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中华肝脏外科手术学电子杂志 ›› 2026, Vol. 15 ›› Issue (02) : 146 -151. doi: 10.3877/cma.j.issn.2095-3232.2026.02.002

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肿瘤免疫治疗相关不良事件的流行病学特征、发生机制和防治策略
谢伟, 张小峰, 沈锋()   
  1. 200438 海军军医大学第三附属医院(上海东方肝胆外科医院)肝外四科
  • 收稿日期:2025-10-08 出版日期:2026-04-10
  • 通信作者: 沈锋
  • 基金资助:
    上海市科学技术委员会项目(20JC1419300); 上海市申康医院发展中心示范性研究型病房建设项目(SHDC2023CRW002)

Eepidemiological characteristics, mechanism, prevention and treatment strategies of immune-related adverse events from tumor immunotherapy

Wei Xie, Xiaofeng Zhang, Feng Shen()   

  1. Department Ⅳ of Hepatibiliary Surgery, Eastern Hepatobiliary Surgery Hospital, the Third Affiliated Hospital of Naval Medical University, Shanghai 200438, China
  • Received:2025-10-08 Published:2026-04-10
  • Corresponding author: Feng Shen
引用本文:

谢伟, 张小峰, 沈锋. 肿瘤免疫治疗相关不良事件的流行病学特征、发生机制和防治策略[J/OL]. 中华肝脏外科手术学电子杂志, 2026, 15(02): 146-151.

Wei Xie, Xiaofeng Zhang, Feng Shen. Eepidemiological characteristics, mechanism, prevention and treatment strategies of immune-related adverse events from tumor immunotherapy[J/OL]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2026, 15(02): 146-151.

免疫治疗通过增强自身的免疫系统以攻击癌细胞,已成为肿瘤治疗领域的里程碑。然而,随着免疫治疗的广泛应用,免疫相关不良事件(irAEs)的发生率显著升高。irAEs可累及皮肤、心脏、消化系统、内分泌系统等多个器官和系统,严重时可危及生命,显著影响患者生活质量和预后。通常对于轻中度的irAEs,停药即可缓解症状,糖皮质激素仍是重度irAEs一线治疗药物,而抗TNF-α药物对激素难治性病例有效。尽管目前研究揭示了遗传因素、肠道菌群及细胞因子水平与irAEs风险的关联性,但其精确预测和诊断仍面临挑战。本文将系统综述irAEs流行病学特征、潜在机制、预测和治疗进展,以期为临床实践提供参考。

Immunotherapy has become a milestone in the field of tumor treatment by strengthening host immune system to attack cancer cells. However, with widespread application of immunotherapy, the incidence of immune-related adverse events (irAEs) has been increased significantly. IrAEs can involve multiple organs and systems, such as skin, heart, digestive system and endocrine system, which can be life-threatening in severe cases and significantly affect the quality of life and clinical prognosis of patients. Most symptoms can be relieved by terminating medication for mild to moderate irAEs. Glucocorticoids are still the first-line treatment drugs for severe IRES, while anti-TNF-α drugs are effective for hormone-refractory cancer. Although studies have revealed the correlation between genetic factors, gut microbiota and cytokine levels and the risk of irAEs, precise prediction and diagnosis still face challenges. In this article, research progress in epidemiological characteristics, potential mechanism, prediction and treatment of irAEs was systematically reviewed, aiming to provide reference for clinical practice.

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