免疫関連の腹部有害事象:腹部に焦点を当てる
Fabian Bauer1, Thorsten Persigehl2
1Institut für Diagnostische und Interventionelle Radiologie, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Kerpener Straße 62, 50937, Köln, Deutschland. fabian.bauer@uk-koeln.de.
Radiologie (Heidelberg, Germany)
|December 17, 2025
まとめ
免疫療法による腹部免疫関連有害事象(irAE)は一般的である。本レビューでは、これらのirAEの画像所見を詳述し、腫瘍患者の診断と管理を支援する。
科学分野:
- 腫瘍学
- 放射線学
- 免疫療法
背景:
- 免疫チェックポイント阻害薬(ICI)およびキメラ抗原受容体(CAR)-T細胞療法は、腫瘍学においてますます使用されている。
- 免疫関連有害事象(irAE)は頻繁に発生し、腹部症状を呈することが多い。
- 放射線画像診断は、腹部irAEの診断と重症度評価に不可欠である。
研究 の 目的:
- ICIおよびCAR-T療法に関連する主な腹部irAEをレビューすること。
- これらの腹部irAEの特徴的な画像所見を記述すること。
- 腹部irAEの主要な鑑別診断を概説すること。
主な方法:
- 物語的な文献レビューを実施した。
- 臨床研究、メタアナリシス、ガイドラインを含めた。
- 免疫療法に関連する腹部irAEに焦点を当てた。
主要な成果:
- ICI誘発性irAEには、腸炎、大腸炎、肝炎、胆管炎、胆嚢炎、膵炎、腎炎、副腎炎が含まれる。
- CAR-T細胞療法irAEは、非特異的な炎症パターンとして現れることが多い。
- 放射線学は、臨床および検査所見と相関させることで、個別化療法と合併症管理に貴重なデータを提供する。
結論:
- 免疫療法後の腹部irAEはまれではない。
- 正確な診断のためには、特徴的な画像パターンの認識が不可欠である。
- 潜在的な合併症の認識は、これらの事象の管理に役立つ。
関連する概念動画
Drugs for Treatment of Diarrhea-Predominant IBS
590
Diarrhea-predominant irritable bowel syndrome (IBS-D) is a subtype of IBS characterized primarily by frequent, loose, or watery stools, abdominal pain, and abdominal discomfort. Therapeutic approaches to managing IBS-D include dietary changes, stress management techniques, and pharmaceutical interventions.
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
590
Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
604
Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
604
Drugs for Treatment of Ulcerative Colitis in IBD
413
Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide...
413
Acute Pancreatitis II: Clinical Manifestations and Management
693
Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...
693
Inflammatory Bowel Disease II: Crohn's Disease
909
Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
909
Drugs for Treatment of Constipation-Predominant IBS
664
Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...
664

