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《中华肺部疾病杂志》[ISSN:1006-6977/CN:61-1281/TN]

卷:

期数:

2023年03期

页码:

400-402

栏目:

临床研究

出版日期:

2023-06-20

文章信息/Info

Title:

-

作者:

王秀清; 诸葛金科; 杨明星; 董 文

570000 海口,海南省肿瘤医院呼吸内科

Author(s):

-

关键词:

免疫检查点抑制剂相关肺炎;  肺癌;  肺气肿;  免疫反应

Keywords:

-

分类号:

R563,R734.2

DOI:

10.3877/cma.j.issn.1674-6902.2023.03.027

摘要:

目的 分析免疫检查点抑制剂(immune checkpoint inhibitors, ICIs)治疗肺癌并发肺气肿致免疫相关性肺炎(checkpoint inhibitor-related pneumonitis, CIP)的临床意义。 方法 选择2019年10月至2022年10月我院收治的经PD-1/PD-L1治疗肺癌患者62例,将并发肺气肿33例为观察组,29例为对照组。观察组采用免疫联合化疗治疗,对照组采用免疫单药治疗,对比两组CIP发生情况,多因素Logistic回归分析不同治疗方案对两组的影响。 结果 观察组CIP发生率高于对照组,观察组CIP发生于ICIs治疗后3个月,严重程度Ⅲ～Ⅳ级(P<0.05); 两组治疗后mMRC等级较治疗前降低,对照组低于观察组,治疗后KPS评分较治疗前升高,对照组高于观察组,对照组平均好转率高于观察组(P<0.05); 23例经免疫检查点抑制剂单药治疗,发生CIP 1例(4.35%),27例经化疗联合免疫检查点抑制剂治疗,发生CIP 7例(25.93%),两种治疗方案的CIP发病率差异有统计学意义(χ²=4.303,P=0.038); 多因素Logistic回归分析显示,mMRC平均好转率(OR=0.444,P=0.001)、KPS平均好转率(OR=0.825,P=0.003)及治疗方案(OR=6.135,P=0.040)是CIP发生的影响因素。 结论 肺癌并发肺气肿经ICIs治疗易致免疫相关性肺炎,可辅助判断免疫治疗潜在风险,具有临床意义。

Abstract:

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参考文献/References:

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备注/Memo

备注/Memo:

基金项目: 2022年海南省自然科学基金高层次人才项目(822RC849)
通信作者: 董 文, Email: tonydwking@126.com

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更新日期/Last Update: 2023-06-20