Ferritin as a diagnostic, differential diagnostic, and prognostic marker for immune-related adverse events.
Ferritin as a diagnostic, differential diagnostic, and prognostic marker for immune-related adverse events.
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铁蛋白作为免疫相关不良事件的诊断、鉴别诊断和预后标志物
DOI：
10.20892/j.issn.2095-3941.2021.0037
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发表时间：
2021-08-11
影响因子：
5.5
通讯作者：
Ren X
中科院分区：
文献类型：
--
作者：
Zhang W;Meng Y;Yang L;Shen M;Zhou L;Li R;Wang Y;Du W;Xiong Y;Han Y;Zhang X;Liu L;Ren X
区分免疫检查点抑制剂（ICI）引起的免疫相关不良事件（irAE）与化疗、靶向治疗或感染引起的AE非常困难。这项研究为评价铁蛋白对ICI诱导的irAE的诊断、鉴别诊断和预后价值提供了新的见解。2018年12月1日至2019年4月1日，我们检查了318例接受血清铁蛋白监测的恶性肿瘤患者。该队列包括231例接受PD-1抑制剂治疗或与化疗联合治疗的患者，以及87例接受化疗的患者。在231例患者中，90例发生irAE（irAE组），70例发生非irAE（非irAE组），67例无AE（无irAE-非irAE组），4例发生未分类AE。在87例患者中，60例发生AE（AE组），27例无AE（无AE组）。采用非参数Mann-Whitney检验进行统计分析。irAE组AE发生时，铁蛋白（正常范围，35-150 µg/L）从基线时的86 µg/L（范围，29-421 µg/L）升高至中位数927 µg/L（范围，117- 17，825 µg/L）（P < 0.001）。irAE组AE发作时的铁蛋白水平显著高于非irAE组（中位数，81 µg/L;范围，32-478 µg/L）（P < 0.001）和AE组（中位数，103 µg/L;范围，23-712 µg/L）（P < 0.001）。irAE组治疗后，铁蛋白在恢复患者中持续下降至正常范围，在稳定患者中无显著变化，在死亡患者中继续升高。铁蛋白可用作接受ICI治疗的患者中irAE的诊断、鉴别诊断和预后标志物。
Distinguishing immune-related adverse events (irAEs) caused by immune checkpoint inhibitors (ICIs) from the AEs caused by chemotherapy, targeted therapy, or infection is highly difficult. This study offers new insights into evaluating the diagnosis, differential diagnostic, and prognostic value of ferritin for irAEs induced by ICIs. From December 1, 2018, to April 1, 2019, we examined 318 patients with malignant tumors who received serum ferritin monitoring. The cohort comprised 231 patients treated with PD-1 inhibitor or combination with chemotherapy, and 87 patients treated with chemotherapy. Of the 231 patients, 90 had irAEs (irAE group), 70 had non-irAEs (non-irAE group), 67 had no AEs (no irAE-non irAE group), and 4 had unclassified AEs. In the 87 patients, 60 had AEs (AE group), and 27 had no AEs (no AE group). Statistical analyses were conducted with nonparametric Mann-Whitney tests. At the onset of AEs in the irAE group, ferritin (normal range, 35–150 µg/L) rose to a median of 927 µg/L (range, 117–17,825 µg/L) from 86 µg/L at baseline (range, 29–421 µg/L) (P < 0.001). Ferritin levels at the onset of AEs in the irAE group were significantly higher than those in the non-irAE group (median, 81 µg/L; range, 32–478 µg/L) (P < 0.001) and the AE group (median, 103 µg/L; range, 23–712 µg/L) (P < 0.001). After treatment in the irAE group, ferritin continuously decreased to a normal range in recovered patients, showed no significant changes in stable patients, and continued to rise in patients who died. Ferritin can be used as a diagnostic, differential diagnostic, and prognostic marker for irAEs in patients treated with ICIs.
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影响因子：
32.4
作者：
Koyama, Motoko;Mukhopadhyay, Pamela;Hill, Geoffrey R.
通讯作者：
Hill, Geoffrey R.
DOI：
10.1056/nejmoa1200694
发表时间：
2012-06-28
期刊：
The New England journal of medicine
影响因子：
--
作者：
Brahmer JR;Tykodi SS;Chow LQ;Hwu WJ;Topalian SL;Hwu P;Drake CG;Camacho LH;Kauh J;Odunsi K;Pitot HC;Hamid O;Bhatia S;Martins R;Eaton K;Chen S;Salay TM;Alaparthy S;Grosso JF;Korman AJ;Parker SM;Agrawal S;Goldberg SM;Pardoll DM;Gupta A;Wigginton JM
通讯作者：
Wigginton JM
DOI：
10.2215/cjn.01390406
发表时间：
2006-09-01
影响因子：
9.8
作者：
Kalantar-Zadeh, Kamyar;Kalantar-Zadeh, Kourosh;Lee, Grace H.
通讯作者：
Lee, Grace H.
影响因子：
8
作者：
Liu, Li;Wei, Qiang;Chen, Zhiwei
通讯作者：
Chen, Zhiwei
影响因子：
64.8
作者：
WEINBERG, JB;HIBBS, JB
通讯作者：
HIBBS, JB