Clinical, Endoscopic, and Pathological Characteristics of Immune Checkpoint Inhibitor-Induced Gastroenterocolitis
Clinical, Endoscopic, and Pathological Characteristics of Immune Checkpoint Inhibitor-Induced Gastroenterocolitis
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DOI：
10.1007/s10620-020-06441-w
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发表时间：
2020-07-03
影响因子：
3.1
通讯作者：
Kanai, Takanori
中科院分区：
文献类型：
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作者：
Hayashi, Yukie;Hosoe, Naoki;Kanai, Takanori
材料和方法这是一个单中心，回顾性和观察性病例系列。我们纳入了2014年8月至2019年7月在庆应义塾大学医院接受免疫检查点抑制剂治疗后有胃肠道症状史的患者。根据病历审查，在我院使用Nivolumab、Pembrolizumab、Atezolizumab、Avelumab、Durvalumab和Ipilimumab的382例患者，并提取了18例腹泻或上腹痛患者（美国国家中心研究所不良事件通用术语标准（CTCAE v4. 0)2、3或4级）。在18例患者中，包括6例接受内镜检查和组织病理学检查的患者。我们还纳入了两名患者，他们在另一家医院接受ICI后出现上腹痛和腹泻，并被转移到我们医院。最后，8名患者被纳入分析。入选标准包括通过内镜检查和组织病理学检查证实的内镜检查结果。排除感染性小肠结肠炎等其他疾病的可能性。我们回顾性收集了病历中的信息，包括年龄、性别、原发疾病、免疫检查点抑制剂使用、症状、CTCAE v4。0级，持续时间从ICI使用症状发作，irAE类型，合并症，内镜检查结果，病理结果，治疗irAE，潜在的ICI中断，irAE治疗结果，和ICI re-challenging.ResultsWe包括8例诊断为irAE胃肠结肠炎的内镜和病理结果。在这些患者中，1例合并肠炎和结肠炎，因此我们分析了2例irAE胃炎，2例irAE肠炎和5例irAE结肠炎。
Materials and MethodsThis is a single-center, retrospective, and observational case series. We included patients with a history of gastrointestinal symptoms after administration of immune checkpoint inhibitors at Keio University Hospital from August 2014 to July 2019. From the chart review, 382 patients who used Nivolumab, Pembrolizumab, Atezolizumab, Avelumab, Durvalumab, and Ipilimumab at our hospital, and extracted 18 patients who had diarrhea or epigastric pain (National Center Institute Common Terminology Criteria for Adverse Events (CTCAE v4. 0) Grade 2, 3 or 4). Of 18, 6 patients who underwent endoscopy with histopathological examination are included. We also included two patients who had epigastric pain and diarrhea after receiving ICI in another hospital and were transferred to our hospital. Finally, eight patients were included in the analysis. Inclusion criteria consisted of endoscopic findings confirmed by performing endoscopy with histopathological examination. The possibility of other diseases such as infectious enterocolitis was excluded. We retrospectively collected information from medical records, including age, sex, primary disease, immune checkpoint inhibitor usage, symptoms, CTCAE v4. 0 Grade, duration from ICI use to onset of symptoms, irAE type, comorbidity, endoscopic findings, pathological findings, treatment for irAE, potential ICI discontinuation, irAE treatment results, and ICI re-challenging.ResultsWe included eight patients diagnosed with irAE gastroenterocolitis by endoscopic and pathological findings. Among these patients, one case had complications with enteritis and colitis, so we analyzed two cases of irAE gastritis, two cases of irAE enteritis and five cases of irAE colitis.