Journal: Scientific reports
This study evaluates the dual diagnostic utility of metagenomic next-generation sequencing (mNGS) in distinguishing pulmonary infections from malignancies.
Conducted prospectively at a single center, mNGS was applied to patients with lung lesions requiring differential diagnosis between infection, cancer, or other pulmonary diseases.
Compared to conventional microbiological tests, mNGS showed significantly higher sensitivity for detecting infections (56.5% vs. 39.1%).
Additionally, host chromosomal copy number variation (CNV) analysis via mNGS demonstrated:
- Moderate sensitivity (38.9%)
- Perfect specificity (100%) for malignancy detection
This helped correctly identify lung cancer cases initially misdiagnosed as pneumonia.
Combining CNV analysis with bronchoalveolar lavage fluid cytology improved malignancy detection sensitivity to 55.6%.
Notably, CNV sensitivity increased when bronchoscopy revealed direct signs of neoplasm.
Overall, the study highlights mNGS as a valuable tool capable of simultaneously identifying infectious pathogens and malignancies, enhancing diagnostic accuracy and clinical decision-making in complex pulmonary cases.