【摘要】 目的探讨免疫相关性肺炎(CIP)的影响因素。方法回顾性分析2019年9月至2020年9月接受PD-1/PD-L1治疗的274例恶性肿瘤患者,收集患者人口学特征及临床资料,计算SII值。采用单因素和多因素logistic回归方法分析系统性免疫炎症指数(SII)及胸部放疗史与CIP的相关性,应用受试者工作曲线(ROC)和曲线下面积(AUC)评价免疫治疗前SII对免疫相关性肺炎发生的预测价值。结果 274例免疫检查点抑制剂(ICIs)治疗患者中有胸部放疗史25例,发生CIP的17例。单因素分析显示,CIP组患者胸部放疗史比例明显高于未发生CIP组[58.8%vs 5.8%;OR0.051;CI(0.017,0.159);P<0.001],且CIP组患者免疫治疗前SII高于未发生CIP组患者,差异有统计学意义(P<0.05)。ROC曲线分析显示,SII预测ICIs治疗发生免疫相关性肺炎的AUC值为0.739(P<0.001),SII值为1 139.82时预测价值最高,其发生CIP的敏感度为64.7%,特异度为77.0%。结论 SII及胸部放疗史是ICIs治疗患者发生CIP的影响因素。更多还原

【Abstract】 Objective To investigate the influencing factors of checkpoint inhibitor pneumonitis(CIP).Methods A retrospective analysis of 274 patients with malignant tumors who received PD-1/PD-L1 treatment was performed.The demographic characteristics and clinical data of the patients were collected and the SII value was calculated.Univariate and multivariate logistic regression methods were used to analyze the correlation between SII,thoracic radiotherapy history and CIP.Receiver operating curve(ROC)and area under the curve(AUC)were used to evaluate the predictive value of SII to CIP.Results Of the 274 patients,25 had a history of chest radiotherapy,and 17 had CIP.Univariate analysis showed that the rate of patients with thoracic radiotherapy in the CIP group was significantly higher than that in the non-CIP group [58.8% vs 5.8%;OR0.051;CI(0.017,0.159);P<0.001],and SII in the CIP group was higher than that in the non-CIP group,with statistical significance(P<0.05).The ROC curve analysis showed that the area under the curve of SII was 0.739(P<0.001).The cutoff value for predicting CIP was 1 139.82,the sensitivity and specificity was 64.7%and 77.0%.Conclusion SII and thoracic radiotherapy were independent risk factors to predict CIP in patients treated with ICIs.更多还原