Abstract
OBJECTIVE: To explore the clinical application value of combining circulating tumor cell (CTC) detection with the artificial intelligence imaging software "uAI platform" in predicting the pathological nature of pulmonary nodules (PN). Develop a joint diagnostic system based on the uAI platform and quantitative detection of CTCs, enable simultaneous classification of pulmonary nodules as benign or malignant and assess the degree of infiltration. METHODS: A total of 76 patients with pulmonary nodules undergoing surgical treatment were enrolled. Preoperatively, three-dimensional nodule risk stratification (low、medium、high risk) was performed using the uAI platform, and CTC high-throughput detection was conducted. Key indicators were selected through multi-group comparisons (Benign、Malignant、Invasive subgroups) and logistic regression analysis. A multi-dimensional nomogram model was constructed, and its clinical utility was evaluated using ROC curves and clinical decision curves. RESULTS: Comparison between benign and malignant pulmonary nodule groups revealed significant differences in the risk stratification of the uAI platform (proportion of high-risk: 75.61% vs 34.29%) and in the median value of CTC quantitative detection (P<0.001). Multivariate logistic regression analysis demonstrated that high-risk classification by uAI and CTC quantitative detection were independent predictors of malignancy in pulmonary nodules (P<0.05). The nomogram model constructed based on these factors exhibited excellent discrimination, and its combined diagnostic performance was significantly better than that of single indicators (AUC=0.805 vs uAI 0.730/CTC 0.743). CONCLUSION: The combined uAI-CTC model breaks through the limitations of single-dimension diagnosis, enabling risk stratification of malignant pulmonary nodules and quantitative assessment of infiltration, providing evidence-based support for clinical treatment strategies.