Li Mengqian, Zhang Xiaomei, Lai Yuxin, Sun Yunlong, Yang Tianshu, Tan Xinlei
Department of Internal Medicine of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.
Department of Pulmonary Nodules and Chest Diseases Center, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China.
Front Oncol. 2025 Jan 29;14:1477730. doi: 10.3389/fonc.2024.1477730. eCollection 2024.
CNKI, Wanfang, VIP, Sinomed, Pubmed, Web of Science, Embase, and other databases were searched. The retrieval time was from the establishment of the database to January 31, 2024. We included all predictive models for the invasion of ground-glass pulmonary nodules established. The modeling group was patients with a pathological diagnosis of ground-glass pulmonary nodules. Two researchers screened the literature, established an Excel table for information extraction, used SPSS 25.0 to perform frequency statistics of each independent risk factor, and used Revman 5.4 software for meta-analysis.
A total of 29 articles were included, involving 30 independent risk factors, with a cumulative frequency of 99 times. There were 16 risk factors with a frequency of ≥2 times, a total of 85 times, accounting for 85.86%. The meta-analysis showed the following: average CT value (MD = 75.57 HU, 95%CI: 44.40-106.75), maximum diameter (MD = 4.99 mm, 95%CI: 4.22-5.77), vascular convergence sign (OR = 11.16, 95%CI: 6.71-18.56), lobulation sign (OR = 3.80, 95%CI: 1.59-9.09), average diameter (MD = 4.46 mm, 95%CI: 3.44-5.48), maximum CT value (MD = 112.52 HU, 95%CI: 8.08-216.96), spiculation sign (OR = 4.46, 95%CI: 2.03-9.81), volume (MD = 1,069.37 mm, 95%CI: 1,025.75-1,112.99), vacuole sign (OR = 6.15, 95%CI: 2.70-14.01), CTR ≥0.5 (OR = 7.24, 95%CI: 3.35-15.65), vascular type [types III and IV] (OR = 13.62, 95%CI: 8.85-20.94), pleural indentation (OR = 6.92, 95%CI: 2.69-17.82), age (MD = 4.18years, 95%CI: 1.70-6.65), and mGGN (OR = 3.62, 95%CI: 2.36-5.56) were risk factors for infiltration of ground-glass nodules. The overall risk of bias in the methodological quality evaluation of the included studies was small, and the AUC value of the model was 0.736-0.977.
The included model has a good predictive performance for the invasion of ground-glass nodules. The independent risk factors included in the model can help medical workers to identify the high-risk groups of invasive lung cancer in ground-glass nodules in time and improve the prognosis.
检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、Web of Science、Embase等数据库。检索时间为各数据库建库至2024年1月31日。纳入所有已建立的磨玻璃肺结节侵袭性预测模型。建模组为病理诊断为磨玻璃肺结节的患者。两名研究人员筛选文献,建立Excel表进行信息提取,使用SPSS 25.0对各独立危险因素进行频数统计,并使用Revman 5.4软件进行Meta分析。
共纳入29篇文章,涉及30个独立危险因素,累计出现频数99次。频数≥2次的危险因素有16个,共85次,占85.86%。Meta分析结果如下:平均CT值(MD = 75.57 HU,95%CI:44.40 - 106.75)、最大直径(MD = 4.99 mm,95%CI:4.22 - 5.77)、血管集束征(OR = 11.16,95%CI:6.71 - 18.56)、分叶征(OR = 3.80,95%CI:1.59 - 9.09)、平均直径(MD = 4.46 mm,95%CI:3.44 - 5.48)、最大CT值(MD = 112.52 HU,95%CI:8.08 - 216.96)、毛刺征(OR = 4.46,95%CI:2.03 - 9.81)、体积(MD = 1069.37 mm,95%CI:1025. \n75 - 1112.99)、空泡征(OR = 6.15,95%CI:2.70 - 14.01)、CTR≥0.5(OR = 7.24,95%CI:3.35 - 15.65)、血管类型[III型和IV型](OR = 13.62,95%CI:8.85 - 20.94)、胸膜凹陷征(OR = 6.92,95%CI:2.69 - 17.82)、年龄(MD = 4.18岁,95%CI:1.70 - 6.65)及混合磨玻璃结节(mGGN)(OR = 82,95%CI:2.36 - 5.56)为磨玻璃结节浸润的危险因素。纳入研究的方法学质量评价中总体偏倚风险较小,模型的AUC值为0.736 - 0.977。
纳入的模型对磨玻璃结节侵袭性具有良好的预测性能。模型中的独立危险因素有助于医务人员及时识别磨玻璃结节中浸润性肺癌的高危人群,改善预后。