Table 1_Volatile organic compounds in exhaled human breath for the diagnosis of malignant pleural mesothelioma: a meta-analysis.docx

ObjectiveMalignant pleural mesothelioma (MPM) is a relatively rare thoracic tumor with a high mortality rate, making early diagnosis and treatment challenging. The present study evaluated the utility of exhaled volatile organic compounds (VOCs) in diagnosing MPM.
MethodsThe Cochrane Library, PubMed, EMBASE, and Web of Science were systematically searched for clinical trials assessing the diagnostic ability of VOCs for MPM through August 30, 2024. Quality was evaluated using the QUADAS-2 tool. A meta-analysis was performed with a bivariate model for sensitivity and specificity using Stata MP 17.0 software.
ResultsEight trials with 859 subjects were included. VOCs were found to have a pooled sensitivity of 0.86 (95% confidence interval [CI] 0.75–0.93), a pooled specificity of 0.73 (95% CI 0.58–0.84), and an area under the curve (AUC) of 0.88 (95% CI 0.85–0.90) in differentiating MPM patients from healthy controls. In addition VOCs had a pooled sensitivity of 0.89 (95% CI 0.83–0.93), a pooled specificity of 0.79 (95% CI 0.57–0.91), and an AUC of 0.91 (95% CI 0.88–0.93) in differentiating MPM patients from asymptomatic individuals formerly exposed to asbestos (AEx).
ConclusionsAlthough the utility of VOCs in diagnosing MPM varied among clinical trials, VOCs in exhaled human breath may have a potential role in the diagnosis of MPM. Large-scale randomized clinical trials are warranted.

目的：恶性胸膜间皮瘤（Malignant pleural mesothelioma, MPM）是一类相对罕见的胸部恶性肿瘤，病死率居高不下，使得其早期诊断与治疗均极具挑战性。本研究旨在评估呼出气挥发性有机物（exhaled volatile organic compounds, VOCs）在MPM诊断中的应用价值。
方法：本研究系统检索了截至2024年8月30日的考克兰图书馆（Cochrane Library）、PubMed、EMBASE及Web of Science数据库，搜集评估VOCs对MPM诊断效能的临床试验。采用QUADAS-2工具对纳入研究的方法学质量进行评价。使用Stata MP 17.0统计软件，采用双变量模型进行合并敏感度与合并特异度的荟萃分析。
结果：最终纳入8项临床试验，共包含859名研究对象。在区分MPM患者与健康对照人群时，VOCs的合并敏感度为0.86（95%置信区间[CI] 0.75~0.93），合并特异度为0.73（95% CI 0.58~0.84），受试者工作特征曲线下面积（AUC）为0.88（95% CI 0.85~0.90）。此外，在区分MPM患者与既往有石棉暴露史的无症状个体（AEx）时，VOCs的合并敏感度为0.89（95% CI 0.83~0.93），合并特异度为0.79（95% CI 0.57~0.91），AUC为0.91（95% CI 0.88~0.93）。
结论：尽管不同临床试验中VOCs用于MPM诊断的应用价值存在一定异质性，但人类呼出气中的VOCs在MPM诊断中具备潜在应用前景，未来需开展大规模随机对照临床试验以进一步验证其临床价值。