Development of breath test for pneumoconiosis: a case-control study

Respiratory Research

Research

Ruei-Hao Shie¹  Che-Jui Chang²  Hsiao-Yu Yang³  Pau-Chung Chen⁴ 

[1] Green Energy & Environmental Research Laboratories, Industrial Technology Research Institute, Hsinchu, Taiwan;Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, No. 17 Xuzhou Road, 10055, Taipei, Taiwan;Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, No. 17 Xuzhou Road, 10055, Taipei, Taiwan;Department of Public Health, National Taiwan University College of Public Health, Taipei, Taiwan;Department of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei, Taiwan;Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, No. 17 Xuzhou Road, 10055, Taipei, Taiwan;Department of Public Health, National Taiwan University College of Public Health, Taipei, Taiwan;Department of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei, Taiwan;Department of Environmental and Occupational Medicine, National Taiwan University College of Medicine, Taipei, Taiwan;

关键词: Breath test;    Volatile organic compounds;    Lipid peroxidation;    Pneumoconiosis;    Breathomics;   

DOI  :  10.1186/s12931-017-0661-3

 received in 2017-07-03, accepted in 2017-10-06,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundLipid peroxidation plays an important role in the pathogenesis of pneumoconiosis. Volatile organic compounds (VOCs) generated from lipid peroxidation might be used to detect pneumoconiosis. The objective of this study was to develop a breath test for pneumoconiosis.MethodsA case-control study was designed. Breath and ambient air were analysed by gas chromatography/mass spectrometry. After blank correction to prevent contamination from ambient air, we used canonical discriminant analysis (CDA) to assess the discrimination accuracy and principal component analysis (PCA) to generate a prediction score. The prediction accuracy was calculated and validated using the International Classification of Radiographs of the Pneumoconiosis criteria combined with an abnormal pulmonary function test as a reference standard. We generated a receiver operator characteristic (ROC) curve and calculated the area under the ROC curve (AUC) to estimate the screening accuracy of the breath test.ResultsWe enrolled 200 stone workers. After excluding 5 subjects with asthma and 16 subjects who took steroids or nonsteroidal anti-inflammatory drugs, a total of 179 subjects were used in the final analyses, which included 25 cases and 154 controls. By CDA, 88.8% of subjects were correctly discriminated by their exposure status and the presence of pneumoconiosis. After excluding the VOCs of automobile exhaust and cigarette smoking, pentane and C5-C7 methylated alkanes constituted the major VOCs in the breath of persons with pneumoconiosis. Using the prediction score generated from PCA, the ROC-AUC was 0.88 (95% CI = 0.80—0.95), and the mean ROC-AUC of 5-fold cross-validation was 0.90. The breath test had good accuracy for pneumoconiosis diagnosis.ConclusionThe analysis of breath VOCs has potential in the screening of pneumoconiosis for its non-invasiveness and high accuracy. We suggest that a multi-centre study is warranted and that all procedures must be standardized before clinical application.

【 授权许可】

CC BY   
© The Author(s). 2017