免疫检查点抑制剂相关的胃肠道不良事件的内镜检测结果
Min Kyu Kim1, Sung Wook Hwang1,2
1Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
免疫检查点抑制剂 (ICI) 治疗可以导致胃肠道问题,如腹和大肠炎. 内镜评估对于诊断和评估严重程度至关重要,指导用皮质类固醇治疗或耐火病例的先进疗法.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 免疫学 免疫学 免疫学
背景情况:
- 免疫检查点抑制剂 (ICI) 越来越多地用于癌症治疗.
- 胃肠道不良事件,包括腹和结肠炎,是ICI的显著副作用.
- 内镜评估对于诊断和分类ICI相关的大肠炎至关重要.
研究的目的:
- 审查与免疫相关的腹和结肠炎的诊断方法和管理.
- 描述ICI诱导性大肠炎的内镜和组织学发现.
- 概述ICI相关的胃肠道毒性治疗策略.
主要方法:
- 对怀疑ICI相关结肠炎的患者内镜和组织学发现的审查.
- 分析肠道炎症的分布和特征.
- 基于临床表现和内镜严重性的治疗结果的评估.
主要成果:
- 广泛性结肠炎是常见的 (23-86%),而孤立的右侧结肠炎 (3-8%) 和结肠炎 (2-16%) 较少发生.
- 内镜检查结果往往模仿炎症性肠道疾病,包括腹痛和.
- 和广泛的炎症与较差的治疗反应相关;微观的炎症可能存在于看起来正常的粘膜.
结论:
- 与ICI相关的结肠炎需要及时进行内镜评估,以准确诊断和严重程度分级.
- 皮质类固醇是适度至严重的ICI相关性结肠炎的第一线治疗.
- 耐药病例可能会受益于先进疗法,如因弗力西马布或维多利祖马布.
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