| Objective: By solid phase micro extraction combined with gas chromatography-mass spectrometer,detecting ten kinds of volatile organic compounds aliphatic aldehydes(formaldehyde,acetaldehyde,propionic aldehyde,butyraldehyde,pentanal,hexanal,heptanal,octanal,nonanal,kronaldehyd)in the patients with lung cancer and pulmonary inflammatory diseases,to determine whether there is a statistical difference between them,to clarify the significance of diagnosis and treatment,so as to provide a more convenient and rapid way for non-invasive detection of lung cancer.Research method:1.Grouping: 52 patients in the lung cancer group and 60 patients in the inflammatory pulmonary disease group.2.Enrollment conditions: the enrolled patients in the LC group were lung cancer individuals with clear histopathology,and all the enrolled patients were required with imaging evidence,no history of received surgical treatment above grade II,radiotherapy,chemotherapy,hormone and other immunotherapy.The lung inflammation patients were admitted in through our hospital outpatient service with imaging evidence,no history of received surgical treatment above grade II,radiotherapy,chemotherapy,hormone and other immunotherapy,and requirements of c-reactive protein(C-reactive protein,CRP)greater than 5 mg/l and calcitonin original(procalcitonin,PCT)greater than 0.05 ng/ml.Anti-infection treatment is effective.This group of patients should be ruled out at the same time with primary lung cancer or secondary pulmonary malignant tumor individuals.If cannot eliminate the tumors might not be enrolled into the groups.3.Information collection:All enrolled patients signed the informed consent form,filled in the information collection form,and recorded the basic classification information,including gender,age,smoking,etc.Patients in lung cancer group were required to register the clinical staging,pathology,distant metastasis and other disease related information of lung cancer at the same time.4.Sample collection: Before sampling,patients are forbidden to eat strong odor or spicy food(such as wine,tea,pepper,garlic,leek,onion,coffee,etc)from 20:00 in the evening before sampling to the morning of the next day.After getting up in the morning,do not brush the teeth or eat food before sampling.Rinse mouth with water.Before blowing,breathe deeply for 3times.Blow the second half of the exhaled air into the collection bag.This test uses Devex bag to collect gas with a volume of 1L,which will be sent for inspection immediately after collection.5.Sample extraction and detection: the gas in the sampling bag was enriched by solid phase microextraction technology.After extraction for60 min,the valve of the sampling bag was closed,the needle tube was pulled out,and the needle tube was transferred to GS-MS instrument for detection,so as to obtain the peak area of the target gas in the sample to be tested.6.Data processing: The experimental data were collected and counted.In the lung cancer group,individual gender,smoking status,pathological types and clinical stages were counted,the constituent ratios were calculated.The species of pulmonary inflammatory disease groups were counted and the composition ratio was calculated.The basic data of the two groups were compared,the counting data were tested by chi-square test,and the measurement data were tested by t test.The peak area of 10 linear aldehydes exhaled by patients in the two groups was analyzed,The mann-whitney U test with non-parametric test was used for comparison between groups,and the diagnostic ability of linear aldehyde was evaluated by ROC curve.All experimental data were collected and statistically analyzed through SPSS23.0,P < 0.05 was considered statistically significant,P < 0.01 was considered statistically significant.Results:1.Compared with the basic data of lung cancer patients and patients with pulmonary inflammatory diseases,there was no statistical difference in gender and smoking status,but there was a statistical difference in age.2.The peak area of formaldehyde,acetaldehyde,propionaldehyde,butyraldehyde,heptaldehyde and kronaldehyde in lung cancer group was higher than that in lung inflammatory disease group,but the difference was not statistically significant.3.The peak area of pentanal,hexanal,octanal and nonanal in lung cancer group was higher than that in lung inflammatory disease group,and the difference was statistically significant.The area under the ROC curve was0.736,0.704,0.695 and 0.766.The AUC of nonaldehyde was relatively high and the diagnostic value was relatively good,while that of octaldehyde was relatively low and the AUC could not reach 0.7.4.In the lung cancer group,the peak area of pentanal,hexanal and nonanal in stage ? and ? patients was higher than that in stage 0,?and ? patients,with statistical difference.Conclusion and significance:1.There was no significant difference between the content of short-chain aldehyde in the exhaled air of lung cancer patients and that of patients with pulmonary inflammatory diseases.The content of pentanal,hexanal,octanal and nonaldehyde in the content of medium-long chain aldehyde was higher than that of individuals with pulmonary inflammatory diseases,which can provide a diagnosis and treatment basis for clinical diagnosis of lung cancer.2.There was a statistical difference in the content of octanal in the exhaled gas between lung cancer patients and the pulmonary inflammatory disease group,but there was no statistical difference in the content of exhaled gas between stage ? and ? patients and stage 0,?and ? patients.Whether octanal can be used as the characteristic VOCs of lung cancer remains to be further studied.3.The diagnostic value of valeraldehyde,hexanal and nonaldehyde for lung cancer is medium,among which the single substance of nonaldehyde is of high diagnostic value,which cannot be used as specific gas and can be used as an auxiliary detection method for the diagnosis and treatment of lung cancer.4.The content of pentanal,hexanal and nonaldehyde in the exhaled air ofpatients with advanced tumor was higher than that of patients with early disease,which can be used as an effective basis to define the course of disease,guide the prognosis and monitor the disease. |
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