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Updated: Jun 19, 2026

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免疫检查点抑制剂的肺毒性:一种诊断方法

Ana Casal^1,2, Virginia Leiro-Fernández^1,2,3, Laura Villar-Aguilar^1,2

¹Pulmonary Department, Hospital Universitario Álvaro Cunqueiro, 36312 Vigo, Spain.

Journal of clinical medicine

|September 13, 2025

概括

免疫检查点抑制剂 (ICI) 改善癌症存活率,但可能导致肺毒性 (肺炎). 早期诊断和多学科的方法对于管理这种严重的副作用至关重要.

科学领域:

在瘤学瘤学.
肺部病理学肺部病理学
免疫学免疫学免疫学

背景情况:

免疫检查点抑制剂 (ICI) 已经彻底改变了癌症治疗,显著提高了患者的生存率.
然而,ICI可以诱导免疫介导的不良事件,肺毒性 (肺炎) 是一个显著的和潜在的严重并发症.
ICI诱导的肺炎发生在5-19%的患者中,通常在治疗的前几个月内发生.

研究的目的:

为提供关于免疫检查点抑制剂诱导的肺毒性的最新叙述性综述.
讨论这种并发症的病理生理学,诊断方法和治疗策略.
突出生物标志物的作用和多学科方法的重要性.

主要方法:

对ICI诱导的肺毒性现有文献的综述.
对诊断工具的分析,包括胸部计算机断层扫描 (CT) 和带支气管支气管洗 (BAL) 的支气管镜检查.
讨论涉及药物停用,皮质类固醇和免疫抑制剂的治疗算法.

主要成果:

ICI诱导的肺炎需要高的怀疑指数,特别是在患有风险因素的患者中,如年龄,吸烟史,先前的肺部或自身免疫性疾病或组合治疗.
胸部CT对于识别特征性放射学模式至关重要,而BAL则有助于排除感染或瘤进展.
治疗策略根据严重程度而异,从药物戒断到全身免疫抑制.

结论:

有效管理ICI诱导的肺毒性需要一个多学科的团队和早期诊断干预.
像KL-6和IL-6这样的新兴生物标志物可能有助于诊断和监测.
需要进行进一步的前性研究,以优化治疗方案并改善患者的治疗结果.

关键词:

免疫检查点抑制剂免疫检查点抑制剂肺部损伤肺部损伤肺炎是一种肺炎.

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