Table 4.
Clinical Data of 15 Cases of Malignant Tumor with CNVs and Pathogens Detected by mNGS
| Case Number | Age/Sex | Sample | Imaging Results | Tumor History | Primary diagnosis | Definitive diagnosis | Diagnostic method | CNV detection` | Pathogens detected by mNGS |
|---|---|---|---|---|---|---|---|---|---|
| [1] | 62/M | PB | Multiple masses with cavities | Left RUC after surgery | Lung abscess* | Lung metastasis | Pathology | Positive | Positive¶a |
| [2] | 83/M | PB | Large mass with cavity in RUL | None | Lung abscess* | PLA | Pathology | Positive | Negative |
| [3] | 51/M | PB | Multiple lung nodules, opacities with cavities | Liver cancer with lung metastasis | MLC with lung abscess | MLC with lung abscess | Clinical diagnosis | Positive | Negative |
| [4] | 66/M | PB | Bilateral lung opacities, multiple masses in the liver | None | Liver abscess with pneumonia* | PHAA with pneumonia | Pathology and Clinical diagnosis | Positive | Negative |
| [5] | 62/M | PB | A mass in LLL with bilateral pleural effusion | Systemic metastasis of left maxillary of ACC after surgery | Pneumonia secondary to MLC | Pneumonia secondary to MLC | Clinical diagnosis | Positive | Negative |
| [6] | 76/M | PB | GGOs in both lungs | Systemic metastasis of right maxillary of ACC | Pneumonia | Radiation pneumonitis | Clinical diagnosis | Positive | Positive¶b |
| [7] | 72/M | LT | Cystic lesion in RLL | None | Fungal pneumonia* | PLA | Pathology | Positive | Negative |
| [8] | 75/M | LT | Multiple nodules in RLL | None | Suspected lung cancer | PLA | Pathology | Positive | Negative |
| [9] | 86/M | LT | Multiple nodules in both lungs | PA with lung metastasis | Secondary fungal pneumonia* | Lung metastasis | Pathology | Positive | Negative |
| [10] | 64/F | LT | Multiple nodules in LLL | None | Fungal pneumonia* | PLA | Pathology | Positive | Negative |
| [11] | 75/M | BALF | Multiple lung bulla, consolidation | None | Pneumonia* | GA with LM | Pathology | Positive | Positive¶c |
| [12] | 65/M | BALF | Consolidation in RLL | None | Pneumonia* | PLA | Pathology | Positive | Negative |
| [13] | 64/F | BALF | Multiple nodules, masses and consolidations | Lung cancer with systemic metastasis | Pneumonia secondary to lung cancer | Pneumonia secondary to lung cancer | Pathology, bacteriology | Positive | Positive¶d |
| [14] | 68/F | BALF | Multiple nodules in both lungs and consolidations in LLL | None | Pneumonia* | PLA | Pathology | Positive | Positive¶e |
| [15] | 29/F | BALF | A nodule with cavity in LUL and multiple GGOs in left lung | None | Pneumonia* | PLA | Pathology | Positive | Positive¶f |
Notes: *These cases were initially misdiagnosed as non-neoplastic diseases, with a misdiagnosis rate of 66.7% (10/15). ¶Non-pathogenic bacteria according to comprehensive clinical adjudications. aCytomegalovirus; bEnterococcus faecalis, Epstein-Barr virus; cStaphylococcus haemolyticus, Candida albicans, Cryptococcus neoformans Grubii variant, Epstein-Barr virus; dPneumocystis jirovecii; eStenotrophomonas maltophilia.
Abbreviations: ACC, adenoid cystic carcinoma; BALF, bronchoalveolar lavage fluid; CNV, copy number variation; GA, Gastric adenocarcinoma; GGOs, ground glass opacities; LLL, left lower lung; LNB, lymph node biopsy; LT, lung tissue; LUL, left upper lung; mNGS, metagenomic next-generation sequencing; MLC, metastatic lung cancer; PA, prostate adenocarcinoma; PB, peripheral blood; PHSA, primary hepatic sarcomatoid carcinoma; PLA, primary lung adenocarcinoma; RLL, right lower lung; RUC, renal urothelial carcinoma; RUL, right upper lung.