免疫相关不良反应:流行病学、临床表现及危险因素

Immune-relatedadverse events:epidemiology,clinical manifestations,and risk factors

免疫检查点抑制剂(immune checkpoint inhibitors,ICIs)是近年来肿瘤学领域的一项重大创新,可显著改善多种恶性肿瘤患者的治疗效果和预后。然而,随着ICIs应用的日益广泛,由此引发的治疗相关不良反应也越来越多。由于免疫相关不良反应(immune-related adverse events,irAEs)可能在治疗结束后或与疾病进展无关的情况下出现,患者可能出现不同系统的症状,且首诊科室为内科而非肿瘤科,这对内科医生识别何管理irAEs的能力提出了更高要求。本文就临床上具有代表性的irAEs流行病学、临床表现及危险因素进行综述,以期提升内科医生对irAEs的认识,从而更好地管理患者。

Immune checkpoint inhibitors(ICIs)represent a significant breakthrough in the field of oncology in recent years,greatly improving treatment outcomes and prognosis for patients with various malignant tumors.However,with the increasing use of ICIs,the incidence of treatment-related adverse events has also risen.As immune-related adverse events(irAEs)can occur after treatment cessation or independently of disease progression,patients may present with symptoms affecting different systems,often initially seeking care from internists rather than oncologists.Consequently,internists are faced with heightened responsibilities to proficiently discern irAEs.This article provides a comprehensive review of the epidemiology,clinical manifestations,and various risk factors associated with representative irAEs in clinical practice,aiming to familiarize internists with diverse irAEs for effective management.