免疫检查点抑制剂治疗与模仿腹腔疾病的肠炎相关
Binny Khandakar1, Amitabh Srivastava2
1Department of Pathology, Yale School of Medicine, Manhattan, NY, US.
对转移性非小细胞肺癌的 pembrolizumab 治疗可能会导致胃肠道问题. 这一案例突显了免疫治疗相关的肠球炎,与腹不同,患者患有腹.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 胃肠病学 胃肠病学
背景情况:
- 转移性非小细胞肺癌 (NSCLC) 需要有效的治疗策略.
- 免疫检查点抑制剂,如PD-1/PD-L1抑制剂,已经彻底改变了NSCLC治疗.
- 胃肠道不良事件是已知的免疫治疗并发症.
研究的目的:
- 为了呈现一种模仿乳病的免疫疗法相关肠球炎病例.
- 根据临床和病理发现,根据临床和病理发现,区分免疫疗法诱导的肠球炎与乳病.
- 强调接受免疫检查点抑制剂的患者准确诊断的重要性.
主要方法:
- 一名用 pembrolizumab 治疗转移性 NSCLC 的患者出现了腹.
- 进行了十二指肠和结肠的内镜活检.
- 进行了活检的组织病理学检查,包括对内皮质淋巴细胞 (IELs) 的评估.
- 进行了乳清学测试以检测患有乳病的情况.
主要成果:
- 肝脏和骨损伤证实了转移性NSCLC,PD-L1综合阳性得分 (CPS) 为15.
- 布罗利祖马布治疗导致腹,十二指甲状腺小缩,IEL增加,以及淋巴细胞性结肠炎.
- 血清学测试的结核病检测结果是负的.
- 这些发现支持了免疫疗法相关肠球炎的诊断.
结论:
- 免疫治疗后的胃肠道症状可以模仿腹腔疾病.
- 区分免疫疗法相关的肠球炎和腹腔疾病对于适当的管理至关重要.
- 增加IEL和结肠炎的病理发现是免疫疗法诱导肠炎的关键指标.
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