Fig. 1

Study design and flowchart. We enrolled 181 patients with LUAD and 118 HCs from Beijing, Suzhou, and Hainan and prospectively collected fecal samples for ITS 2 sequencing. We characterized fungal biodiversity in the matching cohort from Beijing. OTU markers were obtained in the discovery cohort and established a prediction model for LUAD using five supervised ML algorithms. Validation cohorts from Suzhou and Hainan were used to evaluate efficacy