肺癌是肺纤维化和肺气肿（CPFE）的重要并发症。与单纯特发性肺纤维化(IPF)患者相比,普通间质性肺炎(UIP)患者患肺癌的风险是否更高,仍然有争议。我们进行了系统评价和荟萃分析，以评估与IPF患者相比，UIPCPFE患者中肺癌的患病率。
我们搜索了PubMed,Embase,和Cochrane数据库，用于研究CPFE/UIP和IPF组中肺癌的发病率。我们使用固定效应模型根据数据异质性以95%置信区间(CI)分析比值比(OR)。通过累积荟萃分析评估基于发表年份和样本量的累积效应。
共有9项研究，933名患者，包括374名患有UIP的CPFE患者，符合纳入标准。总的来说,与单纯IPF相比，UIPCPFE患者患肺癌的风险更高（OR=2.69；95％CI：1.78-4.05）。存在肺气肿的CPFE/UIP患者的肺癌风险增加（OR=2.93;95％CI：1.79-4.79）或肺气肿在肺容积的10％（OR=2.22;95％CI：1.06-4.68）。
我们的系统评价和荟萃分析显示，与单纯IPF患者相比，UIP患者的肺癌患病率明显更高。本文的评论可通过补充材料部分获得。
Lung cancer is an important complication of combined pulmonary fibrosis and emphysema (CPFE). Whether the risk of lung cancer is higher in CPFE patients with usual interstitial pneumonia (UIP) than those with idiopathic pulmonary fibrosis (IPF) alone, remains controversial. We conducted this systematic
review and meta-analysis to evaluate the prevalence of lung cancer in CPFE patients with UIP compared with IPF patients.
We searched the PubMed, Embase, and Cochrane databases for studies that focused on the incidence of lung cancer in CPFE/UIP and IPF groups. We used a fixed-effects model to analyze the odds ratios (ORs) with 95% confidence intervals (CIs) according to data heterogeneity. The cumulative effects based on the publication year and sample size were assessed by cumulative meta-analysis.
A total of nine studies with 933 patients, including 374 CPFE patients with UIP, fulfilled the inclusion criteria. Overall, CPFE patients with UIP have a higher risk of lung cancer than those with IPF alone (OR = 2.69; 95% CI: 1.78-4.05). There were increased risks of lung cancer in CPFE/UIP patients with the presence of emphysema (OR = 2.93; 95% CI: 1.79-4.79) or emphysema in ⩾10% of the lung volume (OR = 2.22; 95% CI: 1.06-4.68).
Our systematic
review and meta-analysis indicated a significantly higher prevalence of lung cancer in CPFE patients with UIP than in patients with IPF alone.The reviews of this paper are available via the supplemental material section.
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