信迪利单抗致免疫相关内分泌毒性的影响因素分析 点击下载
| 论文标题： | 信迪利单抗致免疫相关内分泌毒性的影响因素分析 |
| 英文标题： | |
| 中文摘要： | 目的 探寻信迪利单抗治疗恶性实体肿瘤后发生免疫相关内分泌毒性的影响因素，为临床合理用药提供参考。方法使用电子病历系统收集2020年1月1日至2024年12月31日锦州医科大学附属第一医院接受信迪利单抗治疗恶性实体肿瘤患者的病历资料，根据患者应用信迪利单抗后是否发生免疫相关内分泌毒性将其分为内分泌免疫相关不良事件（irAEs）组和非内分泌irAEs组。通过单因素与多因素Logistic回归方法探讨预测变量的统计学意义。结果共纳入224例患者，其中非内分泌irAEs组有138例（占61.6%），内分泌irAEs组有86例（占38.4%）。经单因素及多因素Logistic回归分析后发现，治疗1～12个周期是患者发生免疫相关内分泌毒性[比值比（OR）＝7.175，95%置信区间（CI）（1.239，41.563），P＜0.05]、免疫相关高血糖[OR＝6.600，95%CI（1.053，41.359），P＜0.05]及免疫相关亚临床甲减[OR＝20.200，95%CI（3.224，126.558），P＜0.05]的独立影响因素；联合紫杉醇类药物是发生免疫相关亚临床甲亢[OR＝6.410，95%CI（1.790，22.955），P＜0.05]的独立影响因素。结论在接受信迪利单抗治疗的患者中，治疗1～12个周期是免疫相关内分泌毒性、免疫相关高血糖及免疫相关亚临床甲减的危险因素；联合紫杉醇类药物是免疫相关亚临床甲亢的危险因素。建议临床应用信迪利单抗时，尤其是在前几个治疗周期内，应标准化动态监测患者相关内分泌指标，并重点关注联合使用紫杉醇类药物治疗的患者，以警惕内分泌不良事件的发生。 |
| 英文摘要： | OBJECTIVE To explore the influencing factors for immune-related endocrine toxicity in the treatment of malignant solid tumors with sintilimab， aiming to provide a reference for rational drug use. METHODS Case data were collected from patients with malignant solid tumors， who were treated with sintilimab at the First Affiliated Hospital of Jinzhou Medical University from January 1， 2020 to December 31， 2024， using the electronic medical record system. The patients were divided into an endocrine immune-related adverse events （irAEs） group and a non-endocrine irAEs group based on whether they developed immune-related endocrine toxicity after sintilimab administration. The statistical significance of predictive variables was examined through univariate and multivariate Logistic regression methods. RESULTS A total of 224 patients were enrolled， including 138 cases （61.6%） in the non-endocrine irAEs group and 86 cases （38.4%） in the endocrine irAEs group. After univariate and multivariate Logistic regression analysis， a treatment period of 1-12 cycles was identified as an independent influencing factor for immune-related endocrine toxicity [OR＝7.175， 95%CI （1.239， 41.563）， P ＜0.05 ] ， immune-related hyperglycemia [OR＝6.600， 95%CI （1.053， 41.359）， P ＜0.05 ] ， and immune-related subclinical hypothyroidism [OR＝20.200， 95%CI （3.224， 126.558）， P ＜0.05 ] . The combination with paclitaxel-based drugs was identified as an independent influencing factor for immune-related subclinical hyperthyroidism [OR＝6.410， 95%CI （1.790， 22.955）， P ＜0.05 ] . CONCLUSIONS Among patients treated with sintilimab， the treatment cycle is a risk factor for immune-related endocrine toxicity， immune-related hyperglycemia and immune-related subclinical hypothyroidism. The combination of paclitaxel-based drugs is a risk factor for immune-related subclinical hyperthyroidism. It is recommended that when applying sintilimab in clinical practice， especially during the first few treatment cycles， the relevant endocrine indicators should be dynamically monitored in a standardized manner. In addition， special attention should be paid to patients treated with the combination of paclitaxel-based drugs to be vigilant against the occurrence of endocrine adverse events. |
| 期刊： | 2026年第37卷第09期 |
| 作者： | 周霄怡；毕云龙；荆雨 |
| 英文作者： | ZHOU Xiaoyi，BI Yunlong，JING Yu |
| 关键字： | 信迪利单抗；恶性实体肿瘤；免疫相关内分泌毒性；影响因素；甲亢；甲减 |
| KEYWORDS： | sintilimab； malignant solid tumor； immune- |
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