免疫检查点与抑制剂相关的胰腺炎的临床病理学特征
Feidi Chen1, Monika Vyas1, Matthew Gosse2
1Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA.
The American journal of surgical pathology
|April 7, 2025
概括
免疫检查点抑制剂 (ICI) 相关的胰腺炎很少见,但由于非特异性症状,难以诊断. 组织学特征经常与其他疾病重叠,需要对药物进行审查以进行准确的诊断和管理.
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
- 病理学 病理学 病理学
背景情况:
- 免疫检查点抑制剂 (ICI) 已经彻底改变了癌症治疗,但可能会导致罕见的不良事件.
- 与ICI相关的胰腺炎具有非特异性的临床和放射性特征,这给诊断带来了挑战.
- 与ICI相关的胰腺炎的详细组织病理学特征尚未得到充分确立.
研究的目的:
- 描述免疫检查点抑制剂 (ICI) 相关胰腺炎的临床和组织病理特征.
- 提高对这种罕见不良事件的认识和改善诊断准确度.
- 为了区分ICI相关的胰腺炎与恶性瘤和自身免疫性胰腺炎.
主要方法:
- 从4名接受抗PD-1抗体治疗的患者获得的5个胰腺样本的回顾性分析.
- 对人口统计,临床,血清学和放射学数据的审查.
- 详细检查基因病理特征和免疫组织化学.
主要成果:
- 患者接受了Nivolumab或Pembrolizumab治疗各种癌症;胰腺炎的发病幅度很大.
- 常见的组织学发现包括以为中心的炎症,缩和纤维化;注意到了粒细胞上皮病变.
- 炎症透物主要是CD3+T细胞;临床管理涉及ICI停止和类固醇启动.
结论:
- 与ICI相关的胰腺炎模仿恶性瘤和自身免疫性胰腺炎,有可能导致慢性变化.
- 组织学特征与自身免疫性胰腺炎明显重叠,特别是在小型活检中.
- 与ICI使用的临床相关性对于诊断非特异性慢性模式的胰腺炎至关重要.
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