Journal of Shandong University (Health Sciences) ›› 2025, Vol. 63 ›› Issue (11): 36-45.doi: 10.6040/j.issn.1671-7554.0.2025.0344

• Clinical Medicine • Previous Articles    

Value of tNGS testing and conventional culture for BALF in the diagnosis of NSCLC complicated with IPFD

LIU Zhenkun1, LYU Jiling2, XU Weiwei3, MA Litian4,5,6, ZHANG Caiqing1,2   

  1. 1. Qilu Medical College of Shandong University, Jinan 250012, Shandong, China;
    2. Department of Respiratory and Critical Care Medicine, Shandong Second Provincial General Hospital, Jinan 250022, Shandong, China;
    3. Department of Pediatrics, Shandong Second Provincial General Hospital, Jian 250022, Shandong, China;
    4. Department of Thoracic Surgery, Tangdu Hospital, Air Force Military Medical University, Xian 710038, Shaanxi, China;
    5. Department of Integrated Traditional Chinese and Western Medicine Oncology, Tangdu Hospital, Air Force Military Medical University, Xian 710038, Shaanxi, China;
    6. Shaanxi Key Laboratory of Integrated Traditional Chinese and Western Medicine for Tumor Diagnosis and Treatment, Xian 710038, Shaanxi, China
  • Published:2025-11-28

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Abstract: Objective To investigate the diagnostic value of targeted next-generation sequencing(tNGS)for pathogens in bronchoalveolar lavage fluid(BALF)compared with traditional culture in non-small cell lung cancer(NSCLC)complicated with invasive pulmonary fungal disease(IPFD). Methods A retrospective analysis was conducted on the clinical data of 40 patients clinically diagnosed with NSCLC complicated with IPFD at Shandong Second Provincial General Hospital from September 1, 2022, to April 1, 2025. BALF samples were collected for tNGS detection and traditional culture, and the pathogen detection rates and diagnostic efficacy were compared and analyzed. Results Among the 40 IPFD patient samples, the positive detection rates for fungi by tNGS and traditional culture were 85.0% and 52.5%, respectively(corrected χ2=6.86, P=0.01), and for bacteria, they were 70.0% and 50.0%, respectively(corrected χ2=4.08, P=0.04). The detection sensitivities for bacteria by tNGS and traditional culture were 95.5% and 86.4%, respectively(corrected χ2=0.25, P=0.62). All patients improved and were discharged after antifungal, antibacterial, and antitumor treatments. Conclusion tNGS technology demonstrates significantly superior detection efficacy for both fungi and bacteria in pathogen detection for NSCLC complicated with IPFD compared to traditional BALF culture. Clinically, tNGS can be used as an early screening tool, and combined with BALF culture and clinical features for comprehensive interpretation, to optimize diagnosis and treatment and avoid overtreatment.

Key words: Non-small cell lung cancer, Invasive pulmonary fungal disease, Bronchoalveolar lavage fluid, Targeted next-generation sequencing, Diagnostic value

CLC Number: 

  • R735.6
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