肺癌免疫治疗相关性甲状腺功能异常的临床进展

杨 紫娟1, 刘 志波2
1、青海大学
2、青海红十字医院肿瘤内科

摘要


近年来，免疫检查点抑制剂（ICIs）在癌症治疗中取得了显著进展，尤其是 PD-1/PD-L1和 CTLA-4抑制
剂的应用。然而，ICIs的使用也伴随着一系列免疫相关的不良事件（irAEs），其中甲状腺功能异常是最常见的内分泌
系统毒性反应之一。本文综述了 ICIs相关甲状腺功能异常的类型、发生机制及临床管理策略。甲状腺功能异常包括
甲亢、甲减和亚临床异常，通常在治疗早期发生，且其发生率和类型因不同的 ICIs而异。此外，基线TSH水平在预
测甲状腺功能异常风险中具有重要意义。甲状腺功能异常可能与患者的预后改善有关，这提示其可能是 ICIs疗效的
一个潜在生物标志物。本文强调了对 ICIs治疗患者进行甲状腺功能监测和管理的重要性，以期优化治疗效果，提高
患者生活质量。未来需进一步研究甲状腺功能异常的机制及其在癌症免疫治疗中的作用。

关键词


免疫检查点抑制剂；甲状腺功能异常；PD-1/PD-L1抑制剂；综述

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