AUTHOR=Qiao Mingkun , Li Miao , Qi Wenhui , Xu Lei , Miao Xiaohui , Cui Chao 

TITLE=The innovative diagnostic model facilitates the differentiation between non - tuberculous mycobacterial lung disease and pulmonary tuberculosis

JOURNAL=Frontiers in Cellular and Infection Microbiology

VOLUME=Volume 15 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/cellular-and-infection-microbiology/articles/10.3389/fcimb.2025.1667339

DOI=10.3389/fcimb.2025.1667339

ISSN=2235-2988

ABSTRACT=ObjectivesTo construct a differential diagnostic model for Non-Tuberculous Mycobacterial Lung Disease (NTM-LD) and Pulmonary Tuberculosis Lung Disease (PTB-LD).MethodsRetrospective analysis of 300 NTM-LD and 300 PTB-LD patients (pathogen-confirmed) was performed. Patients were randomly split into training (2/3) and validation (1/3) sets. CT imaging, clinical data, and symptoms were analyzed. Logistic regression identified significant discriminative features, followed by random forest modeling to develop a diagnostic tool with web-based calculator. Model performance was validated using the independent validation set.ResultsUnivariate and multivariate analyses identified key discriminative factors (P<0.05): cough with sputum, hemoptysis, thin-walled cavities, centrilobular nodules, bronchiectasis, diabetes, and autoimmune diseases. The diagnostic model achieved 82.5% sensitivity and 85.5% specificity (ROC analysis), with validation showing 78% sensitivity and 85% specificity, confirming strong discriminative power and calibration.ConclusionsThe model constructed based on patients’ CT imaging, basic clinical data, and symptomatic signs demonstrates commendable performance in the differential diagnosis of NTM-LD and PTB-LD, offering a convenient and practical auxiliary tool for clinical practice.