Abstract:

Objective To evaluate the diagnostic value of non-targeted detection of metabolic fingerprinting in pulmonary nodules and to analyze the clinical effective model of multi-omics for assessing the malignant risk of pulmonary nodules. Methods A total of 73 patients who underwent chest CT and completed pathological diagnosis and non-targeted detection of metabolic fingerprinting at Shandong Provincial Hospital Affiliated to Shandong First Medical University from November 2021 to October 2024 were selected as the research subjects. According to the postoperative histopathological diagnosis，the patients were divided into the lung malignant nodule group （61 cases） and the lung benign nodule group （12 cases）. General clinical data of the patients，including sex，age，smoking history，and family history of tumors，as well as imaging data，including nodule density，nodule size，nodule location，nodule number，and special imaging manifestations （spiculation，lobulation，vacuole sign，vascular convergence sign，etc.），and non-targeted detection of metabolic fingerprinting results were collected. The above data were compared between the two groups of patients，and the receiver operator characteristic （ROC） curve was drawn to evaluate the predictive value of each model. Results There were statistically significant differences in age （t=4.41，P<0.001），nodule size （Z=2.67，P=0.008），nodule density （χ²=4.64，P=0.031），and spiculation （χ²=7.67，P=0.006） between the lung malignant nodule group and the lung benign nodule group. There were no statistically significant differences in sex，smoking history，family history of lung cancer，nodule number，nodule location，lobulation，vacuole sign，vascular convergence sign，pleural indentation sign，calcification sign，bronchial truncation sign，vascular supply sign，and bronchial air sign （all P>0.05）. The number of non-targeted detection of metabolic fingerprinting high-risk patients in the lung malignant nodule group （36 cases） was significantly higher than that in the lung benign nodule group （0 case）（χ²=13.97，P<0.001）. ROC curve analysis showed that the area under the curve of the Brock model combined with non-targeted detection of metabolic fingerprinting was 0.930 （95%CI： 0.872-0.988），which was greater than that of the Brock model （0.856，95%CI： 0.769-0.942，Z=0.27，P=0.040） and non-targeted detection of metabolic fingerprinting （0.768，95%CI： 0.650-0.887，Z=0.30，P=0.004） alone. Conclusions Non-targeted detection of metabolic fingerprinting risk assessment may serve as a non-invasive method to assist the Brock model in the diagnosis of pulmonary nodules and has good application value. The combination of the Brock model and non-targeted detection of metabolic fingerprinting can more accurately distinguish the benign and malignant nature of pulmonary nodules.

Key words: Lung neoplasms, Early diagnosis, Metabolomics