Exhaled breath analysis in patients with potentially curative lung cancer undergoing surgery: a longitudinal study

Exhaled breath analysis has emerged as a non-invasive and promising method for early detection of lung cancer, offering a novel approach for diagnosis through the identification of specific biomarkers present in a patient's breath. For this longitudinal study, 29 treatment-naive patients with lung cancer were evaluated before and after surgery. Secondary electrospray ionization high-resolution mass spectrometry was used for exhaled breath analysis. Volatile organic compounds with absolute log2fold change ⩾1 andq-values ⩾ 0.71 were selected as potentially relevant. Exhaled breath analysis resulted in a total of 3482 features. 515 features showed a substantial difference before and after surgery. The small sample size generated a false positive rate of 0.71, therefore, around 154 of these 515 features were expected to be true changes. Biological identification of the features with the highest consistency (m/z-242.18428 andm/z-117.0539) revealed to potentially be 3-Oxotetradecanoic acid and Indole, respectively. Principal component analysis revealed a primary cluster of patients with a recurrent lung cancer, which remained undetected in the initial diagnostic and surgical procedures. The change of exhaled breath patterns after surgery in lung cancer emphasizes the potential for lung cancer screening and detection.

Mycobacterium gordonae Infection in a Patient With Non-small Cell Lung Cancer

Mycobacterium gordonae (MG) is one of the least pathogenic nontuberculous mycobacteria (NTM). We report an unusual case of MG infection in a patient with newly diagnosed lung cancer. A 61-year-old woman presented with shortness of breath and weight loss. Six months prior to admission, she was diagnosed with MG infection based on positive sputum cultures and bronchioalveolar lavage. Despite anti-mycobacterial therapy, her symptoms worsened and she lost approximately 100 pounds. A transbronchial biopsy obtained one week prior to admission revealed adenocarcinoma of the lung. At admission, vital signs were normal, and a physical exam revealed bilateral crackles. Computed tomography (CT) scan of the chest revealed infiltrates with ground-glass opacity. The patient was admitted to the oncology service for evaluation. Our findings suggest that symptomatic individuals with positive cultures of MG should proceed with extensive workup for possible underlying lung cancer especially if not responding to anti-mycobacterial therapy.