| Objective:To explore the risk factors of benign and malignant solitary pulmonary nodules by meta-analysis.That is to say,the benign and malignant of solitary pulmonary nodules are mainly evaluated according to clinical features and CT signs,and then used as a tool to guide clinical decision-making.Methods:We searched of The PubMed and Cochrane Library databases,and collect relevant literatures published in domestic and foreign journals on predictors of benign and malignant solitary pulmonary nodules from the establishment of the database to November 2018.Literatures were screened according to inclusion and exclusion criteria,and the qualified literatures were evaluated for literature quality.Literatures with medium or high quality score were selected,and relevant data were extracted from the included literature.Finally,Meta analysis was conducted using Review Manager 5.3software.Results:Thirteen articles were eventually included,totaling 5676 patients.Among them,1724 cases were benign and 3952 cases were malignant.The patient data collected in this study included clinical and CT imaging data.The Clinical data included the patient's gender,age,smoking history,family history of cancer and previous history of malignant tumors.CT images included nodule diameter,location,clear margin,lobulation sign,spiculation sign,vascular cluster sign,pleural indentation sign,air bronchus sign,vacuole sign,cavity sign and calcification.A meta-analysis of data on a total of 16 risk factors.The statistical results showed that there was no significant difference in the incidence of gender between the benign and malignant groups,and the difference was not statistically significant [Male OR = 0.98,95%CI(0.87,1.10),P >0.05;Female OR = 1.02,95%CI(0.91,1.14),P > 0.05].The age of the malignant group was significantly higher than that of the benign group,and the difference was statistically significant [MD=8.18,95%CI(5.30,11.06),P<0.05].The incidence of smoking in the malignant group was higher than that in the benign group,and the difference was statistically significant [OR=1.51,95%CI(1.10,2.06),P<0.05].Theincidence of family history of cancer in the malignant group was significantly higher than that in the benign group,and the difference was statistically significant [OR=2.93,95%CI(2.23,3.84),P<0.05].The incidence of previous history of malignant tumors in the malignant group was significantly higher than that in the benign group,and the difference was statistically significant [OR=2.31,95%CI(1.68,3.18),P<0.05].The diameter of the malignant nodules(mm)was significantly greater than that of the benign group,and the difference was statistically significant [MD=3.04,95%CI(1.53,4.55),P<0.05].The incidence of spiculation sign in the malignant group was significantly higher than that in the benign group,and the difference was statistically significant[OR=5.72,95%CI(3.74,8.77),P<0.05].The incidence of lobulation sign in the malignant group was significantly higher than that in the benign group,and the difference was statistically significant[OR=3.40,95%CI(1.90,6.99),P<0.05].The incidence of pleural indentation sign in the malignant group was significantly higher than that in the benign group,and the difference was statistically significant[OR=2.68,95%CI(2.28,3.16),P<0.05].The incidence of calcification in the malignant group was significantly lower than that in the benign group,and the difference was statistically significant [OR=0.18,95%CI(0.10,0.31),P<0.05].The incidence of vacuole sign in the malignant group was significantly higher than that in the benign group,and the difference was statistically significant [OR=2.76,95%CI(1.60,4.78),P<0.05].The incidence of cavity sign in the malignant group was not significantly different from that in the benign group,and the difference was not statistically significant [OR=1.25,95%CI(0.83,1.88),P>0.05].The incidence of vascular cluster sign in the malignant group was significantly higher than that in the benign group,and the difference was statistically significant [OR=2.15,95%CI(1.15,4.00),P<0.05].The incidence of clear margin in the malignant group was significantly lower than that in the benign group,and the difference was statistically significant[OR=0.35,95%CI(0.18,0.67),P<0.05].The incidence of air bronchus sign in the malignant group was significantly higher than that in the benign group,and the difference was statistically significant[OR=4.46,95%CI(1.85,10.72),P<0.05].The incidence of nodules in the upper in the malignant group was higher than that in the benign group,and the difference was statistically significant [OR=1.42,95%CI(1.26,1.60),P<0.05].Conclusion:Patient's age,smoking history,family history of cancer,previous history of malignant tumors,nodule diameter,spiculation sign,lobulation sign,pleural indentation sign,vacuole sign,vascular cluster sign,air bronchus sign,nodule in the upper lobe are risk factors for predicting the malignancy of solitary pulmonary nodules.Calcification of the pulmonary nodules and clear margin are protective factors for predicting the benign of solitary pulmonary nodules. |
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