免疫检查点抑制剂相关甲状腺功能障碍研究进展

Research progress of immune checkpoint inhibitors related thyroid dysfunction

摘要:

免疫检查点抑制剂（immune checkpoint inhibitors，ICPIS）对肿瘤患者总体生存率有极大提高，疗效显著，目前已批准用于多种肿瘤治疗，为众多癌症患者带来希望。但治疗同时，过度激活的免疫系统对全身各个器官均可产生免疫损伤，甲状腺功能障碍就是其中较为常见的内分泌不良事件之一。本文回顾相关文献，从ICPIS分布及作用特点、流行病学、发病机制出发，归纳总结其临床特点，并就临床工作中如何筛选高危患者，以及目前国内外指南关于ICPIS相关甲状腺功能障碍随访监测、治疗方式异同进行阐述。

Abstract:

Immune checkpoint inhibitors (ICPIS) can greatly improve the overall survival rate of tumor patients with significant efficacy. Currently, ICPIS have been approved for a variety of tumor treatments, bringing hope to many cancer patients. However, at the same time, due to the overactivation of the immune system, it can produce immune-related adverse reactions to all organs of the body. Thyroid related dysfunction is one of the relatively common endocrine adverse events in the treatment of ICPIS. This paper reviewed relevant literature and summarized the clinical characteristics of ICPIS from the perspectives of distribution, action characteristics, epidemiology and pathogenesis. In addition, how to screen high-risk patients in clinical work, as well as the differences and similarities of follow-up monitoring and treatment methods of ICPIS-related thyroid dysfunction in current domestic and foreign guidelines are discussed.