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肿瘤免疫检查点抑制剂相关内分泌疾病

Tumor immune checkpoint inhibitors-related endocrinopathies

  • 摘要: 近年来,肿瘤免疫检查点抑制剂(immune checkpoint inhibitors,ICPis)在恶性肿瘤患者中的应用越来越广泛,取得较好的抗肿瘤效果,但同时也会导致非特异性免疫相关不良反应。ICPis相关内分泌疾病主要包括垂体炎和垂体功能不全、甲状腺功能障碍、糖尿病、原发性肾上腺功能不全和多内分泌腺功能同时受累,往往不能被准确识别并及时处理,可危及生命。因此,本文就ICPis相关内分泌疾病的种类、发生率、临床表现、预后、可能发病机制等研究进展以及临床诊治管理建议作一述评,以期提高临床医师和患者对ICPis相关内分泌疾病的认识和警惕。

     

    Abstract: Tumor immune checkpoint inhibitors (ICPis) have been using in patients with malignant tumors more and more widely in recent years. ICPis exhibit good effect on tumors, but also lead to non-specific immune-related adverse events. ICPis-related endocrinopathies include hypophysitis and anterior pituitary dysfunction, thyroid dysfunction, diabetes mellitus, primary adrenal insufficiency, and polyendocrine dysfunction. These diseases are usually not accurately identified and treated in time, sometimes can be life-threatening. This article reviews the research progress in types, incidence, clinical manifestations, prognosis, possible pathogenesis of ICPis-related endocrinopathies and clinical management recommendations, so as to improve the awareness and vigilance of clinicians and patients on the ICPis-related endocrinopathies.

     

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