Risk factors for the growth of ground-glass nodules in the lungs: A systematic review and meta-analysis.

Objective: The growth of ground-glass nodules in the lungs is an independent risk factor for the occurrence of lung cancer, which provides the basic conditions for the occurrence of lung cancer. However, risk factors for the growth of ground-glass nodules in the lungs have not been fully identified. The purpose of this meta-analysis was to assess risk factors for the growth of ground-glass nodules in the lungs.

Methods: Computerized searches of the electronic databases of PubMed, Web of Science, Cochrane Library and Scopus for published studies on risk factors for the growth of ground-glass nodules in the lungs. The search time limit is from the establishment of the database to March 2024. Two review authors independently searched the studies according to the inclusion and exclusion criteria, and the quality of the selected studies was evaluated using the Newcastle-Ottawa Scale (NOS), and RevMan 5.4 software was used for meta-analysis. This review is registered in the International Prospective Register of Systematic Reviews (PROSPERO) (identifier CRD42024499763).

Results: Fourteen studies involving 2059 patients were included, and 14 statistically significant risk factors were identified. The results of meta-analysis showed that age (WMD = 4.61, 95 % CI [1.73∼7.49], p = 0.002), female (OR = 0.65, 95 % CI [0.51∼0.82], p = 0.0003), history of smoking (OR = 1.76, 95 % CI [1.07∼2.92], p = 0.03), history of malignancy (OR = 1.53, 95 % CI [1.16∼2.02], p = 0.003), lesion size (≥ 8 mm) (OR = 1.19, 95 % CI [1.12∼1.26], p < 0.00001), air bronchial sign (OR = 6.09, 95 % CI [3∼12.33], p < 0.00001), lobulation sign (OR = 2.3, 95 % CI [1.58∼3.36], p < 0.00001), spiculated sign (OR = 5.56, 95 % CI [1.39∼22.3], p = 0.02), vascular bundle sign [OR = 2.54, 95 % CI [1.85∼3.48], p < 0.00001), initial diameter (≥ 8 mm) (OR = 1.89, 95 % CI [1.34∼2.67], p = 0.0003), vacuolar sign (OR = 2.62, 95 % CI [1.46∼4.69], p = 0.001), solid nodules (OR = 4.6, 95 % CI [1.96∼10.79], p = 0.0005), solid components (OR = 13.77, 95 % CI [7.08∼26.78], p < 0.00001) and nodule roundness (OR = 2.85, 95 % CI [1.19∼6.81], p = 0.02) were risk factors for the growth of ground-glass nodules in the lungs. However, pleural adhesion (p = 0.47) and pleural retraction (p = 0.07) were not statistically significant.

Conclusion: This systematic review and meta-analysis showed that there are many risk factors for the growth of ground-glass nodules in the lungs, and medical staff should identify the above risk factors as early as possible in clinical work and formulate targeted interventions for precise prevention.