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Association between Chest CT–defined Emphysema and Lung Cancer: A Systematic Review and Meta-Analysis
Autores: Xiaofei Yang, MD • Hendrik Joost Wisselink, MSc • Rozemarijn Vliegenthart, MD, PhD • Marjolein A. Heuvelmans, MD, PhD • Harry J. M. Groen, MD, PhD • Marleen Vonder, PhD • Monique D. Dorrius, MD, PhD • Geertruida H. de Bock, PhD
Objetivo:
describir los hallazgos de imagen clave en los estudios de RM estructural de las demen- cias de origen neurodegenerativo más frecuentes: enfermedad de Alzheimer, demencia vascular, demencia de cuerpos de Lewy, variantes de la demencia frontotemporal, parálisis supranu- clear progresiva, variantes de la atrofia multisistémica, parkinson-demencia y degeneración corticobasal.
Conclusión:
El papel de la resonancia magnética hoy en día ya no está limitado a excluir causas subyacentes de deterioro cognitivo, sino que puede mostrar patrones de atrofia y otros datos con un alto valor predictivo para determinadas demencias que, aunque no son específicos ni únicos de cada patología, pueden ayudar a confirmar una sospecha diagnóstica o a identificar inicios tempranos de determinados procesos. Por ello es importante que los radiólogos conozcan los hallazgos típicos de las demencias más frecuentes.
Palabras clave: Resonancia magnética; Atrofia; Demencia; Enfermedad de Alzheimer; Parálisis supranuclear progresiva; Demencia vascular; Atrofia multisistémica; Enfermedad de Parkinson; Demencia frontotemporal
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Background:
Given the different methods of assessing emphysema, controversy exists as to whether it is associated with lung cancer.
Purpose:
To perform a systematic review and meta-analysis of the association between chest CT–defined emphysema and the presence
of lung cancer. Materials and Methods:
The PubMed, Embase, and Cochrane databases were searched up to July 15, 2021, to identify studies on the association
between emphysema assessed visually or quantitatively with CT and lung cancer. Associations were determined by emphysema
severity (trace, mild, or moderate to severe, assessed visually and quantitatively) and subtype (centrilobular and paraseptal, assessed
visually). Overall and stratified pooled odds ratios (ORs) with their 95% CIs were obtained. Results:
Of the 3343 screened studies, 21 studies (107 082 patients) with 26 subsets were included. The overall pooled ORs for lung
cancer given the presence of emphysema were 2.3 (95% CI: 2.0, 2.6; I2 = 35%; 19 subsets) and 1.02 (95% CI: 1.01, 1.02; six subsets)
per 1% increase in low attenuation area. Studies with visual (pooled OR, 2.3; 95% CI: 1.9, 2.6; I2 = 48%; 12 subsets) and quantitative
(pooled OR, 2.2; 95% CI: 1.8, 2.8; I2 = 3.7%; eight subsets) assessments yielded comparable results for the dichotomous assessment.
Based on six studies (1716 patients), the pooled ORs for lung cancer increased with emphysema severity and were higher for visual
assessment (2.5, 3.7, and 4.5 for trace, mild, and moderate to severe, respectively) than for quantitative assessment (1.9, 2.2, and 2.5)
based on point estimates. Compared with no emphysema, only centrilobular emphysema (three studies) was associated with lung cancer
(pooled OR, 2.2; 95% CI: 1.5, 3.2; P , .001). Conclusion:
Both visual and quantitative CT assessments of emphysema were associated with a higher odds of lung cancer, which also
increased with emphysema severity. Regarding subtype, only centrilobular emphysema was significantly associated with lung cancer.
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