Interactions between upper respiratory microbiota and psychological distress in pulmonary nodule patients: a retrospective nested case-control study based on machine learning and exploratory mediation analysis

作者：Xin Ye, Shi-Yan Tan, Qiong Ma, Zifan Wang, Taoyu Wu, Z.Y. Mao, Qian Wang, Chuan Zheng, Xingchen Peng, Fengming You, Yifeng Ren · 发表于：International Journal of Surgery · 年份：2025 · DOI：10.1097/js9.0000000000004331 · 被引用次数：1 · 研究领域：Gut microbiota and health、Tryptophan and brain disorders、Cancer survivorship and care

BACKGROUND: The role of upper respiratory microbiota in the context of psychological distress (PD), particularly in patients with pulmonary nodules (PNs), remains largely unexplored. The study investigates anxiety and depression prevalence, clinical risk factors, and upper respiratory microbiota composition in patients with PNs, and their associations. METHODS: A retrospective nested case-control study (August 2022 to May 2024) surveyed 381 PNs participants using a standardized questionnaire. Univariate analysis and logistic regression examined associations with PD. 16S ribosomal RNA sequencing compared microbiota between groups. Spearman correlation and exploratory mediation analysis explored associations between microbiota, clinical features, and PD. Machine learning algorithms were trained to identify features associated with PD. RESULTS: This study analyzed the sociodemographic and disease characteristics of 381 participants with PNs, revealing that approximately 32% exhibited symptoms of PD. Results showed female patients (OR = 1.77), those with ground-glass nodules (OR = 1.77) and history of nodular disease (OR = 1.94) were associated with a higher prevalence of PD. The main differential bacterial genus between no psychological distress (NPD) and PD groups such as g_Prevotella, g_Neisseria, and g_Haemophilus. The machine learning algorithms revealed that factors such as g_Aggregatibacter, g_Rhodococcus and gender constituted the best predictive group (Area under the cur...