肝脏病理在免疫相关肝炎的发展中的作用:一个病例对照研究
Erica M Storm1, Dimitrios Makrakis2, Genevieve I Lin3
1University of Washington, Seattle, WA, USA. estorm15@uw.edu.
Targeted oncology
|June 26, 2023
概括
接受免疫检查点抑制剂 (ICI) 治疗的肝转移患者面临更高的免疫相关肝炎 (irH) 风险. 这项研究发现,肝转移显著增加了第一次ICI治疗期间发展irH的几率.
科学领域:
- 在瘤学瘤学.
- 肝病学 肝病学是一种肝病学.
- 免疫学 免疫学 免疫学
背景情况:
- 免疫相关肝炎 (irH) 是一种与免疫检查点抑制剂 (ICI) 治疗相关的严重免疫相关不良事件 (IRAE).
- 它可以导致显著的发病率,治疗中断和死亡率.
- 预先存在的肝病,如肝转移,对irH发病率的影响尚不清楚.
研究的目的:
- 调查假设,潜在的肝病理,特别是肝转移,在接受ICI治疗的癌症患者中增加了irH的风险.
- 量化肝转移与irH发展之间的关联.
主要方法:
- 追溯病例控制研究,涉及2016年至2020年期间接受首次ICI治疗的癌症患者.
- 2级或更高的IRH病例被确定并与基于人口统计和治疗开始因素的对照 (2:1比) 相匹配.
- 使用条件后勤回归分析来评估肝转移和irH之间的关系.
主要成果:
- 在97例确诊的irH病例中,在ICI治疗开始时,29%的病例患有肝转移.
- 肝转移与发展irH的几率增加显著相关 (调整后几率比:2.79;95% CI:1.37-5.66;p=0.005).
- 没有发现肝转移和严重程度 (等级) 或复发率的irH与ICI重新挑战后之间的相关性.
结论:
- 肝转移的存在是首次开始ICI治疗的患者中发展免疫相关肝炎的重要风险因素.
- 研究结果表明,肝转移患者在ICI治疗期间可能需要对irH进行更密切的监测.
- 需要进一步的研究,包括外部验证和生物标志物探索,以证实这些产生假设的发现.
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