免疫检查点抑制剂引发的甲状腺功能障碍  

Immune checkpoint inhibitors-related thyroid dysfunction

作　　者：欧阳长青 朱健[1] 储冰峰[1] 杨一鹏[1] 张文杰[1] 张生来[1] Ouyang Changqing;Zhu Jian;Chu Bingfeng;Yang Yipeng;Zhang Wenjie;Zhang Shenglai(Department of General Surgery,Xinhua Hospital of Shanghai Jiaotong University of Medicine,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院附属新华医院普外科,200092

出　　处：《中华实验外科杂志》2022年第8期1621-1625,共5页Chinese Journal of Experimental Surgery

摘　　要：免疫检查点抑制剂(ICI)是近年来治疗恶性肿瘤的一项新进展, 其通过增强抗肿瘤免疫应答, 发挥抗肿瘤作用, 现已在多种实体肿瘤的治疗中取得显著疗效。但由于ICI特定的作用机制, 在发挥特异性抗肿瘤作用的同时能诱发其他系统的免疫相关不良反应(irAEs)。甲状腺功能障碍(TD)是ICI治疗过程中最常见的内分泌irAEs之一, 以甲状腺功能减退最为常见。ICI诱发TD的发病机制尚不明确, 且临床表现轻微, 主要依靠实验室检查进行诊断。本文主要对ICI相关TD的发生机制、流行病学、临床表现、管理方案等进行综述。Immune checkpoint inhibitors(ICI)are new developments in the treatment of malignant tumors in recent years.ICI plays an anti-tumor role by enhancing the anti-tumor immune response,and has achieved significant efficacy in the treatment of a variety of solid tumors.However,due to its specific mechanism of action,ICI can induce immune-related adverse events(irAEs)in other systems as well as exert specific anti-tumor effects.Thyroid dysfunction(TD)is one of the most common endocrine irAEs in the treatment of ICI,among which hypothyroidism is the most common one.The pathogenesis of ICI-induced TD is still unclear,and the clinical manifestations are mild.Diagnosis is mainly based on laboratory tests.This article mainly reviews the pathogenesis,epidemiology,clinical manifestations and treatment of ICI related TD.

关 键 词：免疫检查点抑制剂 免疫相关不良反应 甲状腺 

分 类 号：R730.51[医药卫生—肿瘤] R581[医药卫生—临床医学]