Meta-analysis of the changes in clinical features and characteristics of lung cancer under bronchoscopy.

Abstract

Objective: This study aims to summarize the clinical features and evolutionary changes of lung cancer under bronchoscopy.

Methods: Relevant literature on the "clinical characteristics and evolving features of lung cancer observed under bronchoscopy" was retrieved from Chinese and English databases, including CNKI, Wanfang, VIP, PubMed, and Web of Science.

Results: A total of 21 studies published between 2005 and 2023 were included, involving 8,892 patients, with 10 studies in English and 11 in Chinese. All studies were analyzed using a random-effects model with the Freeman-Tukey double arcsine transformation for meta-analysis of single proportions. The pooled estimate for the diagnostic accuracy of bronchoscopy in lung cancer was 2.22 (95% CI: 2.10-2.34; Q=42.21, P<0.01). Regarding pathological types, the pooled estimates were 1.20 for lung squamous cell carcinoma (95% CI: 0.90-1.50; Q=328.08, P<0.01), 0.77 for small cell lung cancer (95% CI: 0.62-0.93; Q=219.43, P<0.01), 0.67 for non-small cell lung cancer (95% CI: 0.49-0.86; Q=66.84, P<0.01), and 1.53 for lung adenocarcinoma (95% CI: 1.06-2.01; Q=2096.93, P<0.01). For age distribution, the pooled estimate was 1.45 for patients aged ≥60 years (95% CI: 0.91-1.99; Q=886.54, P<0.01) and 1.69 for patients aged <60 years (95% CI: 1.15-2.23; Q=886.54, P<0.01). The pooled estimates for male and female patients were 1.59 (95% CI: 1.17-2.02; Q=983.83, P<0.01) and 1.55 (95% CI: 1.12-1.97; Q=983.83, P<0.01), respectively. Regarding bronchoscopic morphological patterns, the pooled estimates were 1.50 for proliferative-type lung cancer (95% CI: 1.25-1.74; Q=180.64, P<0.01), 1.14 for infiltrative-type lung cancer (95% CI: 0.94-1.35; Q=225.58, P<0.01), and 0.83 for lung cancer with non-specific bronchoscopic changes (95% CI: 0.60-1.06; Q=498.02, P<0.01). Meta-regression analysis of lung adenocarcinoma indicated that publication year and study design were significant sources of heterogeneity among the included studies (P<0.01).

Conclusion: Among lung cancers diagnosed by bronchoscopy, lung adenocarcinoma was the predominant pathological type, and the proliferative type was the most common bronchoscopic morphological pattern. Most patients were younger than 60 years, and the proportion of male patients was slightly higher than that of female patients.