多组学在肺结节良恶性鉴别与风险分层中的研究进展OA

Benign-malignant differentiation and risk stratification of pulmonary nodules are critical issues in lung cancer screening and clinical management.Conventional assessment mainly relies on imaging evaluation,dynamic follow-up,and pathological confirmation,but its diagnostic performance remains limited in clinical scenarios involving small nodules,ground-glass nodules,and inflammatory lesions.In recent years,advances in radiomics,genomics,transcriptomics,proteomics,metabolomics,and microbiomics have provided multi-level biological evidence for the precise evaluation of pulmonary nodules from the perspectives of imaging phenotype,genetic variation,molecular expression,functional status,metabolic reprogramming,and host-microbe interaction.Compared with single-omics approaches,multi-omics integration,through cross-level information fusion,enables a more comprehensive characterization of the biological heterogeneity of pulmonary nodules and further improves the performance of benign-malignant differentiation and risk stratification.Relevant studies showed that the area under the curve(AUC)increased from 0.80-0.87 to 0.93.This review systematically summarizes recent advances in multi-omics research for benign-malignant differentiation and risk stratification of pulmonary nodules,with a focus on their value in biomarker discovery,risk assessment,and clinical decision support.Current challenges,including lack of standardization,insufficient external validation,and barriers to clinical translation,are also discussed to provide references for future research on precision management of pulmonary nodules.