2011-05-012024-05-13https://scholars.lib.ntu.edu.tw/handle/123456789/644618摘要：肺癌是目前發生率最快的癌症之一，也是台灣癌症死亡的第一位。利用開刀來治癒肺癌，只有在肺癌的初期才有可能。不幸的是，肺癌的早期診斷對醫學界仍然是一大難題。早期利用一些技術，包括胸部X光及痰液細胞學檢查，並不能提高肺癌的存活率。近幾年利用電腦斷層作為篩檢工具，似乎對高危險群有幫助，但仍不是一個好方法。呼氣濃縮物（EBC）是近幾年發展出來針對呼吸道疾病（包括肺癌）的非侵襲細檢查。呼出的氣體包括上千種微量揮發性及非揮發性物質。直到最近檢驗技術的進步，我們才有可能檢測這些微量的物質。呼氣濃縮物的研究主要是測量發炎反應及氧化壓力的變化。只有少數的研究利用呼氣濃縮物來鑑別病人是否為癌症。代謝體學是利用大規模測量不同生理狀態下的代謝濃度分布。由於先進的技術已可以偵測各類的疾病中代謝物分布的差異。利用新的代謝體技術來研究呼氣濃縮液稱為呼氣體學（Breathmics）。目前有零星研究，特別是氣喘的病人。本計畫是利用呼氣濃縮液中代謝物的分布情形，作為癌症早期診斷、期別診斷、治療反應及復發時的生物標誌。在最初兩年，預計招募200名新診斷的肺癌病人收集呼氣濃縮液，並於追蹤期間，對於治療有反應或疾病復發時再收集。並於第三年收集100名病人做為確認。我們希望能找出特殊的代謝物分布情形，並找出肺癌特殊的代謝途徑，進而改變這些代謝途徑，評估是否能找出特殊的治療方式。<br> Abstract: Lung cancer ranks among the most commonly occurring malignancies and currently is the leading cause of cancer-related cause worldwide including Taiwan. Cure of the disease by surgery is only achieved in cases representing an early stage of lung cancer. Unfortunately, early detection of lung cancer is still a problem. Application of screening with techniques such as chest radiography, sputum cytology was not supported by previous studies. Screening by Computed tomography is suggested for high risk patients, but it needs more evidence. Breath analysis including exhaled breath condensate (EBC) has been proposed as a non-invasive and simple technique for the diagnosis and monitoring the respiratory diseases including neoplasm in the airway. Exhaled breaths contain thousands of volatile and nonvolatile compounds in trace amounts. After the development of highly sensitive cutting-edge technologies in sample analysis, the evaluation of this type of human specimens becomes possible. EBC has been used in various respiratory diseases by investigating inflammatory and oxidative stress change. There were only a few studies analyzed EBC in lung cancer patients including oxidative stress markers, lipid peroxidation, 3p microsatellite alternations, p53 mutation, endothelin-1, IL-2, IL-6 and TNF-α. Metabolomics is the global quantitative assessment of endogenous (small molecular) metabolites within a biological system. Advances in metabolomic profiling technologies and methods of pattern recognition enable the monitoring of hundreds of metabolites from tissue or body fluids associated with disease physiology. These advanced technologies in metabolomics, GC/LC-MS and pattern recognition computation, generate a field of exhaled biomarker profiling, called “breathomic”. Although, there were a few studies of “breathomics” on the diagnosis of chronic airway diseases including asthma, there is still no study for diagnosis of lung cancer. The current proposal is aimed to establish the metabolomic profiling of exhaled breath condensates (EBC) in human diseases, focusing on lung cancer, in order to setup a useful noninvasive tool for disease diagnosis, outcome prediction, and monitoring.At least 200 lung cancer patients will be enrolled in first 2 years. EBC will be collected before treatment, after response to treatment and after disease progression or recurrence. We will collect anther cohort about 100 patients for validation in the 3rd year. We hope to find the biomarkers from metabolic profiling, and verify the specific metabolic pathway in cancer cell. Therefore, we might develop new and novel strategy to modify or treat these diseases.肺癌呼氣濃縮物代謝體學呼氣體學lung cancerbreathomicsmetabolomicsexhaled breath condensate