首页|PD-1抑制剂对肺癌治疗致甲状腺相关病变的影响因素分析

PD-1抑制剂对肺癌治疗致甲状腺相关病变的影响因素分析

Analysis of influencing factors of thyroid related lesions induced by PD-1 inhibitors in the treatment of lung cancer

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目的 分析程序性死亡受体1(programmed death receptor 1,PD-1)抑制剂对肺癌治疗致甲状腺相关病变的影响因素.方法 选择2021年1月至2022年12月我院收治的57例肺癌患者为对象,接受PD-1抑制剂治疗,1个治疗周期为3周,治疗6个周期,发生甲状腺相关病变21例分为观察组,未发生甲状腺相关病变36例为对照组.对比临床资料,分析PD-1抑制剂在肺癌治疗中发生甲状腺相关病变的疗效.结果 观察组治疗后发生亚临床甲减11例(52.38％)、甲减6例(28.57％)、甲亢3例(14.29％)、亚临床甲亢1例(4.76％).观察组女性14例(66.67％)、身体质量指数(BMI)＞25 kg/m212例(57.14％)、临床分期为Ⅳ期15例(71.43％)、甲状腺内部回声不均匀13例(61.90％),对照组女性7例(19.44％)、身体质量指数(BMI)＞25 kg/m2 12例(33.33％)、临床分期为Ⅳ期10例(27.78％)、甲状腺内部回声不均匀3例(8.33％),P＜0.05.观察组卡氏功能状态评分(KPS)评分(66.13±3.27)分低于对照组(75.44±4.41)分,P＜0.05.二元 Logistic 回归分析显示,女性(OR=2.735,95％CI:1.202～6.221)、病程≥ 1 年(OR=3.171,95％CI:1.394～7.213)、BMI＞25 kg/m2(OR=3.557,95％CI:1.564～8.092)、甲状腺内部回声不均匀(OR=3.827,95％CI:1.682～8.705)为PD-1抑制剂在肺癌治疗中发生甲状腺相关病变的影响因素(P＜0.05).结论 PD-1抑制剂对肺癌治疗致甲状腺相关病变风险高,女性、病程较长、超重、甲状腺内部回声不均匀为甲状腺相关病变风险因素.
Objective To analyze the influencing factors of thyroid related lesions caused by programmed death receptor 1(PD-1)inhibitors in the treatment of lung cancer.Methods The clinical data of 57 patients with lung cancer admitted to the oncology Department of the hospital from January 2021 to December 2022 were retrospectively analyzed.All patients received PD-1 inhibitor treatment,a treatment cycle was 3 weeks,and within 6 treatment cycles,Twenty-one cases with thyroid related lesions were divided into observation group and 36 cases without thyroid related lesions were divided into control group.The clinical data of observation group and control group were compared.The influencing factors of thyroid related lesions induced by PD-1 inhibitors in the treatment of lung cancer were analyzed.Results In the observation group,subclinical hypothyroidism in 11 cases(52.38％),hypothyroidism in 6 cases(28.57％),hyperthyroidism occurred in 3 cases(14.29％)and subclinical hyperthyroidism in 1 case(4.76％).In the observation group,there were 14 females(66.67％),12 females(57.14％)with body mass index(BMI)＞25 kg/m2,15 females(71.43％)with clinical stage Ⅳ,and 13 females(61.90％)with uneven thyroid internal echo.In the control group,there were 7 females(19.44％),12 females(33.33％)with body mass index(BMI)＞25 kg/m2,10 females(27.78％)with stage Ⅳ,and 3 females(8.33％)with uneven thyroid internal echo(P＜0.05).The KPS score of the observation group(66.13±3.27)was lower than that of the control group(75.44±4.41),(P＜0.05).Binary Logistic regression analysis showed that women(OR=2.735,95％CI:1.202-6.221),disease duration≥1year(OR=3.171,95％CI:1.394-7.213),BMI＞25 kg/m2(OR=3.557,95％CI:1.564-8.092)and uneven internal thyroid echo(OR=3.827,95％CI:1.682-8.705)were the influential factors for thyroid related lesions caused by PD-1 inhibitors in the treatment of lung cancer(P＜0.05).Conclusion The risk of thyroid related lesions caused by PD-1 inhibitors in lung cancer treatment is higher,and the risk of thyroid related lesions is higher in women,lung cancer patients with long disease course,overweight,and uneven internal thyroid echo.

Programmed death receptor 1 inhibitorBronchogenic carcinomaThyroid related lesionsInfluencing factor

任洁、檀崇斌、张振华、刘晨露

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242300 宁国,宁国市人民医院药剂科

242300 宁国,宁国市人民医院肿瘤内科

程序性死亡受体1抑制剂 支气管肺癌 甲状腺相关病变 影响因素

安徽省自然科学基金

2108085MH311

2023

10.3877/cma.j.issn.1674-6902.2023.06.008

中华肺部疾病杂志(电子版)
中华医学会

中华肺部疾病杂志(电子版)

CSTPCD
影响因子：1.358
ISSN：1674-6902
年,卷(期)：2023.16(6)
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