检查点抑制剂肺炎患者支气管肺泡灌洗液分析

IF 4.6 2区 医学 Q2 IMMUNOLOGY
Ruxuan Chen, Yujie Shi, Nan Fang, Chi Shao, Hui Huang, Ruili Pan, Yan Xu, Mengqi Wang, Xiangning Liu, Kai Xu, Rui Zhu, Mengzhao Wang
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引用次数: 0

摘要

背景检查点抑制剂肺炎(CIP)是一种相对少见但可能危及生命的免疫相关不良事件(irAE)。对 CIP 患者进行肺活检并不常见。支气管肺泡灌洗液(BALF)分析是诊断间质性肺病的有效方法。然而,不同研究中的 BALF 特征并不一致。方法我们回顾性地查看了 2018 年 7 月至 2022 年 12 月间 154 例经病理证实为恶性肿瘤的 CIP 患者的病历。有支气管肺泡灌洗(BAL)数据的患者被纳入我们的研究。对患者的临床、实验室、放射学和随访数据进行了回顾和分析。结果对42名CIP患者进行了BALF差异细胞计数和淋巴细胞亚群分析。其中男性 32 人(76.2%)。确诊 CIP 的平均年龄为 62.0 ± 10.4(31-78)岁。CIP 发病的中位时间为免疫疗法开始后的 98.5 天。低级别 CIP 患者有 18 人(42.9%),高级别 CIP 患者有 24 人(57.1%)。平均淋巴细胞百分比为 36.7 ± 22.5%。34例(81%)CIP患者的细胞形态为淋巴细胞。CD3+CD4+/CD3+CD8+ 淋巴细胞的中位比率为 0.5 (0.3, 1.0)。31 名 CIP 患者(73.8%)的比率小于 1.0。结论 CD3+CD8+ 淋巴细胞增多模式是该队列中 CIP 患者 BALF 的主要炎症特征。靶向 CD3+CD8+ 淋巴细胞可能是治疗 CIP 的一种选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Bronchoalveolar lavage fluid analysis in patients with checkpoint inhibitor pneumonitis

Bronchoalveolar lavage fluid analysis in patients with checkpoint inhibitor pneumonitis

Background

Checkpoint inhibitor pneumonitis (CIP) is a relatively uncommon but potentially life-threatening immune-related adverse event (irAE). Lung biopsies have not been commonly performed for CIP patients. Bronchoalveolar lavage fluid (BALF) analysis is a useful diagnostic approach for interstitial lung disease. However, BALF features were inconsistent across different studies.

Methods

We retrospectively reviewed the medical records of 154 patients with pathologically confirmed malignancies and suffering from CIPs between July 2018 and December 2022. Patients who had bronchoalveolar lavage (BAL) data available were enrolled in our study. Patient clinical, laboratory, radiological and follow-up data were reviewed and analyzed.

Results

The BALF differential cell count and lymphocyte subset analysis were performed for 42 CIP patients. There were 32 males (76.2%). The mean age at diagnosis of CIP was 62.0 ± 10.4 (range: 31–78) years. The median time to onset of CIP was 98.5 days after the start of immunotherapy. There were 18 patients (42.9%) with low-grade CIPs and 24 patients (57.1%) with high-grade CIPs. The mean lymphocyte percentage was 36.7 ± 22.5%. There were 34 (81%) CIP patients with a lymphocytic cellular pattern. The median ratio of CD3+CD4+/CD3+CD8+ lymphocytes was 0.5 (0.3, 1.0). The ratio was less than 1.0 for 31 CIP patients (73.8%). However, there was no significant difference in the BALF features between patients with low-grade CIPs and those with high-grade CIPs.

Conclusions

The CD3+CD8+ lymphocytosis pattern was the main inflammatory profile in the BALF of CIP patients in this cohort. Targeting CD3+CD8+ lymphocytes might be a treatment option for CIPs.

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来源期刊
CiteScore
10.50
自引率
1.70%
发文量
207
审稿时长
1 months
期刊介绍: Cancer Immunology, Immunotherapy has the basic aim of keeping readers informed of the latest research results in the fields of oncology and immunology. As knowledge expands, the scope of the journal has broadened to include more of the progress being made in the areas of biology concerned with biological response modifiers. This helps keep readers up to date on the latest advances in our understanding of tumor-host interactions. The journal publishes short editorials including "position papers," general reviews, original articles, and short communications, providing a forum for the most current experimental and clinical advances in tumor immunology.
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