关键词： AID, autoimmune liver disease ALD, alcoholic liver disease AUROC, area under receiver operator curve BMI, body mass index Breath analysis CD, cryptogenic disease Cirrhosis Diagnosis limonene GC, gas chromatography HBV, hepatitis B virus HCC, hepatocellular cancer HCV, hepatitis C virus ITU, intensive treatment unit LQ, lower quartile Liver transplant MS, mass spectrometry OPU, out-patient clinic PBC, primary biliary cirrhosis PSC, primary sclerosing cholangitis PTR-MS PTR-MS, proton transfer reaction mass spectrometry ROC, Receiver operating characteristics TAC, transplant assessment clinic TE, transient elastography UKELD, United Kingdom model for end-stage liver disease UQ, upper quartile VMR, volume mixing ratio VOC, volatile organic compounds Volatile organic compounds ppbv, parts per billion by volume ppmv, parts per million by volume

Mesh ： Adult Aged Biomarkers / analysis Breath Tests / methods Cyclohexenes / analysis Female Humans Limonene Liver Cirrhosis / diagnosis Liver Transplantation Male Methanol / analysis Middle Aged Pentanones / analysis ROC Curve Terpenes / analysis Volatilization

来  源：   DOI：10.1016/j.ebiom.2015.07.027   PDF(Sci-hub)

Abstract：
BACKGROUND: The burden of liver disease in the UK has risen dramatically and there is a need for improved diagnostics.
OBJECTIVE: To determine which breath volatiles are associated with the cirrhotic liver and hence diagnostically useful.
METHODS: A two-stage biomarker discovery procedure was used. Alveolar breath samples of 31 patients with cirrhosis and 30 healthy controls were mass spectrometrically analysed and compared (stage 1). 12 of these patients had their breath analysed after liver transplant (stage 2). Five patients were followed longitudinally as in-patients in the post-transplant period.
RESULTS: Seven volatiles were elevated in the breath of patients versus controls. Of these, five showed statistically significant decrease post-transplant: limonene, methanol, 2-pentanone, 2-butanone and carbon disulfide. On an individual basis limonene has the best diagnostic capability (the area under a receiver operating characteristic curve (AUROC) is 0.91), but this is improved by combining methanol, 2-pentanone and limonene (AUROC curve 0.95). Following transplant, limonene shows wash-out characteristics.
CONCLUSIONS: Limonene, methanol and 2-pentanone are breath markers for a cirrhotic liver. This study raises the potential to investigate these volatiles as markers for early-stage liver disease. By monitoring the wash-out of limonene following transplant, graft liver function can be non-invasively assessed.
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