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间质性肺异常的临床结局:系统评价和荟萃分析。

Clinical outcomes of interstitial lung abnormalities: a systematic review and meta-analysis.

机构信息

Division of Allergy and Respiratory Diseases, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, 04401, Republic of Korea.

Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, 14584, Republic of Korea.

出版信息

Sci Rep. 2024 Mar 27;14(1):7330. doi: 10.1038/s41598-024-57831-3.

Abstract

Interstitial lung abnormalities (ILA), incidental findings on computed tomography scans, have raised concerns due to their association with worse clinical outcomes. Our meta-analysis, which included studies up to April 2023 from PubMed/MEDLINE, Embase, and Cochrane Library, aimed to clarify the impact of ILA on mortality, lung cancer development, and complications from lung cancer treatments. Risk ratios (RR) with 95% confidence intervals (CI) were calculated for outcomes. Analyzing 10 studies on ILA prognosis and 9 on cancer treatment complications, we found that ILA significantly increases the risk of overall mortality (RR 2.62, 95% CI 1.94-3.54; I = 90%) and lung cancer development (RR 3.85, 95% CI 2.64-5.62; I = 22%). Additionally, cancer patients with ILA had higher risks of grade 2 radiation pneumonitis (RR 2.28, 95% CI 1.71-3.03; I = 0%) and immune checkpoint inhibitor-related interstitial lung disease (RR 3.05, 95% CI 1.37-6.77; I = 83%) compared with those without ILA. In conclusion, ILA significantly associates with increased mortality, lung cancer risk, and cancer treatment-related complications, highlighting the necessity for vigilant patient management and monitoring.

摘要

间质性肺异常 (ILA) 是计算机断层扫描 (CT) 扫描的偶然发现,由于其与更差的临床结局相关,引起了人们的关注。我们的荟萃分析纳入了截至 2023 年 4 月来自 PubMed/MEDLINE、Embase 和 Cochrane Library 的研究,旨在阐明 ILA 对死亡率、肺癌发展和肺癌治疗并发症的影响。使用风险比 (RR) 和 95%置信区间 (CI) 计算结局的风险。我们分析了 10 项关于 ILA 预后的研究和 9 项关于癌症治疗并发症的研究,发现 ILA 显著增加了总死亡率 (RR 2.62,95% CI 1.94-3.54;I = 90%) 和肺癌发展的风险 (RR 3.85,95% CI 2.64-5.62;I = 22%)。此外,患有 ILA 的癌症患者发生 2 级放射性肺炎的风险更高 (RR 2.28,95% CI 1.71-3.03;I = 0%) 和免疫检查点抑制剂相关的间质性肺病 (RR 3.05,95% CI 1.37-6.77;I = 83%),而无 ILA 的癌症患者则没有。总之,ILA 与死亡率、肺癌风险和癌症治疗相关并发症的增加显著相关,这突出了对患者进行警惕性管理和监测的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f20b/10973382/921b58baceec/41598_2024_57831_Fig1_HTML.jpg

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