肺癌患者免疫检查点抑制剂相关性肺炎发病率及危险因素的Meta分析

Meta-analysis of incidence and risk factors of immune checkpoint inhibitor-associated pneumonia in patients with lung cancer

目的 系统评价肺癌患者免疫检查点抑制剂相关性肺炎(CIP)的发病率及危险因素。方法 从中国生物医学文献数据库(CBM)、中国知网数据库(CNKI)、万方数据库、维普中文生物医学期刊数据库、PubMed、Cochrane Library、Web of Science、EBSCOhost、Medline和CINAHL数据库检索,评价肺癌患者CIP发病率及其影响因素的文献,检索时限为建库至2022年6月30日,应用Stata 17.0软件对CIP发病率及危险因素进行Meta分析。结果 共纳入19篇文献,涉及3 101例肺癌患者。Meta分析结果显示,肺癌患者CIP总发病率为18%(95%CI:0.14~0.21);亚组分析显示,报告年份为2021年及2022年、地区为亚洲国家、研究类型为病例对照研究中的肺癌患者CIP发病率更高;危险因素包括既往慢性阻塞性肺疾病、既往间质性肺疾病、体力状况(PS)评分≥2分和联合治疗。结论 肺癌患者CIP发病率较高,其发生CIP受多种因素影响,临床医护人员应加强对危险因素的识别和筛查,及早干预,避免严重后果。

Objective To systematically evaluate the incidence and risk factors of immune checkpoint inhibitor-associated pneumonia(CIP)in patients with lung cancer.Methods The literature evaluating the incidence of CIP and its influencing factors in lung cancer patients were searched,in Chinese Biomedical Literature Database(CBM),CNKI Database,WanFang Database,VIP Chinese Biomedical Journal Database,PubMed,Cochrane Library,Web of Science,EBSCOhost,Medline and CINAHL Database from the construction of the library to June 30,2022.Stata 17.0 software was applied to perform a Meta-analysis of the incidence and risk factors of CIP.Results A total of 19 articles were included,involving 3101 patients with lung cancer.The results of Meta-analysis showed that the total incidence of CIP in lung cancer patients was 18%(95%CI:0.14-0.21).Subgroup analysis showed that the incidence of CIP was higher in patients with lung cancer reported in 2021 and 2022,Asian countries and case-control studies.Risk factors included prior chronic obstructive pulmonary disease,prior interstitial pulmonary disease,performance status(PS)score≥2 points and combination therapy.Conclusion The incidence of CIP is high in lung cancer patients and the occurrence of CIP is affected by many factors.Clinical medical staff should strengthen the identification and screening of risk factors,and intervene early to avoid serious consequences.