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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\u00a0=\u00a00.79) compared to traditional imaging (0.75) and biochemical tests (0.65). Notably, integrating all three modalities substantially enhanced discriminatory power (AUC\u00a0=\u00a00.85), highlighting the value of multi-dimensional information fusion. Clinical assessment under balanced baseline conditions showed significant advantages for ablation: shorter hospital stays (P\u00a0=\u00a00.003), 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.<\/jats:p>","DOI":"10.3389\/fonc.2026.1836590","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T04:21:22Z","timestamp":1784175682000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Metabolomics-assisted evaluation of differences and clinical value between ablation and surgical treatment for lung adenocarcinoma"],"prefix":"10.3389","volume":"16","author":[{"given":"Youli","family":"Wen","sequence":"first","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Zigong First People\u2019s Hospital","place":["Zigong, 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