抗甲状腺抗体对ICIs治疗晚期恶性肿瘤疗效评估价值  

Values of anti-thyroid antibodies in the evaluation of ICIs in the treatment of advanced malignant tumors

作　　者：闫九玲 孙翠玲[1] 胡文军[1] YAN Jiuling;SUN Cuiling;HU Wenjun(Department of Oncology,Fuyang People's Hospital,Fuyang 236000,China)

机构地区：[1]阜阳市人民医院肿瘤科,安徽阜阳236000

出　　处：《长春中医药大学学报》2022年第7期796-800,共5页Journal of Changchun University of Chinese Medicine

基　　金：安徽省自然科学基金资助项目(1708085MH184)。

摘　　要：目的探讨抗甲状腺抗体在免疫检查点抑制剂(ICIs)治疗晚期恶性肿瘤临床疗效评估的预测价值。方法回顾性分析78例ICIs治疗恶性肿瘤患者的临床资料,检测治疗1个周期后患者的促甲状腺素(TSH)、游离三碘甲状腺原.氨酸(FT_(3))、游离甲状腺素(FT_(4))、抗甲状腺过氧化物抗体(TPO-Ab)、甲状腺球蛋白抗体(TG-Ab)及甲状腺刺激性免疫球蛋白(TR-Ab)。采用受试者工作特征曲线(ROC)分析治疗1个周期后TPO-Ab联合TG-Ab、TR-Ab对ICIs.治疗恶性肿瘤临床疗效的预测价值。结果治疗3个周期后,ICIs治疗恶性肿瘤客观有效率为61.53%;ICIs治疗有效患.者FT_(3) TPO-Ab、TG-Ab、TR-Ab水平均低于治疗无效患者;ICIs治疗无效患者FT、TPO-Ab、TG-Ab、TR-Ab均高于治疗有效患者(P<0.05),经Logistic回归分析,结果显示FTz、TPO-Ab、TG-Ab、TR-Ab、淋巴结转移均是ICIs治疗恶性肿瘤临床疗效的影响因素(P<0.05)。TPO-Ab、TG-Ab、TR-Ab联合预测ICIs治疗恶性肿瘤临床疗效的AUC均高于单独预测(P<0.05)。结论经ICIs治疗1个周期后,恶性肿瘤甲状腺自身抗体TPO-Ab、TG-Ab、TR-Ab水.平呈现较高表达,以上3项指标均是ICIs治疗恶性肿瘤临床疗效的影响因素,对ICIs治疗效果具有一定的预测价值,联合预测时的预测价值更高。Objective To explore the predictive values of anti-thyroid antibodies in evaluating the clinical efficacy of immune checkpoint inhibitors(ICIs)in the treatment of advanced malignant tumors.Methods The clinical data of 78 patients with malignant tumors treated with ICIs in our hospital from July 2019 to July 2021 were analyzed retrospectively.The levels of thyrotropin(TSH),free triiodothyronine(FT_(3)),free thyroxine(FT_(4)),anti-thyroid peroxidate antibody(TPO-Ab),thyroglobulin antibody(TG-Ab)and thyroid stimulating immunoglobulin(TR-Ab)were detected after one cycle of treatment.The receiver operating characteristic curve(ROC)was used to analyze the predictive value of TPO-Ab combined with TG-Ab and TR-Ab on the clinical efficacy of ICIs in the treatment of malignant tumors after one cycle of treatment.Results After 3 cycles of treatment,the objective effective rate of ICIs in the treatment of malignant tumors was 61.53%.The levels of FT_(3),TPO-Ab,TG-Ab and TR-Ab in patients with an effective ICIs treatment were lower than those in patients with an ineffective treatment,while the levels of FT_(3),TPO-Ab,TG-Ab and TR-Ab in patients with an ineffective ICIs treatment were higher than those in patients with an effective ICIs treatment(P<0.05).The Logistic regression analysis showed that FT_(3),TPO-Ab,TG-Ab,TR-Ab and lymph node metastasis were the influencing factors of the clinical efficacy of ICIs in the treatment of malignant tumors(P<0.05).The combined AUC of TPO-Ab,TG-Ab and TR-Ab in predicting the clinical efficacy of ICIs in the treatment of malignant tumors was higher than any index alone(P<0.05).Conclusion After one cycle of ICIs treatment,the levels of thyroid autoantibodies TPO-Ab,TG-Ab and TR-Ab are highly expressed in malignant tumors.The above three indicators are the influencing factors of the clinical efficacy of ICIs in the treatment of malignant tumors,having a certain predictive value for the therapeutic effect of ICIs,but the predictive value is higher when combined.

关 键 词：游离甲状腺素 免疫检查点抑制剂 恶性肿瘤 

分 类 号：R581.1[医药卫生—内分泌]