文章：

结直肠癌患者根治性手术后呼出挥发性有机化合物模式的变化——一项前瞻性初步研究

Alteration of the Exhaled Volatile Organic Compound Pattern in Colorectal Cancer Patients after Intentional Curative Surgery—A Prospective Pilot Study

原文发布日期：29 September 2023

DOI: 10.3390/cancers15194785

类型: Article

开放获取: 是

英文摘要：

As current follow-up modalities for colorectal carcinoma (CRC) have restricted sensitivity, novel diagnostic tools are needed. The presence of CRC changes the endogenous metabolism, resulting in the release of a specific volatile organic compounds (VOC) pattern that can be detected with an electronic nose or AeonoseTM. To evaluate the use of an electronic nose in the follow-up of CRC, we studied the effect of curative surgery on the VOC pattern recognition using AeonoseTM. A prospective cohort study was performed, in which 47 patients diagnosed with CRC were included, all of whom underwent curative surgical resection. Breath testing was performed before and after surgery using the AeonoseTM. A machine learning model was developed by discerning between the 94 pre-and postoperative breath samples. The training model differentiated between the pre-and postoperative CRC breath samples with a sensitivity and specificity of 0.78 (95%CI 0.61–0.90) and 0.73 (95%CI 0.56–0.86), respectively, with an accuracy of 0.76 (95%CI 0.66–0.85), and an area under the curve of 0.79 (95%CI 0.68–0.89). The internal validation of the test set resulted in an accuracy of 0.75 (95%CI 0.51–0.91) and AUC of 0.82 (95%CI 0.61–1). In conclusion, our results suggest that the VOC pattern of CRC patients is altered by curative surgery in a short period, indicating that the exhaled VOCs might be closely related to the presence of CRC. However, to use AeonoseTMas a potential diagnostic tool in the clinical follow-up of CRC patients, the performance of the models needs to be improved through further large-scale prospective research.

摘要翻译： 

鉴于当前结直肠癌随访模式的敏感性有限，亟需开发新型诊断工具。结直肠癌的存在会改变内源性代谢，释放出可通过电子鼻或AeonoseTM检测的特异性挥发性有机化合物模式。为评估电子鼻在结直肠癌随访中的应用价值，本研究采用AeonoseTM探究根治性手术对VOC模式识别的影响。我们开展了一项前瞻性队列研究，纳入47例经病理确诊并接受根治性手术切除的结直肠癌患者。使用AeonoseTM设备分别于术前及术后采集呼吸样本。通过对94份术前术后呼吸样本进行机器学习建模，训练模型区分术前与术后呼吸样本的敏感度为0.78（95%CI 0.61–0.90），特异度为0.73（95%CI 0.56–0.86），准确率达0.76（95%CI 0.66–0.85），曲线下面积为0.79（95%CI 0.68–0.89）。测试集内部验证显示准确度为0.75（95%CI 0.51–0.91），曲线下面积为0.82（95%CI 0.61–1）。研究结果表明，根治性手术可在短期内改变结直肠癌患者的VOC模式，提示呼出气VOC可能与结直肠癌存在状态密切相关。然而，要将AeonoseTM作为结直肠癌临床随访的潜在诊断工具，仍需通过大规模前瞻性研究进一步提升模型性能。

原文链接：

Alteration of the Exhaled Volatile Organic Compound Pattern in Colorectal Cancer Patients after Intentional Curative Surgery—A Prospective Pilot Study