Metabolomics-assisted evaluation of differences and clinical value between ablation and surgical treatment for lung adenocarcinoma.

The optimal transition from surgery to minimally invasive ablation for early lung adenocarcinoma requires elucidation of their differential metabolic impacts and clinical benefits. Using MALDI-MS platform, this study investigated 40 patients (15 ablation, 25 surgery) to characterize treatment-specific metabolic signatures and evaluate diagnostic performance. Following rigorous matrix validation, metabolomic profiling revealed distinct metabolic networks, with supervised OPLS-DA models achieving effective group separation and identifying numerous differentially expressed metabolites. For treatment discrimination, metabolomics demonstrated superior diagnostic efficacy (AUC = 0.79) compared to traditional imaging (0.75) and biochemical tests (0.65). Notably, integrating all three modalities substantially enhanced discriminatory power (AUC = 0.85), highlighting the value of multi-dimensional information fusion. Clinical assessment under balanced baseline conditions showed significant advantages for ablation: shorter hospital stays (P = 0.003), reduced costs, and fewer complications, while maintaining equivalent pulmonary function (FEV1/FVC). These findings provide integrated metabolomic and clinical evidence supporting ablation as a minimally invasive, efficacious alternative to surgery, offering molecular insights into treatment-induced metabolic reprogramming and establishing a foundation for optimized therapeutic decision-making in early lung adenocarcinoma.