Yang Qianfang, Wang Fan, Cao Hongxin
Heilongjiang University of Traditional Chinese Medicine, China.
Harbin Medical University, China.
Clinics (Sao Paulo). 2025 May 7;80:100669. doi: 10.1016/j.clinsp.2025.100669. eCollection 2025.
The growth of ground-glass nodules in the lungs is an independent risk factor for the occurrence of lung cancer, which provides the basic conditions for the occurrence of lung cancer. However, risk factors for the growth of ground-glass nodules in the lungs have not been fully identified. The purpose of this meta-analysis was to assess risk factors for the growth of ground-glass nodules in the lungs.
Computerized searches of the electronic databases of PubMed, Web of Science, Cochrane Library and Scopus for published studies on risk factors for the growth of ground-glass nodules in the lungs. The search time limit is from the establishment of the database to March 2024. Two review authors independently searched the studies according to the inclusion and exclusion criteria, and the quality of the selected studies was evaluated using the Newcastle-Ottawa Scale (NOS), and RevMan 5.4 software was used for meta-analysis. This review is registered in the International Prospective Register of Systematic Reviews (PROSPERO) (identifier CRD42024499763).
Fourteen studies involving 2059 patients were included, and 14 statistically significant risk factors were identified. The results of meta-analysis showed that age (WMD = 4.61, 95 % CI [1.73∼7.49], p = 0.002), female (OR = 0.65, 95 % CI [0.51∼0.82], p = 0.0003), history of smoking (OR = 1.76, 95 % CI [1.07∼2.92], p = 0.03), history of malignancy (OR = 1.53, 95 % CI [1.16∼2.02], p = 0.003), lesion size (≥ 8 mm) (OR = 1.19, 95 % CI [1.12∼1.26], p < 0.00001), air bronchial sign (OR = 6.09, 95 % CI [3∼12.33], p < 0.00001), lobulation sign (OR = 2.3, 95 % CI [1.58∼3.36], p < 0.00001), spiculated sign (OR = 5.56, 95 % CI [1.39∼22.3], p = 0.02), vascular bundle sign [OR = 2.54, 95 % CI [1.85∼3.48], p < 0.00001), initial diameter (≥ 8 mm) (OR = 1.89, 95 % CI [1.34∼2.67], p = 0.0003), vacuolar sign (OR = 2.62, 95 % CI [1.46∼4.69], p = 0.001), solid nodules (OR = 4.6, 95 % CI [1.96∼10.79], p = 0.0005), solid components (OR = 13.77, 95 % CI [7.08∼26.78], p < 0.00001) and nodule roundness (OR = 2.85, 95 % CI [1.19∼6.81], p = 0.02) were risk factors for the growth of ground-glass nodules in the lungs. However, pleural adhesion (p = 0.47) and pleural retraction (p = 0.07) were not statistically significant.
This systematic review and meta-analysis showed that there are many risk factors for the growth of ground-glass nodules in the lungs, and medical staff should identify the above risk factors as early as possible in clinical work and formulate targeted interventions for precise prevention.
肺磨玻璃结节的生长是肺癌发生的独立危险因素，为肺癌的发生提供了基础条件。然而，肺磨玻璃结节生长的危险因素尚未完全明确。本荟萃分析的目的是评估肺磨玻璃结节生长的危险因素。
通过计算机检索PubMed、Web of Science、Cochrane图书馆和Scopus的电子数据库，查找关于肺磨玻璃结节生长危险因素的已发表研究。检索时间范围为数据库建立至2024年3月。两名综述作者根据纳入和排除标准独立检索研究，并使用纽卡斯尔-渥太华量表（NOS）评估所选研究的质量，使用RevMan 5.4软件进行荟萃分析。本综述已在国际系统评价前瞻性注册库（PROSPERO）注册（标识符CRD42024499763）。
纳入14项研究，共2059例患者，确定了14个具有统计学意义的危险因素。荟萃分析结果显示，年龄（加权均数差[WMD]=4.61，95%置信区间[CI][1.73～7.49]，p=0.002）；女性（比值比[OR]=0.65，95%CI[0.51～0.82]，p=0.0003）；吸烟史（OR=1.76，95%CI[1.07～2.92]，p=0.03）；恶性肿瘤史（OR=1.53，95%CI[1.16～2.02]，p=0.003）；病变大小（≥8mm）（OR=1.19，95%CI[1.12～1.26]，p<0.00001）；空气支气管征（OR=6.09，95%CI[3～12.33]，p<0.00001）；分叶征（OR=2.3，95%CI[1.58～3.36]，p<0.00001）；毛刺征（OR=5.56，95%CI[1.39～22.3]，p=0.02）；血管束征[OR=2.54，95%CI[1.85～3.48]，p<0.00001]；初始直径（≥8mm）（OR=1.89，95%CI[1.34～2.67]，p=0.0003）；空泡征（OR=2.62，95%CI[1.46～4.69]，p=0.001）；实性结节（OR=4.6，95%CI[1.96～10.79]，p=0.0005）；实性成分（OR=13.77，95%CI[7.08～26.78]，p<0.00001）及结节圆度（OR=2.85，95%CI[1.19～6.81]，p=0.02）是肺磨玻璃结节生长的危险因素。然而，胸膜粘连（p=0.47）和胸膜凹陷（p=0.07）无统计学意义。
本系统评价和荟萃分析表明，肺磨玻璃结节生长存在多种危险因素，医务人员在临床工作中应尽早识别上述危险因素，并制定针对性干预措施进行精准预防。
