Multidimensional cfRNA response modeling identifies a 5-gene pair signature for high-robust pulmonary tuberculosis diagnosis

= 0.65) and radiological severity. Kappa analysis confirmed substantial diagnostic agreement (kappa = 0.42-0.56) between this signature and chest X-ray systems, with the signature providing high discriminative power in cases with ambiguous radiological findings. This cfRNA-based 5-gene pair signature establishes a robust diagnostic paradigm, offering efficient PTB detection in resource-limited settings and a foundation for future point-of-care diagnostics.