Page 63 - 南京医科大学自然版

第44卷第7期 南京医科大学学报（自然科学版）
2024年7月 Journal of Nanjing Medical University（Natural Sciences） ·947 ·

·临床研究·

肺癌合并免疫检查点抑制剂相关肺炎的临床特征和预后分析

魏艳秋 ，季辰菲 ，孙 伟 ，陶 媛 ，彭思琪 ，吴超杰 ，黄 茂 ，吉宁飞 2*
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徐州市第一人民医院呼吸与危重症医学科，江苏 徐州 221116；南京医科大学第一附属医院呼吸与危重症医学科，江苏
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南京 210029；无锡市锡山人民医院呼吸与危重症医学科，江苏 无锡 214105
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［摘 要］ 目的：总结分析肺癌合并免疫检查点抑制剂相关肺炎（checkpoint inhibitor pneumonitis，CIP）的临床特征和预后。
方法：回顾性收集2018年9月—2022年9月在南京医科大学第一附属医院接受免疫检查点抑制剂（immune checkpoint inhibitor，
ICI）治疗后发生CIP的肺癌患者的临床资料，对基线特征、临床特征及治疗情况分析描述，对预后进行生存分析。结果：共纳入
75例患者，男71例，女4例，年龄（66.7±7.6）岁。发病时间为接受ICI治疗后4~1 054 d。60.0%的患者基线存在肺气肿，36.0%存在
肺间质异常（interstitial lung abnormalities，ILA）/间质性肺病（interstitial lung disease，ILD）。影像学表现为机化性肺炎（organizing
pneumonia，OP）型、非特异性间质性肺炎（nonspecific interstitial pneumonia，NSIP）型、急性间质性肺炎（acute interstitial pneumonia，
AIP）/急性呼吸窘迫综合征（acute respiratory distress syndrome，ARDS）型和其他类型的 CIP 患者分别有 36 例（48.0%）、28 例
（37.3%）、6例（8.0%）和5例（6.7%）。基线是否存在ILA/ILD 和CIP是否表现为AIP/ARDS 型的患者生存情况均存在明显差异
（P < 0.05）。结论：接受ICI治疗前存在ILA/ILD，以及CIP影像学表现为AIP/ARDS型的肺癌合并CIP患者预后较差。
［关键词］ 免疫检查点抑制剂相关肺炎；肺癌；影像学表现
［中图分类号］ R563.1 ［文献标志码］ A ［文章编号］ 1007⁃4368（2024）07⁃947⁃07
doi：10.7655/NYDXBNSN231045

Clinical features and prognosis of immune checkpoint inhibitor⁃related pneumonitis in lung
cancer

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WEI Yanqiu ，JI Chenfei ，SUN Wei ，TAO Yuan ，PENG Siqi ，WU Chaojie ，HUANG Mao ，JI Ningfei 2*
Department of Respiratory and Critical Care Medicine，Xuzhou First People’s Hospital，Xuzhou 221116；Department
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of Respiratory and Critical Care Medicine，the First Affiliated Hospital of Nanjing Medical University，Nanjing
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210029；Xishan People's Hospital of Wuxi City，Wuxi 214105，China
［Abstract］ Objective：To analyze the clinical features and prognosis of immune checkpoint inhibitor⁃related pneumonitis（CIP）in
lung cancer. Methods：Clinical data of lung cancer patients who developed CIP after receiving immune checkpoint inhibitor（ICI）
treatment at the First Affiliated Hospital of Nanjing Medical University from September 2018 to September 2022 were retrospectively
collected. Baseline characteristics，clinical features，treatment conditions were analyzed and described，and survival analysis was
conducted. Results：A total of 75 patients were included，with 71 males and 4 females，with a mean age of（66.7±7.6）years. The onset
time was 4 to 1 054 days after receiving ICI treatment. 60.0% of patients had pre⁃existing emphysema at baseline，and 36.0% had
interstitial lung abnormalities（ILA）/interstitial lung disease（ILD）. Radiological manifestations included organizing pneumonia（OP）
type，nonspecific interstitial pneumonia（NSIP）type，acute interstitial pneumonia（AIP）/acute respiratory distress syndrome（ARDS）
type，and other types，with 36 cases（48.0%），28 cases（37.3%），6 cases（8.0%），and 5 cases（6.7%），respectively. There were
significant differences in survival between patients with pre⁃existing ILA/ILD at baseline and those with CIP manifested as AIP/ARDS
type（P < 0.05）. Conclusion：Lung cancer patients with pre⁃existing ILA/ILD before receiving ICI treatment and CIP manifested as
AIP/ARDS type have a poorer prognosis.
［Key words］ checkpoint inhibitor⁃related pneumonitis；lung cancer；imaging manifestations
［J Nanjing Med Univ，2024，44（07）：947⁃953］

［基金项目］ 江苏省重点研发计划（BE2020616）；无锡市卫生健康委重大项目（Z202113）
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通信作者（Corresponding author），E⁃mail：jiningfei@163.com