佩布罗利祖马布诱导的气道粘膜炎,外观类似于卵石:一个病例报告
Ryo Ikeda1,2, Takeshi Takahashi1, Kosuke Ichikawa3
1Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Japanese journal of clinical oncology
|January 29, 2026
概括
免疫检查点抑制剂 (ICI) 可能导致罕见的全呼吸道炎症. 这一案例表明ICI诱导的粘膜炎模仿感染,强调在治疗患者中考虑呼吸道IRES.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 肺部病理学 肺部病理学
背景情况:
- 免疫检查点抑制剂 (ICI) 是关键的癌症疗法,但可能导致与免疫相关的不良事件 (irAEs).
- 泛气道粘膜干扰是一种不常见的irAE,通常呈现异常,并模仿诸如喉炎等传染性疾病.
- 在ICI诱导的粘膜炎中,喘类症状可能会先于上呼吸道参与.
研究的目的:
- 描述一种罕见的免疫检查点抑制剂诱导的全呼吸道粘膜炎.
- 为了突出诊断挑战和临床重要性,认识到这一特定的irAE.
- 强调需要考虑ICI患者的呼吸道irAEs需要持续或不寻常的呼吸道症状.
主要方法:
- 一个76岁的妇女患有肺状细胞癌的病例报告. 在 pembrolizumab.
- 临床表现,喉腔镜,胸部CT,支气管镜和活检被用于诊断.
- 治疗涉及布罗利祖马布的中止和口服皮质类固醇的管理.
主要成果:
- 患者出现了类似喘的症状,随后出现声和喉疼痛.
- 内镜和放射检查结果显示,从支气管到喉的粘膜连续炎症.
- 活检显示了密集的CD8阳性T细胞透,与ICI诱导的粘膜炎一致.
- 症状和异常在停止治疗和使用类固醇后消失.
结论:
- 由ICI引起的气道粘膜炎是一种罕见但显著的irAE.
- 起初,下呼吸道炎症可能会被掩盖,而上呼吸道症状会在以后变得明显.
- 临床医生应考虑在ICI治疗的患者中出现持续或不典型的上呼吸道症状时进行呼吸道IREs.
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