Urias Rivera Andres C, Pizuorno Machado Antonio, Shatila Malek, Triadafilopoulos George, McQuade Jennifer L, Altan Mehmet, Zhao Dan, Wang Yinghong, Shafi Mehnaz A
Department of Internal Medicine, Baylor College of Medicine, Houston, TX 77030, USA.
Department of Internal Medicine, The University of Texas Health Science Center, Houston, TX 77030, USA.
Cancers (Basel). 2024 Jul 26;16(15):2658. doi: 10.3390/cancers16152658.
Immune checkpoint inhibitors (ICIs) can cause myenteric plexopathy, which could result in delayed gastric emptying (GE) and possibly gastroparesis. We assessed the clinical outcomes of patients who had pre-existing gastroparesis or who developed symptoms of delayed GE following ICI therapy. We retrospectively identified adults with ICD-9 and ICD-10 codes for gastroparesis who received ICI therapy between 1 January 2020 and 31 December 2022 at a tertiary cancer center. Of 76 eligible patients, 37 had pre-existing gastroparesis; 39 (0.2% of the more than 18,000 screened) developed symptoms of delayed GE after ICI therapy, of which 27 (69%) patients had an alternative etiology for delayed GE. Four patients (11%) with pre-existing gastroparesis had a flare-up after ICI, and the median time to flare-up was 10.2 months (IQR, 0.7-28.6 months); for patients with new onset of suspected delayed GE after ICI, the median time to symptom onset was 12.8 months (IQR, 4.4-35.5 months). The clinical symptom duration of patients without an alternative etiology (74.5 days (IQR, 21.5-690 days)) and those with an alternative etiology (290 days (IQR, 147-387 days)) did not differ significantly ( = 1.00). Delayed GE after ICI therapy is a rare presentation but has a late onset and a prolonged symptom duration.
免疫检查点抑制剂（ICIs）可导致肌间神经丛病变，进而可能导致胃排空延迟（GE），甚至可能引发胃轻瘫。我们评估了在ICI治疗前就已存在胃轻瘫或在ICI治疗后出现GE延迟症状的患者的临床结局。我们回顾性地确定了在一家三级癌症中心于2020年1月1日至2022年12月31日期间接受ICI治疗且ICD - 9和ICD - 10编码为胃轻瘫的成年人。在76名符合条件的患者中，37名患者在ICI治疗前就已存在胃轻瘫；39名患者（在超过18000名筛查患者中占0.2%）在ICI治疗后出现GE延迟症状，其中27名患者（69%）存在GE延迟的其他病因。4名（11%）在ICI治疗前就已存在胃轻瘫的患者在ICI治疗后病情复发，复发的中位时间为10.2个月（四分位间距，0.7 - 28.6个月）；对于在ICI治疗后新出现疑似GE延迟的患者，症状出现的中位时间为12.8个月（四分位间距，4.4 - 35.5个月）。无其他病因的患者（74.5天（四分位间距，21.5 - 690天））和有其他病因的患者（290天（四分位间距，147 - 387天））的临床症状持续时间无显著差异（P = 1.00）。ICI治疗后GE延迟是一种罕见的表现，但起病较晚且症状持续时间较长。
