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

Abstract

Objective: To evaluate whether targeted plasma phospholipidomics identifies an externally validated blood panel for pneumoconiosis triage across dust-exposed and nonexposed worker cohorts. Methods: 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. Results: 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. Conclusions: This panel may support occupational triage for confirmatory imaging, pending prospective multicenter validation.