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Meta-Analysis
. 2023 Mar 1;38(2):W19-W29.
doi: 10.1097/RTI.0000000000000693. Epub 2022 Dec 28.

Computed Tomography Features and Tumor Spread Through Air Spaces in Lung Adenocarcinoma: A Meta-analysis

Yan Gu  1 , Bo Zheng, Tianjing Zhao, Yingjie Fan
Affiliations
Meta-Analysis

Computed Tomography Features and Tumor Spread Through Air Spaces in Lung Adenocarcinoma: A Meta-analysis

Yan Gu et al. J Thorac Imaging. .

Abstract

To compare computed tomography (CT)-based radiologic features in patients, who are diagnosed with lung adenocarcinoma with the pathologically detected spread of tumor cells through air spaces (STAS positive [STAS+]) and those with no STAS. PubMed, Embase, and Scopus databases were systematically searched for observational studies (either retrospective or prospective) of patients with lung adenocarcinoma that had compared CT-based features between STAS+ and STAS-negative cases (STAS-). The pooled effect sizes were reported as odds ratio (OR) and weighted mean difference (WMD). STATA software was used for statistical analysis. The meta-analysis included 10 studies. Compared with STAS-, STAS+ adenocarcinoma was associated with increased odds of solid nodule (OR: 3.30, 95% CI: 2.52, 4.31), spiculation (OR: 2.05, 95% CI: 1.36, 3.08), presence of cavitation (OR: 1.49, 95% CI: 1.00, 2.22), presence of clear boundary (OR: 3.01, 95% CI: 1.70, 5.32), lobulation (OR: 1.65, 95% CI: 1.11, 2.47), and pleural indentation (OR: 1.98, 95% CI: 1.41, 2.77). STAS+ tumors had significant association with the presence of pulmonary vessel convergence (OR: 2.15, 95% CI: 1.61, 2.87), mediastinal lymphadenopathy (OR: 2.06, 95% CI: 1.20, 3.56), and pleural thickening (OR: 2.58, 95% CI: 1.73, 3.84). The mean nodule diameter (mm) (WMD: 6.19, 95% CI: 3.71, 8.66) and the mean solid component (%) (WMD: 24.5, 95% CI: 10.5, 38.6) were higher in STAS+ tumors, compared with STAS- ones. The findings suggest a significant association of certain CT-based features with the presence of STAS in patients with lung adenocarcinoma. These features may be important in influencing the nature of surgical management.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
The selection process of the studies included in the meta-analysis.
FIGURE 2
FIGURE 2
Comparison of CT-based features between STAS+ and STAS− lung adenocarcinoma.
FIGURE 3
FIGURE 3
Comparison of CT-based features between STAS+ and STAS− lung adenocarcinoma (continued).
FIGURE 4
FIGURE 4
Comparison of CT-based features between STAS+ and STAS− lung adenocarcinoma (continued).
FIGURE 5
FIGURE 5
Comparison of CT-based features between STAS+ and STAS− lung adenocarcinoma (continued).
See this image and copyright information in PMC

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