用免疫疗法治疗的肺癌中多流的伪进展:一个病例报告
Hiroyasu Kaneda1, Lan Wang2, Takako Oka1
1Department of Clinical Oncology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.
Translational lung cancer research
|October 24, 2025
概括
在接受免疫检查点抑制剂 (ICI) 的患者中,伪进展 (PsP) 很少以多流体的形式出现. 早期识别是避免停止有效治疗肺腺癌的关键.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 放射学 放射学是一门学科.
背景情况:
- 伪进展 (PsP) 是对免疫检查点抑制剂 (ICI) 的非典型反应,在瘤回归之前,有暂时的成像恶化.
- 从临床上来说,区分PsP与真正的疾病进展或与免疫相关的不良事件 (irAEs) 是具有挑战性的.
- PsP通常呈现为瘤大小增加或新的病变;呈现为膜溢出是罕见的.
研究的目的:
- 在患有肺腺癌的患者中报告一种罕见的PsP病例,表现为肺部溢液.
- 强调认识到这种罕见的PsP呈现的重要性,以指导治疗决策.
- 在ICI治疗的背景下,讨论区分PsP与其他疾病的挑战.
主要方法:
- 一个56岁的女性患有肺腺癌和肺部扩散的病例报告,接受了 pembrolizumab 治疗.
- 进行了临床监测,成像和肺部液体分析.
- 治疗的延续和结果被记录下来.
主要成果:
- 患者在开始服用 pembrolizumab 后出现了新发起的多发性输液,多发性液中含有腺癌细胞和淋巴细胞.
- 尽管进行了细胞学,但流血自发地消失了,并且随着持续的ICI治疗,疾病回归.
- 患者继续接受pembrolizumab治疗一年多,直到最终进展为止,输液没有复发.
结论:
- 在接受ICI治疗的患者中,PsP可以表现为新的肺溢液,即使存在恶性细胞.
- 临床稳定性和成像对于区分PsP与进展或irAEs至关重要.
- 在可管理的肺溢症患者中,在选定的患者中继续进行ICI可能会保持治疗效益.
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