病例报告:Sintilimab诱导的史蒂文斯-约翰逊综合征在患有晚期肺腺癌的患者中
Xueqin Li1, Guanghui Li1, Diangang Chen1
1Institute of Cancer, Xinqiao Hospital, Army Medical University, Chongqing, China.
Frontiers in oncology
|October 2, 2023
概括
免疫检查点抑制剂 (ICI) 可以引起严重的皮肤反应,如史蒂文斯-约翰逊综合征 (SJS). 这一案例突显了SJS在一个肺癌患者治疗sintilimab,与独特的PD-L1表达模式观察到.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 皮肤病学 皮肤病学
背景情况:
- 免疫检查点抑制剂 (ICI) 越来越多地用于癌症治疗.
- 与皮肤相关的不良事件在ICI中很常见,包括像史蒂文斯-约翰逊综合征 (SJS) 这样的严重反应.
- 了解ICI诱导的SJS的机制对于患者安全至关重要.
研究的目的:
- 报告一种罕见的史蒂文斯-约翰逊综合征 (SJS) 病例,该病例发生在患者中,该患者接受了辛蒂利马布和帕克利塔塞尔治疗.
- 为了研究这个患者皮肤病变的免疫和分子特征.
- 为了比较观察到的PD-L1表达模式与ICI诱导SJS的先前发现.
主要方法:
- 一个76岁的男性患有转移性肺腺癌的病例报告.
- 患者在化疗/放射治疗后接受了sintilimab和paclitaxel脂肪体.
- 皮肤活检分析免疫细胞透 (CD4,CD8) 和PD-L1表达.
主要成果:
- 该患者患有史蒂文斯-约翰逊综合征 (SJS),涉及广泛的皮肤和粘膜表面.
- 皮肤活检显示了CD4和CD8阳性T淋巴细胞的透.
- 在皮肤的腺体和基底层观察到明显的PD-L1表达,与表皮皮质角质细胞表达不同.
结论:
- 辛提利马布与帕克利塔克塞尔脂酶组合可以诱导严重的史蒂文斯-约翰逊综合征 (SJS).
- 在皮肤腺和基底层观察到的PD-L1表达是ICI诱导SJS的一个独特发现.
- 需要进一步的研究来阐明ICI诱导的SJS的具体机制和PD-L1局部化的作用.
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