电子鼻用于尘肺病呼吸分析试验准确性研究
pau-chung chen1,2,3,4, hsin-yi peng1, che-jui chang1, and hsiao-yu yang1,2,3*
1 institute of occupational medicine and industrial hygiene, national taiwan university college of public health, taipei, taiwan
2 department of public health, national taiwan university college of public health, taipei, taiwan
3 department of environmental and occupational medicine, national taiwan university hospital, taipei, taiwan
4 department of environmental and occupational medicine, national taiwan university college of medicine, taipei, taiwan
abstract
breath analyses have attracted substantial attention as screens for occupational environmental lung disease. the objective of this study was to develop breath tests for pneumoconiosis by analysing volatile organic compounds using an electronic nose. a case-control study was designed. we screened 102 subjects from a cohort of stone workers. after excluding three subjects with poorly controlled diabetes mellitus and one subject with asthma, 98 subjects were enrolled, including 34 subjects with pneumoconiosis and 64 healthy controls. we analysed the subjects’ breath using an electronic nose (cyranose 320)with 32 nanocomposite sensors. data were randomly split into 80% for model building and 20% for validation. using a linear discriminate analysis, the sensitivity, specificity, accuracy, and area under the receiver operating characteristic curve (auroc) were 67.9%, 88.0%, 80.8%, and 0.91, respectively, in the training set and 66.7%, 71.4%, 70.0%, and 0.86, respectively, in the test set. in subgroup analysis divided by smoking status, the aurocs for current smokers, former smokers, and subjects who never smoked were 0.94, 0.93, and 0.99, respectively. in subgroup analysis divided by gender, the aurocs for males and females were 0.95 and 0.99, respectively. breath tests may have potential as a screen for pneumoconiosis. a multi-centre study is warranted, and the procedures must be standardized before clinical application.
呼吸分析作为职业性环境肺病的筛查手段，已引起人们的广泛关注。本研究的目的是通过使用电子鼻分析挥发性有机化合物开发尘肺呼吸测试。设计了一个病例对照研究。我们从一组石工中筛选了102名受试者。排除3例糖尿病控制不良和1例哮喘患者后，入选98例，其中尘肺34例，健康对照64例。我们用一个装有32个纳米复合传感器的电子鼻(cyranose 320)来分析受试者的呼吸。数据被随机分成80%用于模型构建和20%用于验证。采用线性判别分析，受试者操作特征曲线(auroc)下的灵敏度、特异性、准确性和面积在训练集分别为67.9%、88.0%、80.8%和0.91，在测试集分别为66.7%、71.4%、70.0%和0.86。根据吸烟状况分组分析，当前吸烟者、前吸烟者和从未吸烟的受试者的极光分别为0.94、0.93和0.99。在按性别划分的亚组分析中，男性和女性的极光分别为0.95和0.99。呼吸测试有可能作为尘肺的筛查手段。多中心研究是有必要的，并且在临床应用之前必须对程序进行标准化。
keywords: breath testing, volatile organic compounds, pneumoconiosis, sensitivity, specificity
关键词：呼吸测试；挥发性有机化合物；尘肺；敏感性；特异性