Metabonomic Study On Exhaled Brealth Condensate (EBC) Of Lung Cancer With Syndrome Of Turbid Phlegm Obstructing Lung And Syndrome Of Deficiency Of Both Qi And Yin

Background:Lung cancer is the worst malignant to human health and life, and has a poor prognosis when diagnosed. A combination treatment of traditional Chinese and western medicines has obvious advantage, such as ameliorating clinical symptoms, reducing side effects in chemoradiation therapy, improving life quality, preventing relapse and metastasis etc. Therefore, discovery of the novel biomarkers for lung cancer diagnosis, differentiate the traditional Chinese medicine syndrome type in patients with lung cancer, will provide effective basis for the diagnosis and treatment of lung cancer.Objectives:To study the exhaled breath condensate (EBC) of the patients with lung cancer of syndrome of turbid phlegm obstructing lung and syndrome of deficiency of both Qi and Yin with a GC-MS based metabonomic approach. To explore the results of metabonomics and connotation of modern science on syndrome of turbid phlegm obstructing lung and syndrome of deficiency of both Qi and Yin in lung cancer, and to try to discover biomarkers. The aim of the present research is to provide a basis for the diagnosis and treatment of lung cancer with traditional Chinese and western medicines.Methods:The study included 21 patients with lung cancer of syndrome of turbid phlegm obstructing lung,21 patients with lung cancer of syndrome of deficiency of both Qi and Yin, and 20 healthy volunteers. After collection of about 0.7 ml of EBC, the EBC samples were kept in the refrigerator at -20℃. The EBC samples were analyzed with GC-MS, and the results were analyzed by using the area normalization method, and each peak was determined with the NIST MS Spectral Library. Based on the GC-MS results, a statistical analysis was conducted to discover the small molecules which could differentiate the healthy persons and the patients with lung cancer of syndrome of turbid phlegm obstructing lung and syndrome of deficiency of both Qi and Yin.Results:The patients of syndrome of turbid phlegm obstructing lung and syndrome of deficiency of both Qi and Yin were clearly distinguished from healthy persons.9 Potential tumor biomarkers were found, including 3 molecules existed in most patient group samples, and 6 in all groups, while the quantities of the 6 molecules in patient groups was significantly different compared with healthy group. And patients of syndrome of turbid phlegm obstructing lung were able to distinguish from those of syndrome of deficiency of both Qi and Yin.3-Amino-2-benzoyl-4,5,6,7-tetrahydrobenzo[b]thiophene exists only in patients of syndrome of turbid phlegm obstructing lung,1-benzenesulfonyl-lH-pyrrole is only in patients of syndrome of deficiency of both Qi and Yin.Conclusion:1. Metabonomic study on exhaled breath condensate (EBC) by GC-MS could differentiate the healthy people and the patients with lung cancer.9 Molecules including Cedro1,1,2-Benzenedicarboxylic acid, bis(2-methylpropyl) ester and 2-butyne might be the potential biomarkers for lung cancer diagnosis; 2. GC-MS based metabonomic approach on EBC might be used for differentiate the syndrome of turbid phlegm obstructing lung and syndrome of deficiency of both Qi and Yin on lung cancer.3-Amino-2-benzoyl- 4,5,6,7-tetrahydrobenzo[b]thiophene and 1-benzenesulfonyl-lH-pyrrole might be the potential biomarkers of Chinese medicine syndrome type; 3. The EBC analysis showed a great potential for disease diagnosis and study on Chinese medicine syndrome type. The current metabonomic method might be one of the useful measures to discover the evidence of different types of traditional Chinese medicine syndrome type.