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Large-Scale T-cell Receptor Repertoire Profiling Unveils Tumor-Specific Signals for Diagnosing Indeterminate Pulmonary Nodules.

December 15, 2025pubmed logopapers

Authors

Luo H,Guo W,Luan X,Yue T,Yu S,Yin X,Zu R,Rao L,Hu B,Liu X,Xiang R,Zhou P,Liu J,Zhang P,Chen Y,Zhang X,Zhou S,Wang J,Li ZC,Qin W,Yang X,Gu J,Guo AY,Xu M,Yi Q,Huang J,Liu J,Wang D,Chen S

Affiliations (13)

  • Department of Clinical Laboratory, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, China.
  • LifeX Institute, School of Medical Technology, Gannan Medical University, Ganzhou, China.
  • HaploX Biotechnology, Shenzhen, China.
  • Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.
  • Department of Thoracic Surgery, Peking University Shenzhen Hospital, Shenzhen, China.
  • Department of Thoracic Surgery and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China.
  • Department of Medical Oncology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, China.
  • Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, China.
  • Department of Radiology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, China.
  • School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China.
  • Faculty of Data Science, City University of Macau, Macau, China.
  • Department of Critical Care Medicine, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, China.
  • Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, China.

Abstract

Indeterminate pulmonary nodules (IPN) are increasingly detected due to increasing health awareness and widespread lung cancer screening, yet distinguishing benign from malignant nodules remains a critical challenge. Emerging evidence suggests that recognizing cancer-associated immune signatures represents a powerful approach for early-stage cancer detection. This study explored the clinical utility of T-cell receptor (TCR) repertoire analysis in IPN evaluation. By conducting large-scale TCR sequencing (6,059 blood and 988 tumor samples), we established LungTCR (https://www.lungtcr.com/), a comprehensive TCR repertoire database, and proposed a method for the quantitative assessment of tumor-related immune responses. LungTCR was leveraged to develop TCRnodseek plus, a diagnostic model integrating clinical data, CT imaging, and TCR features. A multicenter prospective study (ChiCTR2200055761) involving 1,107 patients with IPN validated the superior diagnostic performance of TCRnodseek plus over existing approaches. Mechanistic analyses revealed that the identified lung cancer-related TCR clones are enriched in non-small cell lung cancer and are predominantly present in malignant nodules and tumor tissues. This study provides a robust TCR database and an advanced diagnostic model, offering a framework for precise IPN differentiation. Construction of the largest TCR database of lung nodules enabled identification of lung cancer-specific TCR sequences and development of an advanced machine learning model to distinguish benign from malignant pulmonary nodules. This article is part of a special series: Driving Cancer Discoveries with Computational Research, Data Science, and Machine Learning/AI .

Topics

Receptors, Antigen, T-CellLung NeoplasmsMultiple Pulmonary NodulesCarcinoma, Non-Small-Cell LungSolitary Pulmonary NoduleJournal ArticleMulticenter Study

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