, LIU Mingxin, XIANG Run, XIE Tianpeng, YANG Xiaojun, HU Bin, ZHUANG Xiang, YANG Xiaozun, TIAN Bo, LI Wenwen, DUAN Yixiang, LI Qiang. Predictive value of volatile organic compounds in exhaled breath on pulmonary nodule in people aged less than 50 years. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(6): 675-680. doi: 10.7507/1007-4848.202002125 Copy

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12.	Wang Y, Hu Y, Wang D, et al. The analysis of volatile organic compounds biomarkers for lung cancer in exhaled breath, tissues and cell lines. Cancer Biomark, 2012, 11(4): 129-137.
13.	Phillips M, Altorki N, Austin JH, et al. Prediction of lung cancer using volatile biomarkers in breath. Cancer Biomark, 2007, 3(2): 95-109.
14.	Phillips M, Cataneo RN, Cummin AR, et al. Detection of lung cancer with volatile markers in the breath. Chest, 2003, 123(6): 2115-2123.
15.	Gaspar EM, Lucena AF, Duro da Costa J, et al. Organic metabolites in exhaled human breath--a multivariate approach for identification of biomarkers in lung disorders. J Chromatogr A, 2009, 1216(14): 2749-2756.
16.	Saalberg Y, Wolff M. VOC breath biomarkers in lung cancer. Clin Chim Acta, 2016, 459: 5-9.
17.	Hakim M, Broza YY, Barash O, et al. Volatile organic compounds of lung cancer and possible biochemical pathways. Chem Rev, 2012, 112(11): 5949-5966.
18.	Guengerich FP, Shimada T. Oxidation of toxic and carcinogenic chemicals by human cytochrome P-450 enzymes. Chem Res Toxicol, 1991, 4(4): 391-407.
19.	Haick H, Broza YY, Mochalski P, et al. Assessment, origin, and implementation of breath volatile cancer markers. Chem Soc Rev, 2014, 43(5): 1423-1449.
20.	Shin JY, Yoon JK, Marwaha G. Progress in the treatment and outcomes for early-stage non-small cell lung cancer. Lung, 2018, 196(3): 351-358.
21.	Heleno B, Siersma V, Brodersen J. Estimation of overdiagnosis of lung cancer in low-dose computed tomography screening: a secondary analysis of the Danish lung cancer screening trial. JAMA Intern Med, 2018, 178(10): 1420-1422.
22.	Usman Ali M, Miller J, Peirson L, et al. Screening for lung cancer: A systematic review and meta-analysis. Prev Med, 2016, 89: 301-314.
23.	Bach PB, Mirkin JN, Oliver TK, et al. Benefits and harms of CT screening for lung cancer: a systematic review. JAMA, 2012, 307(22): 2418-2429.
24.	Peled N, Hakim M, Bunn PA Jr, et al. Non-invasive breath analysis of pulmonary nodules. J Thorac Oncol, 2012, 7(10): 1528-1533.
25.	Bajtarevic A, Ager C, Pienz M, et al. Noninvasive detection of lung cancer by analysis of exhaled breath. BMC Cancer, 2009, 9: 348.

1. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
2. Goldstraw P, Chansky K, Crowley J, et al. The IASLC Lung Cancer Staging Project: Proposals for revision of the TNM stage groupings in the forthcoming (eighth) edition of the TNM classification for lung cancer. J Thorac Oncol, 2016, 11(1): 39-51.
3. Khullar OV, Liu Y, Gillespie T, et al. Survival after sublobar resection versus lobectomy for clinical stageⅠA lung cancer: An analysis from the National Cancer Data Base. J Thorac Oncol, 2015, 10(11): 1625-1633.
4. 周清华, 范亚光, 王颖, 等. 中国肺癌低剂量螺旋CT筛查指南(2018年版). 中国肺癌杂志, 2018, 21(2): 67-75.
5. Hua Q, Zhu Y, Liu H. Detection of volatile organic compounds in exhaled breath to screen lung cancer: a systematic review. Future Oncol, 2018, 14(16): 1647-1662.
6. Jia Z, Patra A, Kutty VK, et al. Critical review of volatile organic compound analysis in breath and in vitro cell culture for detection of lung cancer. Metabolites, 2019, 9(3): E52.
7. Tirzīte M, Bukovskis M, Strazda G, et al. Detection of lung cancer in exhaled breath with an electronic nose using support vector machine analysis. J Breath Res, 2017, 11(3): 036009.
8. Dragonieri S, Schot R, Mertens BJ, et al. An electronic nose in the discrimination of patients with asthma and controls. J Allergy Clin Immunol, 2007, 120(4): 856-862.
9. Machado RF, Laskowski D, Deffenderfer O, et al. Detection of lung cancer by sensor array analyses of exhaled breath. Am J Respir Crit Care Med, 2005, 171(11): 1286-1291.
10. Poli D, Carbognani P, Corradi M, et al. Exhaled volatile organic compounds in patients with non-small cell lung cancer: cross sectional and nested short-term follow-up study. Respir Res, 2005, 6: 71.
11. Chen X, Xu F, Wang Y, et al. A study of the volatile organic compounds exhaled by lung cancer cells in vitro for breath diagnosis. Cancer, 2007, 110(4): 835-844.
12. Wang Y, Hu Y, Wang D, et al. The analysis of volatile organic compounds biomarkers for lung cancer in exhaled breath, tissues and cell lines. Cancer Biomark, 2012, 11(4): 129-137.
13. Phillips M, Altorki N, Austin JH, et al. Prediction of lung cancer using volatile biomarkers in breath. Cancer Biomark, 2007, 3(2): 95-109.
14. Phillips M, Cataneo RN, Cummin AR, et al. Detection of lung cancer with volatile markers in the breath. Chest, 2003, 123(6): 2115-2123.
15. Gaspar EM, Lucena AF, Duro da Costa J, et al. Organic metabolites in exhaled human breath--a multivariate approach for identification of biomarkers in lung disorders. J Chromatogr A, 2009, 1216(14): 2749-2756.
16. Saalberg Y, Wolff M. VOC breath biomarkers in lung cancer. Clin Chim Acta, 2016, 459: 5-9.
17. Hakim M, Broza YY, Barash O, et al. Volatile organic compounds of lung cancer and possible biochemical pathways. Chem Rev, 2012, 112(11): 5949-5966.
18. Guengerich FP, Shimada T. Oxidation of toxic and carcinogenic chemicals by human cytochrome P-450 enzymes. Chem Res Toxicol, 1991, 4(4): 391-407.
19. Haick H, Broza YY, Mochalski P, et al. Assessment, origin, and implementation of breath volatile cancer markers. Chem Soc Rev, 2014, 43(5): 1423-1449.
20. Shin JY, Yoon JK, Marwaha G. Progress in the treatment and outcomes for early-stage non-small cell lung cancer. Lung, 2018, 196(3): 351-358.
21. Heleno B, Siersma V, Brodersen J. Estimation of overdiagnosis of lung cancer in low-dose computed tomography screening: a secondary analysis of the Danish lung cancer screening trial. JAMA Intern Med, 2018, 178(10): 1420-1422.
22. Usman Ali M, Miller J, Peirson L, et al. Screening for lung cancer: A systematic review and meta-analysis. Prev Med, 2016, 89: 301-314.
23. Bach PB, Mirkin JN, Oliver TK, et al. Benefits and harms of CT screening for lung cancer: a systematic review. JAMA, 2012, 307(22): 2418-2429.
24. Peled N, Hakim M, Bunn PA Jr, et al. Non-invasive breath analysis of pulmonary nodules. J Thorac Oncol, 2012, 7(10): 1528-1533.
25. Bajtarevic A, Ager C, Pienz M, et al. Noninvasive detection of lung cancer by analysis of exhaled breath. BMC Cancer, 2009, 9: 348.

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Predictive value of volatile organic compounds in exhaled breath on pulmonary nodule in people aged less than 50 years

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