Clinical study on the combined use of serum RHOXF1-AS1 and CT features to improve the accuracy of benign/malignant diagnosis and prognosis assessment in pulmonary nodules

This study aims to investigate the clinical utility of serum lncRNA RHOXF1-AS1 combined with chest CT imaging features in distinguishing benign from malignant pulmonary nodules (PNs) and assessing prognosis in lung cancer patients. This study included 249 patients with pathologically confirmed PNs (100 benign, 149 malignant). The relative expression level of serum RHOXF1-AS1 was detected using RT-qPCR. Binary logistic regression analysis was performed to identify independent risk factors for malignant PNs. ROC curves assessed diagnostic performance. The association between RHOXF1-AS1 expression and prognosis was analyzed using Kaplan-Meier curves and Cox analysis. Serum RHOXF1-AS1 expression levels were significantly lower in the malignant nodule group compared to the benign nodule group. Low serum RHOXF1-AS1 expression, nodule diameter, spiculation, and nodule density were independent risk factors for predicting nodule malignancy. Among individual markers, serum RHOXF1-AS1 demonstrated the highest diagnostic curve AUC of 0.845. The AUC of the combined diagnostic model integrating all four markers increased to 0.900. Survival analysis indicated that patients with low serum RHOXF1-AS1 expression exhibited shorter survival times and represented an independent prognostic risk factor in multivariate analysis. Serum RHOXF1-AS1 serves as an effective biomarker for distinguishing benign from malignant PNs, and its low expression correlates with poor prognosis in lung cancer patients. Integrating serum RHOXF1-AS1 with key CT imaging features enables the construction of a combined model with superior diagnostic performance, offering a novel integrated strategy for early, precise diagnosis and prognostic assessment of PNs.