Diagnostic and prognostic evaluation of early benign and malignant pulmonary nodules using serum miR-148a-3p combined with CT findings

Abstract Objectives This research sought to explore the clinical application value of serum miR-148a-3p combined with computed tomography (CT) features for differentiating benign from malignant pulmonary nodules and assessing patient prognosis. Methods The experimental group included 80 patients with malignant pulmonary nodules, and the control group consisted of 70 patients with benign pulmonary nodules. Serum expression of miR-148a-3p was quantified using RT-qPCR. The diagnostic performance of serum miR-148a-3p and nodule diameter for distinguishing malignant pulmonary nodules was assessed via the receiver operating characteristic (ROC) curve. Overall survival was estimated using the Kaplan-Meier method, and risk prediction was conducted using the multivariate Cox regression. Results Compared with benign nodules, malignant nodules displayed significantly different CT imaging characteristics, particularly in terms of larger diameters, ground-glass or mixed-density patterns, lobulation, spiculation, vascular convergence, pleural indentation, and calcification features. The expression of miR-148a-3p was significantly lower in the malignant nodule group. The combination of miR-148a-3p expression and CT features yielded enhanced diagnostic accuracy (AUC=0.8966) for distinguishing benign and malignant nodules. However, these results were obtained from a single retrospective cohort without independent validation, which may lead to an overestimated AUC. Further multi-center studies with independent validation were needed to verify its real diagnostic performance in broader clinical populations. Moreover, low miR-148a-3p expression was associated with poorer survival outcomes with malignant pulmonary nodules and may be an independent factor influencing disease progression. Conclusions The integrated use of serum miR-148a-3p and CT exhibited superior clinical diagnostic performance in differentiating benign from malignant pulmonary nodules.