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[1]陳新旺,薛聃,黃崢慧,等.慢性阻塞性肺疾病對(duì)肺癌患者免疫治療相關(guān)性肺炎風(fēng)險(xiǎn)影響的Meta分析[J].福建醫(yī)藥雜志,2022,44(06):25-31.
　CHEN Xinwang,XUE Dan,HUANG Zhenghui,et al.Impact of chronic obstructive pulmonary disease on risk of immune checkpoint inhibitor pneumonitis in patients with lung cancer: a meta-analysis[J].FUJIAN MEDICAL JOURNAL,2022,44(06):25-31.
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慢性阻塞性肺疾病對(duì)肺癌患者免疫治療相關(guān)性肺炎風(fēng)險(xiǎn)影響的Meta分析()
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《福建醫(yī)藥雜志》[ISSN:1002-2600/CN:35-1071/R]

卷:
44
期數(shù):
2022年06期
頁碼:
25-31
欄目:
臨床研究
出版日期:
2022-12-15

文章信息/Info

Title:
Impact of chronic obstructive pulmonary disease on risk of immune checkpoint inhibitor pneumonitis in patients with lung cancer: a meta-analysis
文章編號(hào):
1002-2600（2022）06-0025-07
作者:
陳新旺; 薛聃; 黃崢慧; 林瓊; 陳湘琦1
福建醫(yī)科大學(xué)附屬協(xié)和醫(yī)院呼吸內(nèi)科（福州 350001）
Author(s):
CHEN Xinwang; XUE Dan; HUANG Zhenghui; LIN Qiong; CHEN Xiangqi
Department of Respiratory Medicine，F(xiàn)ujian Medical University Union Hospital，F(xiàn)uzhou，F(xiàn)ujian 350001，China
關(guān)鍵詞:
肺癌; 慢性阻塞性肺疾病; 免疫檢查點(diǎn)抑制劑相關(guān)肺炎
Keywords:
lung cancer; chronic obstructive pulmonary disease; checkpoint inhibitors pneumonitis
分類號(hào):
R563；R734.2
文獻(xiàn)標(biāo)志碼:
B
摘要:
目的 系統(tǒng)評(píng)價(jià)合并慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）對(duì)肺癌患者發(fā)生免疫檢查點(diǎn)抑制劑相關(guān)性肺炎（checkpoint inhibitor pneumonitis，CIP）風(fēng)險(xiǎn)的影響，為該臨床問題提供循證依據(jù)。方法 通過PubMed、EMBASE、萬方等數(shù)據(jù)庫進(jìn)行文獻(xiàn)檢索，采用薈萃分析的方法，以合并比值比（odds ratio，OR）評(píng)價(jià)COPD對(duì)CIP發(fā)生風(fēng)險(xiǎn)的影響。通過敏感性分析、亞組分析評(píng)估合并結(jié)果的可靠性。結(jié)果 共7項(xiàng)觀察性研究、包含20 668例接受抗腫瘤免疫治療的肺癌患者被納入薈萃分析，其中，合并COPD與不合并COPD的患者分別為5 993例及14 675例。上述研究中CIP的發(fā)生率約為2.49%～25.3%。我們的薈萃分析結(jié)果顯示，合并COPD不會(huì)增加肺癌免疫治療并發(fā)CIP的風(fēng)險(xiǎn)，OR=1.47 [95%CI（0.91，2.36），P=0.11]，敏感性分析提示結(jié)果穩(wěn)定。亞組分析顯示，無論是合并美國或東亞國家的研究數(shù)據(jù)，COPD均不增加肺癌患者CIP的發(fā)病風(fēng)險(xiǎn)。進(jìn)一步根據(jù)接受胸部放療患者的比例（≥40%或＜40%）進(jìn)行亞組分析，結(jié)果顯示在上述兩組患者中，合并COPD均不增加CIP發(fā)病風(fēng)險(xiǎn)。結(jié)論 對(duì)于接受抗腫瘤免疫治療的肺癌患者，合并COPD不會(huì)增加CIP的發(fā)病風(fēng)險(xiǎn)。
Abstract:
Objective To evaluate concurrent chronic obstructive pulmonary disease（COPD）on the risk of immune checkpoint inhibitor pneumonitis（CIP）in patients with lung cancer. Methods A meta-analysis was performed by searching literature through major electronic databases, including PubMed, EMBASE, and WanFang database. Pooled odds ratio（OR）was calculated to assess the effect of COPD on risk of CIP. Sensitivity analysis and subgroup analysis were conducted to examine the reliability of the pooled results. Results Seven eligible studies, involving 20, 668 lung cancer patients who received anti-tumor immunotherapy were enrolled in this meta-analysis. Among them, 5 993 patients had a history of COPD, while the rest 14, 675 patients did not. Prevalence of CIP ranged from 2. 49% to 25. 3%. Our pooled results showed concurrent COPD did not increase the risk of CIP [OR=1. 47, 95% confident interval（0. 91, 2. 36）, P=0. 11]. This result was stable in sensitivity analysis. In subgroup analysis by incorporating data from different research sites, COPD did not raise the risk of CIP from either American studies or East Asian studies. Regardless of percentage of patients with history of thoracic radiotherapy（≥40% or <40%）, concurrent COPD had no impact on the risk of CIP. Conclusion For patients with lung cancer who receive anti-tumor immunotherapy, concurrent COPD may not increase the risk of CIP.

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備注/Memo

備注/Memo:
基金項(xiàng)目：福建省醫(yī)療“創(chuàng)雙高”建設(shè)經(jīng)費(fèi)資助（閩衛(wèi)醫(yī)政[2021]76號(hào)）
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更新日期/Last Update: 2022-12-15