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免疫检查点抑制剂(抗CTLA-4以及抗PD-1/PD-L1)的肝脏和消化系统不良事件:临床病理综述

[Hepatic and digestive adverse events of immune checkpoint inhibitors (anti-CTLA-4 and, anti-PD-1/PD-L1): A clinico-pathological review].

作者信息

Papouin Barbara, Mussini Charlotte, De Martin Eleonora, Guettier Catherine

机构信息

Service d'anatomie et cytologie pathologiques, hôpital Bicêtre, AP-HP, 78, rue du Général Leclerc, 94270 Le Kremlin-Bicêtre, France.

Service d'anatomie et cytologie pathologiques, hôpital Bicêtre, AP-HP, 78, rue du Général Leclerc, 94270 Le Kremlin-Bicêtre, France.

出版信息

Ann Pathol. 2018 Dec;38(6):338-351. doi: 10.1016/j.annpat.2018.07.005. Epub 2018 Aug 22.

Abstract

Immune checkpoint inhibitors (anti-CTLA-4 and anti-PD-1/PD-L1) have recently revolutionized anti-cancer therapy and are nowadays used in different metastatic cancers. These treatments may induce immune-related adverse events which frequently involve the digestive tract and, to a less extent the liver. The tissular injuries, which are still poorly characterized from a morphological and physiopathological point of view, may lead on one side to the interruption of a life-saving treatment and on the other side to the development of severe complications, if not death. Therefore, it is crucial to diagnose as early as possible and treat these digestive and hepatic adverse effects in an optimal way. This article aims to describe the clinical and pathological presentations of digestive and hepatic adverse events induced by these immunotherapies.

摘要

免疫检查点抑制剂(抗CTLA-4和抗PD-1/PD-L1)最近彻底改变了抗癌治疗方式,如今已用于不同的转移性癌症。这些治疗可能会引发免疫相关不良事件,这些事件常累及消化道,在较小程度上累及肝脏。从形态学和生理病理学角度来看,组织损伤仍未得到充分表征,一方面可能导致挽救生命的治疗中断,另一方面如果不导致死亡,也可能引发严重并发症。因此,尽早诊断并以最佳方式治疗这些消化和肝脏不良反应至关重要。本文旨在描述这些免疫疗法引起的消化和肝脏不良事件的临床和病理表现。

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