Associação entre a histologia do câncer de pulmão e o desenvolvimento de metástase óssea: uma revisão sistemática e meta-análise

Abstract

Objective: To compare the frequency and risk of developing bone metastasis among histological subtypes of lung carcinoma. Methods: A Systematic Review and Meta-Analysis were conducted with searches in PubMed/MEDLINE involving patients with bone metastasis secondary to lung cancer. The primary outcome was the frequency of bone metastasis, and the secondary was the pooled odds ratio (OR) with a 95% confidence interval (CI95%), to determine the risk of bone metastasis, according to the histology of the primary tumor, referencing non-small cell lung carcinoma. The quality assessment and risk of bias in the studies were performed using the Newcastle-Ottawa Scale (NOS). Results: From 164 records identified in the initial search, nine were considered eligible for quantitative synthesis. The overall rate of bone metastasis among lung cancer patients was 24%, according to the histological subtypes. Regarding the risk of metastasis, adenocarcinoma presented OR = 1.97 and CI95% = 1.75–2.22, large-cell carcinoma OR = 1.66 and CI95% = 1.51–1.83, unspecified non-small cell carcinoma OR = 2.30 and CI95% = 1.76–3.03, and small-cell carcinoma OR = 2.21 and CI95% = 1.61–3.04, all showing a higher risk than squamous cell carcinoma with statistical significance. Conclusion: Small-cell lung carcinoma showed a higher bone metastasis rate than other histological subtypes. Adenocarcinoma, large-cell carcinoma, unspecified non-small cell carcinoma, and small-cell carcinoma presented a higher risk of bone metastasis than squamous cell carcinoma.