评估免疫检查点抑制剂对肝硬化和功能的影响:回顾性队列分析
Sophie K Schellhammer1, Jessica Quintos Day1, Run Fan2
1Vanderbilt University School of Medicine, Nashville, TN, United States.
Frontiers in oncology
|October 20, 2025
概括
免疫检查点抑制剂 (ICI) 在癌症患者中没有显著改变肝衰减或肝酶. 这表明ICI可能不会在癌症免疫疗法期间恶化肝脂肪或亚临床损伤.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 肝病学 肝病学是一种肝病学.
背景情况:
- 免疫检查点抑制剂 (ICI) 是关键的癌症免疫疗法.
- ICI对慢性炎症状况 (如肝硬化症) 的影响尚不清楚.
- 在CT扫描中肝脏衰减是肝脏脂肪和炎症的非侵入性标志物.
研究的目的:
- 研究ICI治疗对癌症患者肝衰减和肝酶水平的影响.
- 评估ICI治疗后肝硬化或亚临床肝损伤的潜在恶化.
- 以更大的患者队列建立在之前的研究基础上.
主要方法:
- 对164名接受ICI治疗的癌症患者进行了回顾性队列研究 (2017-2022年).
- 在ICI治疗前和后 (≥1年) 的肝衰减和肝酶 (总 bilirubin,AST,ALT,性酸酶) 的分析.
- 评估临床因素,包括体重变化,肝转移和类固醇使用;使用CTCAE v5.0.0分级的肝脏不良事件.
主要成果:
- 在ICI治疗后,肝衰减 (59.86 ± 8.07 HU vs 59.38 ± 8.36 HU,p=0.42) 或肝酶没有显著变化.
- 14.0%的患者经历了治疗后的肝脏异常,主要是1级升高 (11.0%).
- 体重增加与下部肝脏衰减相关 (p<0.0001);肝脏转移与较高的总 bilirubin 和 AST 水平相关.
结论:
- 在这个队列中,ICI治疗没有显著改变肝脏衰减或肝酶水平.
- 研究结果表明,ICI可能不会加剧肝脏脂肪沉积或引起亚临床肝损伤.
- 建议使用先进的成像方法进行进一步的研究,以确认这些结果.
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