Externally Validated Plasma Phospholipid Panel for Pneumoconiosis Triage Across Dust-Exposed and Unexposed Worker Cohorts.

Wang, Junyun; Feng, Yuzhen; Zhao, Junxiu; Dai, Jing; Peng, Fangda; He, Yazhen; Yu, Xiao; Kong, Xiaomei et al. · J Occup Environ Med · 2026

prospective_cohort · Level II

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Abstract

To evaluate whether targeted plasma phospholipidomics identifies an externally validated blood panel for pneumoconiosis triage across dust-exposed and nonexposed worker cohorts. We quantified 53 plasma phospholipids by UPLC-MS/MS in discovery (n=392) and external (n=221) cohorts comprising pneumoconiosis, dust-exposed noncase, and nonexposed healthy control participants. Candidate lipids were selected by covariate-adjusted screening and LASSO, then tested with clinical covariates. A five-lipid panel was retained. In the external cohort, Firth logistic regression achieved AUC 0.983, sensitivity 0.923, and specificity 0.955. Cytokine-lipid correlations supported inflammatory plausibility. This panel may support occupational triage for confirmatory imaging, pending prospective multicenter validation.