通讯作者: 郑建军, zhjjnb2@163.com

DOI：10.12201/bmr.202407.00008

CT Findings and Clinical Features of checkpoint Inhibitor-related pneumonitis

• 摘要：目的 探讨免疫检查点抑制剂相关性肺炎(CIP)的CT表现及临床特点。方法 回顾性分析我院34例CIP患者的胸部CT图像及临床资料,并比较肺癌和其他恶性肿瘤患者之前的差异。结果 CIP临床症状以咳嗽(70.59%) 及呼吸困难(52.94%) 多见,发生中位时间为130.5d(54.750,231.250),且肺癌组(114.5d,41.50,281.50)比其他恶性肿瘤组(144d,55.75,226.25)更早发生,时间跨度更大。嗜酸性粒细胞计数仅在其他恶性肿瘤组中明显升高(p=0.009)。激素治疗后 18例患者好转,8例稳定,8例进展或死亡。CT征象以磨玻璃影(70.59%)及实变影(76.47%)多见,影像学模式以机化性肺炎(47.6% ) 为主,与原发肿瘤类型无关,部分可出现结节样肉芽肿性反应。相较于肺癌组,其他恶性肿瘤组更容易表现为对称性浸润(58.33%)分布。结论 CIP患者的临床特点不具有特异性,但肺癌与其他恶性肿瘤患者之间CIP在嗜酸性粒细胞计数及胸部CT表现具有差异。

  关键词： 免疫检查点抑制剂; 肺炎; 多层螺旋计算机体层摄影术

   

  Abstract: Objective：To explore the CT manifestations and clinical features of checkpoint Inhibitor-related pneumonitis (CIP). Methods: Chest CT images and clinical data of 34 patients with CIP in our hospital were collected to retrospectively analyzed , as well as comparing the differences between lung cancer and other types of cancer patients. Results: Cough (70.59%) and dyspnea (52.94%) were the most common clinical symptoms, and the median time to onset of CIP was 130.5d (54.750,231.250), and it occurred earlier and over a greater time span in the lung cancer group (114.5d, 41.50,281.50) than in the other types of cancer group (144d, 55.75,226.25). Eosinophil count was significantly higher only in the other types of cancer group (p=0.009). After hormonal therapy 18 patients improved, 8 were stable and 8 progressed or even died. CT signs were prevalent in ground glass shadow (70.59%) and solid shadow (76.47%), and the imaging pattern was dominated by organic pneumonia (OP) pattern (16 cases, 47.6%), which was not related to the type of primary tumor, and some of them could show nodular granulomatous reaction.Compared to the lung cancer group, the other types of cancer group was more likely to exhibit symmetrical infiltration (58.33%) distribution . Conclusion: The clinical features of CIP are nonspecific,but CIP was different in eosinophil count and chest CT findings between lung cancer and patients with other malignancies

  Key words: Immune Checkpoint Inhibitors; Pneumonia; Multidetector Computed Tomography

  提交时间：2024-08-15

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• 序号	提交日期	编号	操作
  1	2024-07-05	10.12201/bmr.202407.00008V1	下载

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