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胸部CT检测到的间质性肺异常的患病率和进展率:一项系统评价和荟萃分析。

Prevalence and progression rate of interstitial lung abnormalities detected on thoracic CT: a systematic review and meta-analysis.

作者信息

Hwang Jisun, You Seulgi, Lee Ye Jin, Sun Joo Sung

机构信息

Department of Radiology, Ajou University School of Medicine, Suwon, Republic of Korea.

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.

出版信息

Eur Radiol. 2025 Jan;35(1):276-288. doi: 10.1007/s00330-024-10952-9. Epub 2024 Jul 19.

DOI:10.1007/s00330-024-10952-9
PMID:39026064
Abstract

OBJECTIVES

To estimate the pooled prevalence and progression rate of ILAs and identify the risk factors for radiological progression.

MATERIALS AND METHODS

An EMBASE and PubMed search was undertaken, identifying all studies meeting the inclusion criteria performed before May 10, 2023. Random effect models were used to estimate pooled prevalence, ILA progression rates, and odds ratio for radiological progression based on radiological subtype. Subgroup analyses were performed to compare the general and high-risk populations for lung cancer. The quality of the included studies was evaluated using the risk of bias assessment tool for non-randomized studies.

RESULTS

We analyzed 19 studies (241,541 patients) and 10 studies (1317 patients) for the pooled prevalence and progression rate of ILA, respectively. The pooled ILA prevalence was 9.7% (95% CI, 6.1-13.9%). The pooled prevalence was 6.8% (95% CI, 3.1-11.6%) and 7.1% (95% CI, 2.2-14.4%) in the general (six studies) and high-risk population for lung cancer (six studies), respectively. The pooled progression rate was 47.1% (95% CI, 29.1-65.5%). The pooled progression rate was 64.2% (95% CI, 45.0-81.2%, five studies) and 31.0% (95% CI, 8.2-60.5%, five studies) for longer (≥ 4.5 years) and shorter follow-up periods (< 4.5 years), respectively (p = 0.009). Fibrotic ILAs were significantly associated with a higher progression probability (combined OR, 5.55; 95% CI, 1.95-15.82).

CONCLUSIONS

The prevalence of ILAs was approximately 9.7%. Approximately half of the patients exhibited radiological progression, with the rate increasing over a longer follow-up period. Fibrotic ILA was a significant risk factor for radiological progression.

CLINICAL RELEVANCE STATEMENT

The prevalence of interstitial lung abnormalities (ILAs) is approximately 9.7%, with about half exhibiting progression; a longer follow-up duration and fibrotic ILAs are associated with a higher progression rate.

KEY POINTS

ILAs are increasingly recognized as important, but few population data are available. ILAs exhibited a pooled prevalence of 9.7% with a progression rate of 47.1%. Fibrotic ILAs were associated with increased progression likelihood.

摘要

目的

估计间质性肺异常(ILA)的合并患病率和进展率,并确定影像学进展的危险因素。

材料与方法

进行了EMBASE和PubMed检索,识别出所有在2023年5月10日前进行的符合纳入标准的研究。采用随机效应模型估计合并患病率、ILA进展率以及基于影像学亚型的影像学进展优势比。进行亚组分析以比较肺癌的一般人群和高危人群。使用非随机研究的偏倚风险评估工具对纳入研究的质量进行评估。

结果

我们分别分析了19项研究(241541例患者)和10项研究(1317例患者)以获取ILA的合并患病率和进展率。ILA的合并患病率为9.7%(95%CI,6.1 - 13.9%)。在肺癌的一般人群(6项研究)和高危人群(6项研究)中,合并患病率分别为6.8%(95%CI,3.1 - 11.6%)和7.1%(95%CI,2.2 - 14.4%)。合并进展率为47.1%(95%CI,29.1 - 65.5%)。随访时间较长(≥4.5年)和较短(<4.5年)的合并进展率分别为64.2%(95%CI,45.0 - 81.2%,5项研究)和31.0%(95%CI,8.2 - 60.5%,5项研究)(p = 0.009)。纤维化ILA与更高的进展概率显著相关(合并OR,5.55;95%CI,1.95 - 15.82)。

结论

ILA的患病率约为9.7%。约一半的患者出现影像学进展,且进展率随随访时间延长而增加。纤维化ILA是影像学进展的重要危险因素。

临床相关性声明

间质性肺异常(ILA)的患病率约为9.7%,约一半出现进展;随访时间延长和纤维化ILA与更高的进展率相关。

关键点

ILA越来越被认为很重要,但可用的人群数据很少。ILA的合并患病率为9.7%,进展率为47.1%。纤维化ILA与进展可能性增加相关。

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