基于办公室的灵活晶体镜可快速评估和管理疑似免疫检查点抑制剂相关的大肠炎
Alana Siev1, Pamela Livingstone2, Erika Tom2
1Department of Medicine, Memorial Sloan Kettering Cancer Center, New York (Alana Siev).
基于办公室的半导体镜是一种安全有效的工具,用于诊断癌症患者的免疫治疗相关性结肠炎 (irColitis). 这种快速评估指导治疗,避免不必要的免疫抑制,并支持持续的癌症治疗.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
背景情况:
- 免疫检查点抑制剂 (ICI) 提供先进的癌症治疗,但可能导致与免疫相关的不良事件,特别是与免疫治疗相关的结肠炎 (irColitis).
- 早期诊断IrColitis对于有效的管理至关重要,但即时内镜评估的临床实用性尚未得到充分证实.
研究的目的:
- 评估办公室的可行性和临床影响,用于在接受ICI的患者中快速诊断怀疑的IrColitis.
- 评估专用快速访问程序 (RAPID-GI) 在加快诊断和指导管理决策方面的作用.
主要方法:
- 在2019年2月至2022年4月期间,对94名患者进行了无性柔性晶体镜检查的回顾性分析.
- 胃肠炎的诊断是由经验丰富的胃肠病理学家根据组织学发现确认的.
- 程序是在办公室环境中进行的,仅使用阴囊制剂,没有镇静剂.
主要成果:
- 免疫治疗相关的大肠炎 (irColitis) 在70%的患者中得到证实.
- 从转诊到咨询和西格莫镜检查的中位时间为8天.
- 在80%的IrColitis病例中,西格米多斯科普检查发现了炎症,导致89%的这些患者进行了管理变化. 在没有皮膜炎的患者中,79%的患者避免了不必要的免疫抑制,57%的患者继续进行ICI治疗.
结论:
- 基于办公室的灵活的半导体镜是一种安全的,可行的,高效的诊断方法,可用于怀疑IrColitis.
- 快速访问程序有助于及时诊断,优化治疗策略,减少不必要的免疫抑制,并支持继续ICI治疗.
- 这种针对瘤学和胃肠道学的综合护理模式,需要更广泛的考虑,以改善患者的治疗结果.
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