A multimarker panel for diagnosis and prognosis prediction of fungal infections

用于真菌感染诊断和预后预测的多标志物组合

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Abstract

To develop and validate a routine indicator-based multimarker panel for fungal infection (FI) diagnosis and prognosis prediction. A retrospective cohort of 134 patients (63 FI, 71 non-FI) was stratified randomly into a training set (n = 75) and validation set (n = 59). Differential indicators were screened via non-parametric tests and univariate logistic regression, with LASSO regression verifying core variables. Four machine learning algorithms (logistic regression, SVM, GNB, LightGBM) were compared via 5-fold cross-validation. The model with the best performance was validated in the validation set. Six core indicators (hsCRP, BNP, PT%, D-Dimer, IL-17, PCT) were selected. The logistic regression algorithm was finally selected for modeling because of its optimal efficacy in the training set. The logistic-based model in validation set showed better performance than others. The diagnostic AUC was 0.845, sensitivity was 80.00%, specificity was 72.41%. The prognostic AUC was 0.767, sensitivity was 72.41% and specificity was 90.00%, outperforming single indicators. The logistic regression-derived multimarker panel integrates inflammatory, coagulation, and cardiac biomarkers, offering a reliable, accessible tool for FI diagnosis and prognostic stratification, especially in resource-limited settings.

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