Association between Chest CT-defined Emphysema and Lung Cancer: A Systematic Review and Meta-Analysis.
Association between Chest CT-defined Emphysema and Lung Cancer: A Systematic Review and Meta-Analysis.
复制标题
胸部 CT 定义的肺气肿与肺癌之间的关联：系统评价和荟萃分析。
作者：
Xiaofei Yang;H. J. Wisselink;R. Vliegenthart;M. Heuvelmans;H. Groen;M. Vonder;M. Dorrius;G. H. de Bock
鉴于评估肺气肿的方法不同，关于其是否与肺癌相关存在争议。目的对胸部ct诊断的肺气肿与肺癌之间的关系进行系统回顾和荟萃分析。材料和方法检索PubMed、Embase和Cochrane数据库，检索截止到2021年7月15日的相关研究，以确定肺气肿与肺癌之间的相关性。通过气肿严重程度（轻度、轻度或中度至重度，目测和定量评估）和亚型（小叶中心型和隔旁型，目测评估）确定相关性。获得总体和分层合并优势比（ORs）及其95% ci。在筛选的3343项研究中，纳入了21项研究（107082例患者），共26个亚群。在肺气肿存在的情况下，肺癌的总合并or值为每低衰减区增加1%为2.3 （95% CI: 2.0, 2.6; I2 = 35%； 19个亚群）和1.02 （95% CI: 1.01, 1.02； 6个亚群）。视觉评估（合并OR， 2.3; 95% CI: 1.9, 2.6; I2 = 48%； 12个子集）和定量评估（合并OR， 2.2; 95% CI: 1.8, 2.8; I2 = 3.7%； 8个子集）的研究与二分类评估的结果相当。根据6项研究（1716例患者），肺癌的总or值随着肺气肿严重程度的增加而增加，并且视觉评估的or值（轻度、轻度和中重度分别为2.5、3.7和4.5）高于基于点估计的定量评估的or值（1.9、2.2和2.5）。与无肺气肿相比，只有小叶中心肺气肿（三项研究）与肺癌相关（合并OR为2.2;95% CI: 1.5, 3.2; P < .001）。结论肺气肿的视觉和定量CT评估与肺癌的发生率相关，且随肺气肿严重程度的增加而增加。就亚型而言，只有小叶中心肺气肿与肺癌显著相关。临床试验注册号：CRD42021262163©RSNA， 2022另见Hunsaker在本期的社论。本文的在线补充材料是可用的。
Background Given the different methods of assessing emphysema, controversy exists as to whether it is associated with lung cancer. Purpose To perform a systematic review and meta-analysis of the association between chest CT-defined emphysema and the presence of lung cancer. Materials and Methods The PubMed, Embase, and Cochrane databases were searched up to July 15, 2021, to identify studies on the association between emphysema assessed visually or quantitatively with CT and lung cancer. Associations were determined by emphysema severity (trace, mild, or moderate to severe, assessed visually and quantitatively) and subtype (centrilobular and paraseptal, assessed visually). Overall and stratified pooled odds ratios (ORs) with their 95% CIs were obtained. Results Of the 3343 screened studies, 21 studies (107 082 patients) with 26 subsets were included. The overall pooled ORs for lung cancer given the presence of emphysema were 2.3 (95% CI: 2.0, 2.6; I2 = 35%; 19 subsets) and 1.02 (95% CI: 1.01, 1.02; six subsets) per 1% increase in low attenuation area. Studies with visual (pooled OR, 2.3; 95% CI: 1.9, 2.6; I2 = 48%; 12 subsets) and quantitative (pooled OR, 2.2; 95% CI: 1.8, 2.8; I2 = 3.7%; eight subsets) assessments yielded comparable results for the dichotomous assessment. Based on six studies (1716 patients), the pooled ORs for lung cancer increased with emphysema severity and were higher for visual assessment (2.5, 3.7, and 4.5 for trace, mild, and moderate to severe, respectively) than for quantitative assessment (1.9, 2.2, and 2.5) based on point estimates. Compared with no emphysema, only centrilobular emphysema (three studies) was associated with lung cancer (pooled OR, 2.2; 95% CI: 1.5, 3.2; P < .001). Conclusion Both visual and quantitative CT assessments of emphysema were associated with a higher odds of lung cancer, which also increased with emphysema severity. Regarding subtype, only centrilobular emphysema was significantly associated with lung cancer. Clinical trial registration no. CRD42021262163 © RSNA, 2022 See also the editorial by Hunsaker in this issue. Online supplemental material is available for this article.
影响因子：
5.3
作者：
Henschke, Claudia I.;Yip, Rowena;Yankelevitz, David F.
通讯作者：
Yankelevitz, David F.
影响因子：
19.7
作者：
Liu Y;Wang H;Li Q;McGettigan MJ;Balagurunathan Y;Garcia AL;Thompson ZJ;Heine JJ;Ye Z;Gillies RJ;Schabath MB
通讯作者：
Schabath MB
影响因子：
19.7
作者：
Lynch, David A.;Austin, John H. M.;Crapo, James D.
通讯作者：
Crapo, James D.