Prevalence and prognostic significance of interstitial lung abnormalities in lung cancer: A meta-analysis

With the increasing popularity of lung cancer screening (LCS), substantial incidental findings in CT have been identified, particularly interstitial lung abnormalities (ILAs). ILAs have been reported in several studies on lung cancer. However, the relationship between ILAs and lung cancer has not been comprehensively investigated.

To explore the occurrence of ILAs in lung cancer and its effect on the prognosis of lung cancer.

PubMed, Web of Science, Embase, and Scopus were searched for relevant publications. Pooled prevalence, odds ratios (ORs), and hazard ratios (HRs) were utilized to assess the prevalence of ILAs and their association with clinical outcomes in lung cancer. This study was performed in line with PRISMA and was registered at PROSPERO.

Twenty-four studies involving 7859 patients were identified. The prevalence of ILAs in lung cancer was 17 % (unadjusted, 95 % confidence interval [CI]: 13 %-21 %), and the prevalence after correction was 9 % (95 %CI: 6 %-13 %), while reticulation and ground glass attenuation are the main imaging patterns. ILAs are also associated with shortened overall survival in lung cancer (HR = 2.01, 95 %CI: 1.71-2.36) and increased risk of checkpoint inhibitor pneumonia (OR = 2.86, 95 %CI: 1.42-5.75) and radiation pneumonitis (OR = 2.98, 95 %CI: 1.39-6.38).

ILAs are unignorable and associated with poor outcomes of treatment and survival in patients with lung cancer. Therefore, clinicians should focus on these patients with ILAs during lung cancer diagnosis and treatment. Standardized identification and reporting of ILAs in chest CT examinations are also crucial.