[1]陈新旺,薛聃,黄峥慧,等.慢性阻塞性肺疾病对肺癌患者免疫治疗相关性肺炎风险影响的Meta分析[J].福建医药杂志,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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慢性阻塞性肺疾病对肺癌患者免疫治疗相关性肺炎风险影响的Meta分析()
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《福建医药杂志》[ISSN:1002-2600/CN:35-1071/R]

卷:
44
期数:
2022年06期
页码:
25-31
栏目:
临床研究
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
文章编号:
1002-2600（2022）06-0025-07
作者:
陈新旺; 薛聃; 黄峥慧; 林琼; 陈湘琦1
福建医科大学附属协和医院呼吸内科（福州 350001）
Author(s):
CHEN Xinwang; XUE Dan; HUANG Zhenghui; LIN Qiong; CHEN Xiangqi
Department of Respiratory Medicine，Fujian Medical University Union Hospital，Fuzhou，Fujian 350001，China
关键词:
肺癌; 慢性阻塞性肺疾病; 免疫检查点抑制剂相关肺炎
Keywords:
lung cancer; chronic obstructive pulmonary disease; checkpoint inhibitors pneumonitis
分类号:
R563；R734.2
文献标志码:
B
摘要:
目的 系统评价合并慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）对肺癌患者发生免疫检查点抑制剂相关性肺炎（checkpoint inhibitor pneumonitis，CIP）风险的影响，为该临床问题提供循证依据。方法 通过PubMed、EMBASE、万方等数据库进行文献检索，采用荟萃分析的方法，以合并比值比（odds ratio，OR）评价COPD对CIP发生风险的影响。通过敏感性分析、亚组分析评估合并结果的可靠性。结果 共7项观察性研究、包含20 668例接受抗肿瘤免疫治疗的肺癌患者被纳入荟萃分析，其中，合并COPD与不合并COPD的患者分别为5 993例及14 675例。上述研究中CIP的发生率约为2.49%～25.3%。我们的荟萃分析结果显示，合并COPD不会增加肺癌免疫治疗并发CIP的风险，OR=1.47 [95%CI（0.91，2.36），P=0.11]，敏感性分析提示结果稳定。亚组分析显示，无论是合并美国或东亚国家的研究数据，COPD均不增加肺癌患者CIP的发病风险。进一步根据接受胸部放疗患者的比例（≥40%或＜40%）进行亚组分析，结果显示在上述两组患者中，合并COPD均不增加CIP发病风险。结论 对于接受抗肿瘤免疫治疗的肺癌患者，合并COPD不会增加CIP的发病风险。
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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备注/Memo

备注/Memo:
基金项目：福建省医疗“创双高”建设经费资助（闽卫医政[2021]76号）
1 通信作者，Email:drchxq@163.com
更新日期/Last Update: 2022-12-15