【摘要】 目的 探索接受程序性死亡受体1(Programmed death-1,PD-1)抑制剂治疗的肺癌患者发生免疫相关不良事件（Immune-related adverse events,irAEs）的潜在生物标志物。方法 回顾性分析新疆石河子大学第一附属医院2021年1月1日至2023年12月31日接受PD-1抑制剂治疗的202例肺癌患者，描述患者的一般资料、临床特征及irAEs的毒谱特点，采用单因素、多因素Logistic回归探究irAEs的潜在生物标志物。结果 本研究中，75例（37.13%）患者发生irAEs，最为常见的irAEs为甲状腺功能异常（41.30%）和皮疹（28.00%）；轻、重度irAEs的发生率分别为27.72%、9.41%；发生irAEs的中位时间为107 d。多因素分析结果显示，中性粒细胞绝对计数（Absolute neutrophil count,ANC）(OR=1.89,95%CI:1.19～3.02,P=0.007)与irAEs的发生呈正相关，血清白蛋白（Albumin,ALB）(OR=0.67,95%CI:0.12～0.97,P=0.002)、预后营养指数（Prognostic nutritional index,PNI）(OR=0.67,95%CI:0.49～0.91,P=0.012)与irAEs的发生呈负相关。结论 接受PD-1抑制剂治疗的肺癌患者irAEs发生率高，ANC、ALB、PNI可能是预测肺癌患者发生irAEs的生物标志物。更多还原

【Abstract】 Objective To explore the potential biomarkers of immune-related adverse events(irAEs) in lung cancer patients treated with programmed death-1(PD-1) inhibitors. Methods A retrospective analysis was performed on 202 patients with lung cancer who received at least one cycle of PD-1 inhibitors treatment in the First Affiliated Hospital of Shihezi University from January 1,2021 to December 31,2023,and their general data,clinical characteristics and toxicologic characteristics of irAEs were described. The potential biomarkers of irAEs were investigated by univariate and multivariate Logistic regression. Results In this study,75 patients(37. 13%) had irAEs,and the most common irAEs were thyroid dysfunction(41. 30%) and rash(28. 00%); the incidences of mild and severe irAEs were 27. 72% and 9. 41%,respectively; the median time of irAEs was 107 d. Multivariate analysis showed that absolute neutrophil count(ANC)(OR=1. 89,95%CI: 1. 19～3. 02,P=0. 007) was positively correlated with the occurrence of irAEs,while serum albumin(ALB)(OR=0. 67,95%CI: 0. 12～0. 97,P=0. 002) and prognostic nutritional index(PNI)(OR=0. 67,95%CI: 0. 49～0. 91,P=0. 012) were negatively correlated with the occurrence of irAEs. Conclusion The incidence of irAEs in lung cancer patients treated with PD-1 inhibitors is high. ANC,ALB and PNI may be biomarkers to predict the occurrence of irAEs in lung cancer patients.更多还原