Prevalence of Airflow Limitation and Emphysema in Lung Cancer Screening Populations: A Systematic Review and Meta-Analysis.

Despite the higher risk of COPD among individuals participating in lung cancer screening, many of these patients continue to show rates of underdiagnosis of lung cancer.

尽管参与肺癌筛查的个体中慢性阻塞性肺病（COPD）的风险更高，但这些患者中许多人仍然显示出肺癌诊断不足的情况。

research_question

How many participants in lung cancer screening have emphysema or airflow limitation?

在肺癌筛查中，有多少参与者患有肺气肿或气流受限？

If spirometry is incorporated into the screening, how many additional patients with airflow limitation could be identified?

如果将肺功能检测纳入筛查，还能识别出多少额外的气流受限患者？

study_design_and_methods

The Ovid-MEDLINE and Embase databases were searched from inception through November 30, 2023.

我们检索了从创建之初至2023年11月30日的Ovid-MEDLINE和Embase数据库。

We included original studies reporting the prevalenceof CT scan-confirmed emphysema and spirometry-confirmed airflow limitation.

我们纳入了报告CT扫描确诊的肺气肿和肺功能检测确诊的气流受限发生率的原始研究。

The primary outcomes were the prevalenceof emphysema and airflow limitation.

主要结果是肺气肿和气流受限的患病率。

For studies reporting severity, we analyzed the percentage of mild vs moderate to severe disease.

对于报告疾病严重程度的研究，我们分析了轻度与中度至重度疾病的百分比。

We also calculated the proportion of newly confirmed cases of airflow limitation via spirometry.

我们还计算了通过肺功能检测新确诊的气流受限病例的比例。

Results

In total, 42 studies were included (emphysema, n = 18; airflow limitation, n = 13; both, n = 11), comprising 126,842 individuals with emphysema and 72,209 individuals with airflow limitation.

总共纳入了42项研究（肺气肿，n=18；气流受限，n=13；两者兼有，n=11），涵盖了126,842名肺气肿患者和72,209名气流受限患者。

The pooled prevalenceof emphysema was 45.3% (95% CI, 39.3%-51.2%), and that of airflow limitation was 40.1% (95% CI, 33.4%-46.8%).

肺气肿的综合患病率为45.3%（95%置信区间，39.3%-51.2%），而气流受限的患病率为40.1%（95%置信区间，33.4%-46.8%）。

Moderate to severe emphysema was observed in 28.8% of patients with emphysema (95% CI, 24.2%-33.4%), whereas 54.3% patients with airflow limiation (95% CI, 40.6%-60.6%) showed moderate to very severe airflow limitation.

在患有肺气肿的患者中，观察到28.8%的患者存在中度至重度肺气肿（95%置信区间，24.2%-33.4%），而54.3%的气流受限患者（95%置信区间，40.6%-60.6%）表现出中度至重度气流受限。

Furthermore, 65.2% of patients with airflow limitation (95% CI, 55.7%-74.7%) identified by spirometry had been unrecognized previously.

此外，通过肺功能检测识别出的65.2%（95%置信区间，55.7%-74.7%）的气流受限患者之前未被诊断。

interpretation

Among screening participants, 45.3% demonstrated emphysema and 40.1% demonstrated airflow limitation, with 28.8% and 54.3% of these patients showing moderate to severe disease, respectively.

在筛查参与者中，45.3%显示出肺气肿，40.1%显示出气流受限，其中28.8%和54.3%的患者分别显示出中度至重度疾病。

Furthermore, 65% of patients with airflow limitation had not received a diagnosis previously.

此外，65%的气流受限患者之前未曾接受过诊断。

These findings suggest that incorporating spirometry into screening programs may enhance COPD detection and management.

这些发现表明，将肺功能检测纳入筛查计划可能会提高COPD的检测和管理。

clinical_trial_registry

International Prospective Register of Systematic Reviews; No.: CRD42024513248; URL: https://www.crd.york.ac.uk/prospero/.

国际前瞻性系统评价注册; 编号: CRD42024513248; 网址: https://www.crd.york.ac.uk/prospero/