Prevalence, Risk Factors, and Outcomes of Adult Interstitial Lung Abnormalities: A Systematic Review and Meta-Analysis

Grant-Orser, Amanda; Min, B.; Elmrayed, Seham; Podolanczuk, Anna J.; Johannson, Kerri A.

doi:10.1164/rccm.202302-0271oc

Cited by 25 publications

(9 citation statements)

References 49 publications

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“…Our findings are consistent with previous research demonstrating that ILA and indeterminate ILA are associated with increased mortality compared to non-ILA individuals 3 , 7 , 9 , 11 , 16 – 18 . Recent meta-analyses reported a higher pooled mortality risk in individuals with ILAs compared to those without (odds ratio (OR), 3.56; 95% CI 2.19–5.81) 7 , which aligns with our findings. However, our study extends its analysis by examining cause-specific mortality in the ILA, specifically identifying associations with lung cancer and respiratory-related causes of death.…”

Section: Discussionsupporting

confidence: 93%

“…Within the spectrum of ILD, interstitial lung abnormalities (ILA) have emerged as incidental radiographic findings on computed tomography (CT) scans of the lungs 2 . The prevalence of ILA is 2–7% in the general population 3 – 7 and 4–9% in individuals with a history of smoking 3 , 7 – 11 . Notably, a recent meta-analysis reported an ILA prevalence of 26% in familial pulmonary fibrosis cohorts 7 .…”

Section: Introductionmentioning

confidence: 99%

“…The prevalence of ILA is 2–7% in the general population 3 – 7 and 4–9% in individuals with a history of smoking 3 , 7 – 11 . Notably, a recent meta-analysis reported an ILA prevalence of 26% in familial pulmonary fibrosis cohorts 7 . Several risk factors have been proposed for the development of ILA, including advanced age, male sex, lower forced vital capacity (FVC)% predicted, smoking history, genetic mutations (e.g., MUC5B ), and exposure to occupational and environmental pollutants 3 , 4 , 7 , 12 – 15 .…”

Section: Introductionmentioning

confidence: 99%

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Clinical outcomes of interstitial lung abnormalities: a systematic review and meta-analysis

Seok,

Park,

Yoon

et al. 2024

Sci Rep

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Interstitial lung abnormalities (ILA), incidental findings on computed tomography scans, have raised concerns due to their association with worse clinical outcomes. Our meta-analysis, which included studies up to April 2023 from PubMed/MEDLINE, Embase, and Cochrane Library, aimed to clarify the impact of ILA on mortality, lung cancer development, and complications from lung cancer treatments. Risk ratios (RR) with 95% confidence intervals (CI) were calculated for outcomes. Analyzing 10 studies on ILA prognosis and 9 on cancer treatment complications, we found that ILA significantly increases the risk of overall mortality (RR 2.62, 95% CI 1.94–3.54; I2 = 90%) and lung cancer development (RR 3.85, 95% CI 2.64–5.62; I2 = 22%). Additionally, cancer patients with ILA had higher risks of grade 2 radiation pneumonitis (RR 2.28, 95% CI 1.71–3.03; I2 = 0%) and immune checkpoint inhibitor-related interstitial lung disease (RR 3.05, 95% CI 1.37–6.77; I2 = 83%) compared with those without ILA. In conclusion, ILA significantly associates with increased mortality, lung cancer risk, and cancer treatment-related complications, highlighting the necessity for vigilant patient management and monitoring.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical outcomes of interstitial lung abnormalities: a systematic review and meta-analysis

Seok,

Park,

Yoon

et al. 2024

Sci Rep

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“…ILA is considered to be an early stage of fibrotic lung disease (4), and there is a strong correlation between ILA and lung cancer (5). Numerous studies (5,6) indicating an increased occurrence of lung cancer and heightened pulmonary complications following cancer therapy in ILA patients. Additionally, some studies (7)(8)(9)(10)(11)(12)(13)(14) suggest that combined ILA significantly worsens the prognosis in lung cancer patients.…”

Section: Introductionmentioning

confidence: 99%

Prognostic impact of interstitial lung abnormalities in lung cancer: a systematic review and meta-analysis

Tang,

Sun,

Guo

et al. 2024

Front. Oncol.

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BackgroundNewly identified as a radiological concept, interstitial lung abnormalities (ILA) is emerging as a prognostic factor for lung cancer. Yet, debates persist regarding the prognostic significance of ILA in lung cancer. Our inaugural meta-analysis aimed to investigate the correlation between ILA and lung cancer outcomes, offering additional insights for clinicians in predicting patient prognosis.MethodsArticles meeting the criteria were found through PubMed, the Cochrane Library, EMBASE, and Web of Science by February 29, 2024. The outcomes evaluated were the survival rates such as overall survival (OS), disease-free survival (DFS), progression-free survival (PFS), and cancer-specific survival (CSS).ResultsA total of 12 articles with 4416 patients were included in this meta-analysis. The pooled results showed that lung cancer patients with interstitial lung abnormalities had an inferior OS (n=11; HR=2.22; 95% CI=1.68-2.95; P<0.001; I2 = 72.0%; Ph<0.001), PFS (n=3; HR=1.59; 95% CI=1.08-2.32; P=0.017; I2 = 0%; Ph=0.772), and CSS (n=2; HR=4.00; 95% CI=1.94-8.25; P<0.001; I2 = 0%; Ph=0.594) than those without, however, the ILA was not significantly associated with the DFS (n=2; HR=2.07; 95% CI=0.94-7.02; P=0.066; I2 = 90.4%; Ph=0.001). Moreover, lung cancer patients with ILA were significantly correlated with male (OR=2.43; 95% CI=1.48-3.98; P<0.001), smoking history (OR=2.11; 95% CI=1.37-3.25; P<0.001), advanced age (OR=2.50; 95% CI=1.56-4.03; P<0.001), squamous carcinoma (OR=0.42; 95% CI=0.24-0.71; P=0.01), and EGFR mutation (OR=0.50; 95% CI=0.32-0.78; P=0.002). The correlation between ILA and race, stage, ALK, however, was not significant.ConclusionILA was a availability factors of prognosis in patients with lung cancers. These findings highlight the importance of early pulmonary fibrosis, namely ILA for prognosis in patients with lung cancer, and provide a partial rationale for future clinical work.

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“…In addition to IPF, the investigators applied the PRS methodology to ILAs, which are abnormal interstitial changes affecting >5% of lung parenchyma on computed tomography scan ( 9 ). ILAs are detectable in approximately 7% of individuals >50 years of age and can in some instances precede development of clinical IPF by several years ( 10 ). In ILA studies, the PRS model was associated with presence (odds ratio, 1.25) and progression (odds ratio, 1.16) of ILAs; however, this association was only observed in subjects with European ancestry.…”

mentioning

confidence: 99%

PRS-ing Forward to Identify Genetic Risk in Idiopathic Pulmonary Fibrosis

Blackwell,

Gudmundsson

2023

Am J Respir Crit Care Med

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Prevalence, Risk Factors, and Outcomes of Adult Interstitial Lung Abnormalities: A Systematic Review and Meta-Analysis

Cited by 25 publications

References 49 publications

Clinical outcomes of interstitial lung abnormalities: a systematic review and meta-analysis

Clinical outcomes of interstitial lung abnormalities: a systematic review and meta-analysis

Prognostic impact of interstitial lung abnormalities in lung cancer: a systematic review and meta-analysis

PRS-ing Forward to Identify Genetic Risk in Idiopathic Pulmonary Fibrosis

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