免疫检查点抑制剂相关甲状腺毒性研究进展  

Research progress of thyroid toxicity related to immune checkpoint inhibitors

作　　者：李洪敏 赵永才[2] 郭鹏 王彦荣[1] 陈然[1] 刘莹[1] LI Hongmin;ZHAO Yongcai;GUO Peng;WANG Yanrong;CHEN Ran;LIU Ying(Department of Phase I Clinical Trial Research,Cangzhou Central Hospital,Hebei Cangzhou 061000,China.;the Fourth Department of Endocrinology and Diabetes,Cangzhou Central Hospital,Hebei Cangzhou 061000,China.)

机构地区：[1]沧州市中心医院Ⅰ期临床试验研究室,河北沧州061000 [2]沧州市中心医院内分泌糖尿病四科,河北沧州061000

出　　处：《现代肿瘤医学》2023年第8期1568-1572,共5页Journal of Modern Oncology

基　　金：河北省重点科技研究计划(编号:20200340)。

摘　　要：免疫检查点抑制剂(ICIs)作为肿瘤免疫治疗的一种强效抗癌方式越来越多地应用到肿瘤治疗中。其通过解除肿瘤细胞对于机体免疫细胞的抑制作用达到杀伤肿瘤细胞的作用,但在作用过程中由于过度激活免疫细胞引发机体包括内分泌系统在内的多个系统出现自身免疫反应,即免疫相关不良事件(irAEs)。甲状腺毒性是比较常见的内分泌毒性,包括甲状腺功能减退、甲状腺功能亢进、甲状腺炎甚至甲状腺危象等。随着临床上ICIs的广泛应用,甲状腺毒性的发生势必越来越多,现就其流行病学、发病机制、临床表现及临床管理方面做如下综述,以提高临床医生的认识,改善癌症患者的生存质量。Immune checkpoint inhibitors(ICIs),as a powerful anticancer method of tumor immunotherapy,have been increasingly applied in tumor therapy.It kills tumor cells by relieving the inhibitory effect of tumor cells on immune cells,but in the process of action,due to the over-activation of immune cells,autoimmune reactions occur in multiple systems of the body,including the endocrine system,namely immune-related adverse events(irAEs).Thyroid toxicity is a common endocrine toxicity,including hypothyroidism,hyperthyroidism,thyroiditis and even thyroid crisis.With the wide application of ICIs in clinic,the occurrence of thyroid toxicity is bound to be increasing.This article reviews its epidemiology,pathogenesis,clinical manifestations and clinical management,in order to improve the understanding of clinicians and improve the quality of cancer patients'life.

关 键 词：免疫检查点抑制剂 免疫相关不良事件 甲状腺毒性 

分 类 号：R730.5[医药卫生—肿瘤]