免疫检查点抑制剂相关结肠炎中的C-反应性蛋白:证据和知识差距的范围审查
Ryuichi Ohta1,2,3, Yoshinori Ryu1,3, Kaoru Tanaka2
1Department of Community Care, Unnan City Hospital, Unnan, Shimane, Japan.
Cancer management and research
|November 13, 2025
概括
在癌症患者中,C-反应蛋白 (CRP) 对于诊断免疫介导腹和结肠炎 (IMDC) 的证据有限. 虽然CRP具有潜在的支持性,但缺乏验证的值,不能取代IMDC的当前诊断方法.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 免疫学 免疫学 免疫学
背景情况:
- 免疫检查点抑制剂 (ICI) 是关键的癌症疗法,但可以引起免疫媒介腹和结肠炎 (IMDC).
- 准确的IMDC诊断和严重程度评估至关重要,但往往需要侵入性手术.
- C-反应蛋白 (CRP) 是潜在的炎症生物标志物,但其在IMDC中的作用尚不清楚.
研究的目的:
- 进行范围审查,对C反应蛋白 (CRP) 和免疫介导腹和结肠炎 (IMDC) 的证据进行映射.
- 识别有关CRP在诊断和评估IMDC严重性的有用性方面的知识差距.
主要方法:
- 在PubMed,Embase和Web of Science (2010年1月至2025年4月) 进行了全面的文献搜索.
- 包括的研究集中在接受ICI的成年患者中,有胃肠道免疫相关的不良事件和报告的CRP水平.
- 数据提取涉及研究设计,患者特征,CRP测量以及与IMDC诊断,严重程度或结果的关联.
主要成果:
- 包括5个观察性研究,包括583名患者.
- 只有一个研究分析了确认IMDC的CRP,显示了与严重程度的相关性,但没有验证的诊断值.
- 没有研究提供了足够的数据关于CRP的IMDC诊断准确性 (灵敏度,特异性,预测值).
结论:
- 将CRP与IMDC联系在一起的证据有限且异质,没有经过验证的诊断性能数据.
- 虽然CRP可以作为进一步调查的辅助标记,但它不能取代已建立的IMDC诊断途径.
- 未来的研究应该专注于前性研究,将CRP与器官特异性生物标志物相结合,用于IMDC分拣和严重性评估.
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