Diagnostic and prognostic performance of biomarkers for pneumoconiosis: a systematic review and meta-analysis

The global incidence of pneumoconiosis is rising, significantly impacting individuals' quality of life. While traditional symptomatic treatments have shown some therapeutic effects, understanding underlying risk factors and biomarkers is crucial for better management. This meta-analysis aims to evaluate the diagnostic and prognostic performance of parameters for pneumoconiosis, particularly focusing on parameters such as forced expiratory volume in 1 s (FEV1) %, forced vital capacity (FVC) %, FEV1/FVC%, C-reactive protein (CRP), Interleukin-6 (IL-6), partial pressure of oxygen in arterial blood (PaO2), and transforming growth factor beta 1 (TGF-β1). A comprehensive search of databases, including PUBMED, MEDLINE, EMBASE, Cochrane CENTRAL, and ClinicalTrials.gov, was conducted using search terms related to pneumoconiosis, silicosis, and occupational lung diseases until September 11th, 2025. Data were analyzed using Review Manager 5.4, employing fixed and random-effects models to assess heterogeneity. The I 2 statistic and p-values were used to evaluate variability between studies, while publication bias was examined through sensitivity analysis. A total of 21 clinical studies, involving 2,696 participants in the experimental groups and 2,250 controls, were included. Significant differences in biomarker levels were found between pneumoconiosis patients and healthy controls. FEV1% (P < 0.00001), FVC% (P < 0.00001), and FEV1/FVC% (P = 0.0002) were notably lower in pneumoconiosis patients. Additionally, CRP and IL-6 levels were significantly elevated in patients with pneumoconiosis (CRP: P = 0.004; IL-6: P = 0.004). PaO2 and TGF-β1 levels also showed significant differences, underscoring their potential as biomarkers for disease severity and progression. Pneumoconiosis was associated with impaired pulmonary function, lower PaO₂, and higher CRP and IL-6 levels, whereas the evidence for TGF-β1 was inconclusive. These group-level associations do not establish diagnostic or prognostic utility. Given the predominantly observational evidence and substantial heterogeneity, the pooled estimates should be interpreted cautiously. Prospective diagnostic-accuracy and longitudinal studies using standardized methods are needed to determine the clinical utility of these parameters.