间质性肺异常（ILA）是提示无先前诊断或怀疑ILD的个体中患有间质性肺疾病的CT表现。以往的研究表明，ILA与包括死亡在内的临床重要结果有关。本研究目的在于确定大规模CT肺癌筛查计划中ILA的患病率和与死亡、住院、癌症和ILD诊断等临床重要结果的关联。这是对2012年至2014年参加CT肺癌筛查计划的个体的回顾性研究。根据Fleischner Society指南对基线和纵向CT扫描进行ILA评分。主要分析检查基线ILA和死亡、全因住院和肺癌发病率之间的关联。生成Kaplan-Meier图以可视化ILA和肺癌、全因死亡之间的关联。使用Cox回归比例风险模型在单变量和多变量模型中测试这种关联。1699个受试者符合纳入标准。41例（2.4％）具有ILA和101例（5.9％）具有基线CT上不确定的ILA。41例基线CT上的ILA患者中诊断了ILD，患病率达24.4％，其基线CT到诊断的平均时间为4.47 ± 2.72年。在多变量建模中，ILA的存在仍是死亡的显著预测因子，HR为3.87（2.07、7.21；p <0.001），当考虑到年龄、性别、BMI、吸烟包年数和活跃吸烟时，但对肺癌和全因住院不具有预测意义。约50％的基线ILA患者在纵向扫描中有进展。在基线肺癌筛查检查中发现的ILA与全因死亡有关。此外，相当数量的ILA患者随后被诊断出患有ILD，并在纵向扫描中出现CT进展。 ClinicalTrials.gov; No .: NCT04503044. © 2023.作者。

Interstitial lung abnormalities (ILA) are CT findings suggestive of interstitial lung disease in individuals without a prior diagnosis or suspicion of ILD. Previous studies have demonstrated that ILA are associated with clinically significant outcomes including mortality. The aim of this study was to determine the prevalence of ILA in a large CT lung cancer screening program and the association with clinically significant outcomes including mortality, hospitalizations, cancer and ILD diagnosis.This was a retrospective study of individuals enrolled in a CT lung cancer screening program from 2012 to 2014. Baseline and longitudinal CT scans were scored for ILA per Fleischner Society guidelines. The primary analyses examined the association between baseline ILA and mortality, all-cause hospitalization, and incidence of lung cancer. Kaplan-Meier plots were generated to visualize the associations between ILA and lung cancer and all-cause mortality. Cox regression proportional hazards models were used to test for this association in both univariate and multivariable models.1699 subjects met inclusion criteria. 41 (2.4%) had ILA and 101 (5.9%) had indeterminate ILA on baseline CTs. ILD was diagnosed in 10 (24.4%) of 41 with ILA on baseline CT with a mean time from baseline CT to diagnosis of 4.47 ± 2.72 years. On multivariable modeling, the presence of ILA remained a significant predictor of death, HR 3.87 (2.07, 7.21; p < 0.001) when adjusted for age, sex, BMI, pack years and active smoking, but not of lung cancer and all-cause hospital admission. Approximately 50% with baseline ILA had progression on the longitudinal scan.ILA identified on baseline lung cancer screening exams are associated with all-cause mortality. In addition, a significant proportion of patients with ILA are subsequently diagnosed with ILD and have CT progression on longitudinal scans.ClinicalTrials.gov; No.: NCT04503044.© 2023. The Author(s).