摘要
免疫检查点抑制剂(ICIs)联合化疗已成为晚期胆道恶性肿瘤(BTC)的一线标准治疗方案。然而,ICIs的应用伴随着独特的免疫相关不良事件(irAEs)风险。BTC病人由于常伴有基础肝功能异常、胆道梗阻等特殊情况,其irAEs的诊断和管理面临更大挑战,特别是免疫相关性肝炎的鉴别诊断。本文旨在系统综述BTC免疫治疗的现状、irAEs的发生谱系、临床特点、预防策略以及管理原则,重点探讨BTC病人irAEs管理的特殊性及应对措施,以优化BTC病人的免疫治疗管理,最大化治疗获益并保障病人安全,并展望未来的研究方向。
Immune checkpoint inhibitors(ICIs)combined with chemotherapy has become the first-line standard treatment for advanced biliary tract cancers(BTC).However,the application of ICIs comes with its risks of immune-related adverse events(irAEs).BTC patients often face greater challenges in the diagnosis and management of irAEs,especially in the differential diagnosis of immune related hepatitis,due to the presence of special conditions such as underlying liver dysfunction and biliary obstruction.We aimed to systematically review the current status of BTC immunotherapy,the spectrum of irAEs,clinical characteristics,prevention strategies,and management principles.We focused to investigate the specificity and response measures of irAEs management in BTC patients,optimizing immunotherapy management for BTC patients,maximizing treatment benefits and ensuring patient safety,and exploring the future research directions.
作者
刘坤
郭伟
LIU Kun;GUO Wei(Department of General Surgery,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)
出处
《外科理论与实践》
2025年第2期112-119,共8页
Journal of Surgery Concepts & Practice
关键词
胆道恶性肿瘤
免疫治疗
免疫检查点抑制剂
免疫相关不良事件
Biliary tract cancer(BTC)
Immunotherapy
Immune checkpoint inhibitor(ICI)
Immune-related adverse event(irAE)
