Am J Surg Pathol. 2026 Jun 1;50(6):695-704. doi: 10.1097/PAS.0000000000002533. Epub 2026 Mar 13.

ABSTRACT

With the application of molecular techniques in pathologic diagnosis, several novel primary pulmonary epithelial tumors have been continuously discovered and classified under the WHO classification of thoracic tumors. Recently, a pulmonary tumor with NFATC2 :: NUTM2B fusion was first documented, but the spectrum of NFATC2::NUTM2 fusion variants and their associated pathologic features remains incompletely characterized. Coincidentally, we also found and described 6 primary pulmonary tumors harboring recurrent NFATC2::NUTM2A/E fusions through integrated genomic analysis. These patients, including 4 females and 2 males, with a median age of 53 years, presented with incidentally detected peripheral lung nodules composed of monotonous epithelioid cells arranged in cords, nests, and trabeculae within a prominent desmoplastic stroma. All tumors exhibited a consistent immunophenotype: CK5/6+/GATA3+/calponin+/EMA+/DOG1 (perinuclear dot-like staining)/p63-. High-throughput chromosome conformation capture (Hi-C) analysis showed the structural variation of NFATC2::NUTM2E in all 6 cases, whereas RNA sequencing detected the fusion transcripts in 5 cases ( NFATC2::NUTM2A , n=2; NFATC2::NUTM2E , n=3). Ultrastructural examination of 1 case suggested epithelial differentiation. All patients remained disease-free after complete resection (median follow-up: 24 mo; range: 9 to 41 mo). These findings define a novel primary pulmonary tumor entity driven by NFATC2::NUTM2 fusions, and characterized by a distinctive immunophenotype, expanding the spectrum of NUTM2 -associated neoplasms. Our study underscores the utility of multiomics approaches for characterizing rare neoplasms and provides a diagnostic framework for this entity.

PMID:41821426 | DOI:10.1097/PAS.0000000000002533

Transl Cancer Res. 2026 Feb 28;15(2):127. doi: 10.21037/tcr-2025-664. Epub 2026 Feb 25.

ABSTRACT

BACKGROUND: In recent years, multi-omics models based on a variety of biomarkers have been continuously developed and increasingly applied in the field of oncology, especially in the early diagnosis of lung cancer. This study aimed to integrate computed tomography (CT) radiomics with seven lung cancer-associated autoantibodies (AABs) to develop multi-omics predictive models for pulmonary nodule (PN) characterization.

METHODS: This retrospective study enrolled 179 patients with PNs measuring from 5 to 30 mm in diameter who underwent thoracic surgery at Zhongda Hospital, Southeast University between January 2020 and December 2024. The patients were pathologically categorized into lung cancer (n=87) and non-lung cancer (n=92) groups, and then randomly allocated into training and test sets at a ratio of 7 to 3. Least absolute shrinkage and selection operator (LASSO) regression was used for feature screening to construct a clinical model based on five clinical characteristics. A radiomics prediction model was constructed based on the radiomics features identified after delineating the regions of interest and extracting the radiomics features; the rad-score for each patient was calculated to develop a multi-analytic comprehensive model by combining different markers. The diagnostic performances of the models were compared using the area under the curve (AUC), accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value.

RESULTS: The multi-omics model demonstrated superior diagnostic accuracy with an AUC of 0.902 [95% confidence interval (CI): 0.817-0.986], accuracy of 82.4%, sensitivity of 88.5%, and specificity of 80.0%, outperforming the clinical (AUC =0.848; 95% CI: 0.777-0.919) and radiomics (AUC =0.854; 95% CI: 0.786-0.922) models. Notably, the radiomics model exhibited high sensitivity (96.6%) but poor specificity (63.6%), while the multi-omics model resolved this trade-off via the synergistic integration of clinical-radiomic-biomarker features, achieving significant improvements in the PPV (81.5% vs. 72.7%) compared to the clinical model.

CONCLUSIONS: Integrating CT radiomics with seven lung cancer-AABs established a robust multi-omics framework for PN diagnosis. Compared to the standalone clinical or radiomics models, this comprehensive model demonstrated superior diagnostic performance.

PMID:41815158 | PMC:PMC12971553 | DOI:10.21037/tcr-2025-664

Front Cell Infect Microbiol. 2026 Feb 23;16:1732958. doi: 10.3389/fcimb.2026.1732958. eCollection 2026.

ABSTRACT

INTRODUCTION: Lung adenocarcinoma (LUAD), the most common subtype of non-small cell lung cancer, is a form of malignant pulmonary nodule that requires clinical differentiation from benign pulmonary nodules (BPN). The mechanisms underlying the development of LUAD are complex, and effective non-invasive methods for differentiating BPN from LUAD are lacking. This study aimed not only to distinguish BPN from LUAD using gut fungi and serum metabolites, but also to establish an integrated network of gut fungi-metabolite-cytokine interactions.

METHODS: Fecal and serum samples from individuals with BPN and patients with LUAD were subjected to internal transcribed spacer sequencing, ultra-performance liquid chromatography-tandem mass spectrometry, and multiplex Luminex assays to quantify gut fungi, metabolites, and cytokines, respectively.

RESULTS: A significant difference in gut fungal communities was observed between the BPN and LUAD groups. Multiple genera and species were more abundant in LUAD than in BPN. Docosapentaenoic acid n-6 (DPAn-6), indole-3-propionic acid (IPA), and interferon-γ-induced protein 10 (IP-10) were significantly elevated in the LUAD group. The integrated model established using a combination of gut fungi and metabolites demonstrated excellent performance in distinguishing BPN from LUAD. A network of interactions was established among differentially abundant gut fungi, serum metabolites, and cytokines.

CONCLUSION: Our study identifies a novel panel of fungal and metabolite biomarkers for differentiating between BPN and LUAD, and constructs a multi-omics network that provides new insights into investigating the mechanistic role of gut mycobiota dysbiosis in LUAD.

PMID:41809995 | PMC:PMC12968269 | DOI:10.3389/fcimb.2026.1732958